The Breadth and Scope of Telemedicine

20/11/2016
On the cover of a 1925 science and invention magazine, an illustration appeared of an instrument suggested by Dr. Hugo Gernsback. The instrument had robotic digits examining a patient, after which it sent the relevant data through radio to a doctor in a geographically removed area from the patient, who would then give the patient the proper diagnosis. Although this instrument never saw the light of day, it can be considered the first inkling of the idea to perform telemedicine which is currently en vogue in the science and media conventions. Today, after around two centuries since the invention of the stethoscope (the most famous of the data transmission tools between doctor and patient), science is beginning to develop a new opinion regarding the traditional model of medicine which relied on direct contact. We now see the concept of telemedicine gaining interest, and even entering into practical trials in a number of countries.

Telemedicine relies on the use of telecommunication and IT technologies to provide medical services from afar. Telemedicine in its current form first started in the 1950s when two medical centers in Pennsylvania, set at a distance of around 36 kilometers apart, would trade X-Ray results over the phone. Since then, a number of important developments have occurred in the telemedicine field, which aims to provide medical services such as diagnosis and consultations to remote rural areas. One of the telemedicine projects was supported in the 1970s by NASA, aiming to treat Native Americans in Arizona on the one hand, and astronauts spending long periods in space shuttles or stations on the other.

The most essential factors that have led to the rapid development of this field can be summarized to two main points: the first is the major increase in the population, and the difficulty of providing traditional medical services based on the availability of medical personnel in all of the settlements from villages, towns, and cities. The second is the great developments of telecommunication, and the rapid speeds with which data can be transferred between two points of the globe. Telemedicine does away with the need for direct communication between the doctor and patient, and replaces it with communicating with the doctor through the internet, sending whatever scans or tests they may need to perform a diagnosis.

Psychology has taken over a large segment of the platforms in this field, and among other medical fields, radiology – which performs diagnoses based on scans – has had one of the highest number of practitioners willing to perform telemedicine. This is because it is possible, and quite simple, to send a scan over email or any other method to a doctor and from there receive a proper diagnosis. The same is true for dermatologists in cases where they may need only look at the patient and ask a few questions in order to give a proper diagnosis. Internists, neurologists, and cardiologists among others need to perform a “virtual consult”, which may require the acquisition of further medical information such as heart rate, blood pressure, blood sugar levels, and other data that may be provided through household appliances available to a number of people. The data from these appliances are provided to the doctor through a number of telecommunication means, including voice or video calls. Ophthalmologists are in a different position, however – highly specialized images of the eye must be taken by equipment only available with doctors normally, after which these scans would have to be sent to a specialist. This has led to the development of a new segment of workers in the medical profession: nurses capable of running equipment previously only used by doctors. This segment may expand into another of other professions in future.

Many medical centers now employ doctors prepared to receive calls around the clock, or to treat various cases for patients they only see virtually. A few of the major centers even contain a network of clinics across a vast geographic space, and exchange data with the main center on a continuous basis. In addition, many specialized medical centers will now monitor patients daily, and issue warnings both to the patient and the doctor when any change in the measured factors requires action or a specific process. According to the American Telemedicine Association, there are currently around 200 programs covering 3,000 rural areas in the United States. These programs have lowered annual medical expenditures by around 200 billion USD.

The possible features that telemedicine can offer are limitless, especially for those areas that do not have access to basic medical services. There are a number of factors that can inhibit the spread of telemedicine, however. Among them is the reliance on a multi sided platform that requires development and marketing to encourage the use of these products. It is also insufficient to only provide telemedicine centers that provide this service, but rather the field requires a segment of beneficiaries that has the technical know-how to interact with modern telecommunications media, including telephone apps, that must be developed to ensure effective communication between doctor and patient. This knowledge may not be available to a large number of people, particularly those in the demographic that telemedicine is targeting in the remote rural areas.

People will still have to sit for a little while longer in waiting rooms throughout the world, reading old magazines from 2010 or earlier, in order to receive a medical consult. Many will have traveled from afar to receive this consult, and patients may be referred after this visit to a radiology center that will require them to stay in the city for another day. In the coming years, however, great changes and innovations are expected in the telemedicine field a doctor will remain in one of the major medical centers worldwide, and their consults will reach the furthest points of the globe, or even beyond to astronauts off the surface of the earth. Telecommunications will expand doctors reach and connect them with patients in sight and sound, allowing them to exchange all types of data instantaneously – or near instantaneously.