is the transfer of medical data through electronic communication means from
one location to another. Due to rapid innovations in telecommunications and
computer technology over the years especially in this century, many elements
of medical practice can be accomplished when the patients and health care
provider are separated geographically. The separation could be way beyond
the world to outer space or across the world or states or even across the
different zones and districts of the country.
Telemedicine may be as simple as two health professionals counseling over a
case ever the telephone or can be as complex as using fiber optics or and
satellite communication technology and video conferencing equipment based on
H-323, H-239, H-264, H-460 standard costing more than a million rupees for
each station to conduct a real time consultation among medical specialists
in different countries. In general Telemedicine refers to the use of ICT.
Information communication technology to deliver clinical care.
|Out of 1000 plus patients from Shipkhana, Kalikot, some of the pictures of patients
more patients ....
Distance medical care during
old clinical practice is also known as РІР‚�AbsentiaРІР‚� care that used to be
conducted via post usually taking weeks to even months. Today due to
development in communication technology that information is communicated at
electronic speed within our planet and way beyond.
The Royal Flying Doctor service of Australia in the early 19th century used
to communicate over the two-way radios powered by a generator driven by a
set of bicycle pedals.
Telemedicine began in the early 1960s. The National Aeronautics and space
Administration (NASA) played an important role in the early development of
Telemedicine. Humans began traveling in space and physiological information
of the spaceman were telemetered from spacecraft and space suits during
In a book by Rashid Bashshur published in 1975 lists fifteen telemedicine
projects active during the period in Russia, USA and all over the world,
pioneering work in that field had been carried out. Since 1977, Telemedicine
center at Memorial University of Newfound Land (MUN) has worked toward
developing programs on transmission of medical data among the guidelines
followed were to use the simplest and least expensive technology. MUN has
been playing an active role in International Teleconferencing in the school
of medicine at the university of Nairobi, Kenya linking Nairobi and Kampala
through Intelsat in 1985. MUN has been a model for judicious and low cost
use of Telemedicine technology.
NASA has conducted the first International Telemedicine program in 1989.
The North-West Telemedicine Project
was setup in 1984 in Australia to provide health care to people in five
remote towns through satellite. 2/3rd of these people were Aborigines. This
project proved that the technology has improved the health care of these
Types of Telemedicine:
1) Real Time
2) Store and forward.
Real Time Telemedicine can be as simple as telephone call or as complex
as robotic surgery, requires the presence of both or all parties at the same
time and communication link among them that allows a real time interaction
to take place. In real time or synchronous Telemedicine, video conferencing
equipments consisting of video camera with audio and computer along with
appropriate software that can aid in an interactive examination such as a
Tele-otoscope to see inside patientРІР‚в„ўs ear and a Tele-stethoscope allows
consulting remote physician to hear the patientРІР‚в„ўs heart beat etc. On line
medical consultations are provided in various medical disciplines such as
pathology and pharmacy, neurology, gynecology, obstetrics, pediatrics,
urology, oncology cardiology, psychiatry, infectious diseases /HIV-AIDS,
opthalmology, radiology etc.
Store and forward Telemedicine involves obtaining medical data and
transmitting data to a medical specialist at a convenient time for
assessment off line. It does not require the presence of both parties at the
same time. Tele-dermatology, Tele-radiology and Tele -pathology are common
specialties that are conductive to a synchronous Telemedicine. Medical
records that are properly structured as per pre-requisite to the software
involved in electronic form should be a component for transmitting.
Telemedicine can play a vital role as a communication tool between a
specialist and a general practioner. A doctor uses devices to examine
remotely to treat a patient and at any given time a specialist can treat
many patients located in different locations with the help of Telemedicine
devices. A specialist can save lot of his/her time on visiting patients and
traveling. A specialist stationed in Calcutta has been treating patients
located in Madras, Delhi, Bombay, Trivandrum and some other cities through
communication media like broadband, Internet communication and tools like
video conference equipments.
In Nepali context today with acute shortage of medical specialists, the
patients all over 75 districts can be remotely treated by small number of
super specialists using broadband communication media like ISDN, CDMA, ADSL,
3G telecommunication services and video conferencing technology that are
already available in Nepal. Perhaps what we lack is a sincere dedication,
good planning and strong urge to serve the patients all over Nepal.
By Muni Sakya
High Tech Pioneer P.Ltd.
CEO, JNICT P.Ltd.
Technical Advisory Group Member, Nick Simon Institute.
Executive Board member, Human Development for Community Services (HDCS)
Tel : 977-1-4770472