Among contemporary medical technologies in the field of health protection, an important role is paid to telehealth. The main purpose of telehealth is the enforcement of the right of a person to qualified medical care in any place and at any time. Telehealth is the logical development of the first telephone medical consultation that has taken place in the early 20th century. Nowadays telehealth is the upcoming trend for the informatization of society. Telehealth may be viewed as the system that provides a person with access to contemporary medical resources including international ones. The given system is the aggregate of resources and components that unlock the potential of telecommunication technologies in the field of health care.
This system includes various health care organizations with their informative and learning resources, medical diagnostic devices, databases, and users. Among other things, this system implies the use of various technical means with telecommunication networks, channels of communication, and network tools.
Telehealth is a comparatively new trend in the sphere of health care protection that gives a wide range of opportunities in administering medical aid distantly. Apart from solutions to many complicated problems, the main advantage of telehealth lies in its ability to provide inhabitants of outlying and isolated regions with the medical assistance given by highly trained professionals. Now the necessity of the development of telehealth is recognized by all leading countries of the world.
There are many definitions of the term telehealth. In several sources, this term is sometimes substituted with the notion of telemedicine. Castro, Miller, and Nager (2014) treat telehealth as “health care services provided directly to patients using telecommunications technology, including Internet and telephone” (p.2).
History of telehealth
Traditionally it is possible to distinguish two main areas of telemedicine. They are the remote health care services and the skill improvement of health care providers. To the category of the remote health care services, it is also possible to include consultations of those experts who are the narrowly focused specialists in their field. It is recognized that the appearance of telehealth has taken place at the beginning of the twentieth century. At that time, due to the invention of telephone communication, remote consultations with doctors became possible. The quality of such consultations, as well as diagnostic capability, was significantly confined to the quality of the connection. Nevertheless, the main purpose of telehealth, which was remote health care delivery, was fulfilled. Later on, such innovation as the telegraph was used for the transposition of various medical data.
Beginning from the twentieth many countries have been using the Morse code to administer medical aid to seamen of the maritime fleet. For instance, in 1922 in the hospital of Gothenburg there were carried out medical consultations of seamen who were at sea. From 1935, a similar service started in Italy (Zundel, 1996).
One of the principal aims of telemedicine is remote diagnostics. In the modern sense of the term, medical diagnostics always requires visual information. In such a way, one of the necessary conditions for the appearance of telehealth was a modern communication medium that allowed a medical provider to see a patient. It is considered that the first successful attempt to transmit the image on the home television receiver has been realized in 1959. Later on, the image of a chest X-ray was transmitted by means of the coax connection. In the middle 60s, in relation to various NASA space programs, telehealth technologies were used for the physiological monitoring of astronauts.
Nowadays big health care centers have their own telemedicine programs. In the middle of the 70s, there was a special project aiming the demonstration the possibilities of telehealth. During this program, the specialists from leading medical centers have coordinated the actions of American doctors in remote districts of Alaska and Canada. The translation of medical examinations, consideration of diagnosis, and prescriptions of medicines was realized with the help of satellite channels.
Information technologies in contemporary medicine
It is possible to distinguish several principle purposes of telehealth. They are direct patient care, remote patient monitoring, medical education, mentoring, and consumer medical information (Telemedicine, Telehealth, and Health Information Technology, 2006). Nowadays informational systems in medicine are used more frequently. The serious clinic is unimaginable without IT constituents. Apart from the benefits for medical staff and patients, informational systems are profitable from an economic point of view. In addition, it is quite natural that health care institutions investors include in the budget costs for IT systems implementation. It is obvious that information systems are to be used in complex that includes all other aspects of the medical institutions activity. That is why local software applications are now integrated into complex information systems the basis for which is a modular principle. The most important modules in these systems are automation-equipped working places, electronic registries, medical programs of treatment settings with detailed medical indications, and business accounting. In such a way, a clinical information system is a complex solution that enables to perform various types of managerial, diagnostic, therapeutic, and statistical tasks.
The rapid development of technologies gave birth to the appearance of electronic case record forms, which provide a health care specialist with powerful capabilities. The electronic health record is a system that combines software applications and various modules linking together different structures of medical institutions.
Asynchronous and synchronous telehealth
Depending on the transfer time of information and on the cooperation of participants, no matter whether it is a communication between different health care providers or whether it is the physician to patient telehealth services, the application field of telemedicine may be subdivided into two main areas. They are asynchronous and synchronous telehealth. Asynchronous telehealth uses the interchange of prerecorded data. For instance, a patient or a medical worker sends the description of a medical case by email to a health care expert. Later on, this expert replies to the sender with his own opinion concerning the diagnosis and the appropriate treatment.
In contrast to this, synchronous telehealth requires the simultaneous presence of all participants during interactive information sharing. “Real-time telemedicine could be as simple as a telephone call or as complex as robotic surgery” (What is Telemedicine? n.d.,p.1). This type of telemedicine also implies the use of various peripheral devices by means of which a physician can interactively diagnose a patient. For example, “a tele-otoscope allows a remote physician to see inside a patients ear, a tele-stethoscope allows the consulting remote physician to hear a patients heartbeat” (What is Telemedicine? n.d.,p.1).
In both types of telehealth, the necessary information may be interchanged in various forms, such as text, audio, video or images. These two different approaches are applied to a wide range of medical services. Sometimes telehealth is used for the remote monitoring functions, during which “health care providers use IT to remotely monitor and collect data on the health of patients while in their residence or care facility” (Castro et al.,2014,p.3).
Apart from the functions of treatment, telehealth provides many teaching opportunities. Due to this technology, a physician has the possibility of continuous professional training including both theoretical and practical skills. Lectures and video consultations may be held in the multipoint mode for the participants from several regions simultaneously. The use of network video cameras permits to the organization a translation of a surgical operation. This technology allows sharing experiences between health providers. Moreover, it permits to perform a function of mentoring when a highly skilled doctor coordinates the actions of his less experienced colleague.
Economic issues if telehealth
The economic benefits of the telehealth systems implementation is a matter of argument. On the one hand, the wide usage of remote monitoring programs in chronic illnesses treatment allows many clinics to save money by reducing the number of hospitalizations. Castro et al. (2014) state that due to these programs “hospitals save $9.655 per patient from reductions in hospitalizations” (p.8). The fact is that the treatment of chronic diseases such as diabetes, heart diseases, asthma, and mental illnesses implies continual medical assistance. The traditional physician visits are rather expensive and time sapping for a patient. Various telehealth programs ranging from a simple telephone consultation and to complicated remote monitoring systems can reduce avoidable visits to hospitals. Moreover, “it reduces waiting times and hospital admissions, patients can receive a quicker diagnosis, and the patient experience is extremely positive” (Using telehealth to monitor the patient remotely: an RCN guide on using technology to complement nursing practice, 2012, p.4).
Nowadays there are many systems including sensors of blood pressure, body temperature, oxygen partial pressure that are connected with a computer that sends all the necessary data to the server in a medical center. These systems provide a patient with the opportunity to receive appropriate medical assistance without leaving home. Various telehealth programs make possible audio or visual contacts between a patient and a consulting physician.
At the same time, apart from the benefits for a patient, one of the barriers to the implementation of telehealth systems is the high cost of the required equipment. “Cost of equipment, maintenance, staff training, and transportation required for telemedicine is a daunting issue for governments and health providers” (Telemedicine. Opportunities and developments in member states, 2009, p.72).
Telehealth systems and complexes are rapidly developing all over the world, providing efficient medical assistance in remote districts. At the same time, in spite of the widespread of telemedicine its medical effectiveness and economic benefits are not proven. Contemporary research has shown that there is not a big difference between the effectiveness of the telehealth systems and the effectiveness of the conventional approach implying personal contact of a physician and a patient. At the same time, the expensiveness of the equipment leaves serious doubts concerning the financial viability of the telehealth systems. Moreover, the usage of telemedicine arises the question of medical confidentiality, which can be violated by a hacker attack. Nevertheless, it is possible to conclude that telehealth is a promising trend in the sphere of health care with multifold possibilities.
Castro, D., Miller, B., & Nager, A. (2014). Unlocking the Potential of Physician-to-Patient Telehealth Services. Web.
Telemedicine. Opportunities and developments in member states. (2009). Web.
Telemedicine, Telehealth, and Health Information Technology. (2006). Web.
Using telehealth to monitor the patient remotely: an RCN guide on using technology to complement nursing practice. (2012). Web.
What is Telemedicine? (n.d.) Web.
Zundel, K. (1996). Telemedicine: history, applications, and impact on librarianship. Bull Med Libr Assoc, 84(1), 71-79. Web.