Telemedicine Benchmarks: Global Strides Span eRisk Norms To Space Diagnosis

New Delhi: | Updated: Dec 23 2002, 05:30am hrs
Even as Indias role in telemedicine cannot be dismissed, advanced countries such as the US have far more to talk about the initiatives in the sector. Heres a selection of some such developments in the area of telemedicine.

n Take for instance the US-based eRisk Working Group for Healthcare. The eRisk Working Group for Healthcare recently issued guidelines to assist physicians in setting policies for online communication with patients. The group comprises the American Medical Association, some 40 other national and regional medical societies, and medical malpractice carriers covering more than 70 per cent of insured physicians, according to Health Data Management.

The guidelines include disclosure of fee structure before an online consultation, obtaining prior consent, maintaining records pertinent to an online consultation in the patients medical record, and explaining to the patient that the online consultation may not be an adequate substitute for an office visit. Physicians should also limit online consultations to pre-existing conditions, ongoing treatment and follow-up questions related to previously discussed conditions. The guidelines also discuss concerns and risks associated with online consultations, including data security and confidentiality, sensitive or emergency subject matters, licensing issues, and liability. For details on the guidelines, the website of Medem Inc, a San Francisco-based vendor of Internet services for physicians, is a good place to check out.

* The First Consulting Group recently prepared a report on successful implementation of new technology for rural healthcare. Funded by the California HealthCare Foundation, the report provides an overview of technology tools available to assist healthcare providers in rural settings, according to California HealthCare Foundation website. The report helps providers understand the tools available and how they work; the collaborative environment needed to adopt and implement the technology; and funding and reimbursement resources.

The case studies in the report describe medical groups and practitioners who are using a wide range of technology solutions, from email-based and Web portal applications to image capture and interpretation applications. The technologies discussed also include real-time video conferencing, remote patient monitoring, and support tools for rural home care.

* Also, consider this. Advocate Health Care of Oak Brook, Illinois, is set to have continuous remote specialist monitoring of intensive care units in its eight hospitals, employing eICU technology, as per information provided by Health Management Data. Visicu Inc of Baltimore is the vendor of the remote monitoring technology, called eICU.

In the eICU setup, cameras, speakers and microphones are installed near each ICU bed. Intensivists monitor the patients from a remote command centre. Patient monitoring devices are connected to a database, which is programmed with a series of alerts. If a patients condition changes, the intensivists are electronically alerted to the problem and can interact with physicians, nurses and patients via the audio and visual connections. The integrated delivery system will not reduce existing ICU specialist staffing, according to Advocate officials. Advocate will initially deploy the eICU in two hospitalsLutheran General and Good Shepherdby spring 2003. It expects by early 2004 to extend the technology to all 212 adult ICU beds among its eight acute care hospitals.

* Also, the European Space Agency (ESA) recently coordinated a demonstration in medical telediagnostics, performed on board the French hospital ship Sirocco. In a project initiated by ESA, in association with the Department of Space Medical Physiology at the University of Tours, the Vision and Robotics Laboratory at Bourges, Sinters Toulouse, and CNES (National Center for Space Study), this was the first real-time demonstration of the use of a tele-operated robotic arm for echographic diagnosis in a remote situation.

A radiologist at St Annes Hospital in Toulon used the tele-operated robotic arm to diagnose a test patient on board the ship stationed at sea. Medical tele-diagnostic research has important implications not only for the space program, but also for delivery of efficient medical care in small rural hospitals where access to radiologists is limited, or in situations where second opinions are needed. The demonstration was carried out in conjunction with the conference on telemedicine held in Toulon on December 5-6.

* A device that attaches to a normal mobile phone and allows patients to check their breathing and heart rate has been developed by researchers in the US, according to a BBC News report. The device, designed by researchers at Lucent Technologies Bell Labs, combines an antenna and a sensor that can pick up respiratory and heart activity when connected to a mobile phone and placed in front of a patient. The information could then be sent to a remote health monitoring centre using the existing telephone network. The device works by monitoring the microwaves transmitted by a mobile phone, some of which bounce back to the phone from he chest, heart and lungs of the person using it.

The add-on module picks up these signals to produce a pattern of the users heartbeat and breathing. It is estimated that 100 million Americans suffer from chronic health problems such as heart disease and lung disorders.

The upside of developing applications to monitor health outside hospitals: to save money and cut down on waiting time.