Telemedicine is the provision of health care from a distance. However, telemedicine has since evolved to encompass more than just providing health services, it also includes the technologies and organization of resources facilitates the dissemination of health information between physicians, patients and specialists from a distance
Telemedicine was first developed and investigated by the National Aeronautics and Space Administration (NASA) in the United States for the purpose of remotely monitoring the physical and mental health of astronauts who were stationed outside of Earth and unable to be seen by medical professionals in person. Their specialized space suits contained special sensors that detected any physiological anomalies while a dedicated team of healthcare professionals monitored the health and wellbeing of the astronauts.
Like most Cold War technologies, telemedicine was later introduced for civilian use. In particular, it was used in rural, remote and developing areas where access to health care was unavailable. This early form of telemedicine was not designed to change the methods traditional medicine used, but to act in the places where traditional healthcare infrastructures had not yet been set up. Telemedicine was used and studied extensively by the World Health Organization and non-governmental organizations (NGOs), such as Medecins Sans Frontieres (MSF), that saw telemedicine as the most cost-effective and efficient method for providing medical support to remote, developing regions of the world. Its use in Africa was extensively studied where villages located far from capital cities had few doctors and little health infrastructure to support major health epidemics that plagued the region. The goal of these agencies was to set up telemedicine clinics in these remote areas that allowed remote villages to access medical help from the closest city, where doctors and specialists would be available to screen sick patients and determine if they needed to be transported to central hospitals. This model of telemedicine still is in use in places such as Bangladesh where remotely accessible clinics are set up in villages which link to the major central hospitals until health infrastructures can be further developed locally.
The rise of home computing and the birth of the Internet in the early 1990s led to a new age for telemedicine, where medical professionals could diagnose and treat patients remotely using computer-mediated telecommunications systems that were connected to the Internet, and send medical information anywhere with an Internet connection. While telephonic and satellite-based telemedicine still continues to play a vital role in remote locations where Internet infrastructures are slow or non-existent, the internet revolutionized telemedicine, moving it from the remote clinics in developing nations to patient’s homes and community clinics in nations with advanced economies.
Telemedicine reorganizes the practice of modern medicine through the utilization of telecommunications technologies within the healthcare fields. The three main categories in telemedicine are remote monitoring, Store-and-Forward (SAF) telemedicine, and Real Time (RT) telemedicine.
Remote monitoring also known as telecare, allows patients to be constantly monitored with the use of various medical devices that are remotely connected to healthcare providers. Cardiology, rheumatology and geriatrics require constant monitoring of patients as chronic conditions can have better health outcomes when regularly monitored, minimizing disruptions to the everyday activities of patients. Sensors that can prematurely detect any changes in the condition of a patient remotely alerts healthcare providers to treat the patient to prevent unnecessary and expensive hospitalization.
Store-and-Forward (SAF) Telemedicine allows for rapid transfer of health information and imagery between specialists and primary care providers to improve patient access to specialist care while reducing costs. The transfer of high-resolution images and videos, as well as other pertinent health information, between specialists and primary care physicians used to be difficult and time consuming. However, SAF Telemedicine allows improved utilization of primary care physician by reducing the need for time consuming physical examinations when medical images can be sent directly to specialists for more efficient and more accurate diagnoses of conditions. SAF Telemedicine has been hugely successful in the fields of Radiology and Dermatology, where new internet-connected imagery devices can send high resolution photo and video files between primary and secondary care so conditions can be remotely diagnosed more accurately and treated faster than before.
Real Time telemedicine allows patients and healthcare providers to remotely assess patients in real time through video and telephonic services, whereby physicians can take medical history and provide appropriate medical advice. This form of telemedicine has the potential for greatest impact on improving access to health care by reducing overhead costs, reducing waiting times for patients and improving health outcomes for patients. While there are various arguments made for and against whether these remote consultations can effectively replace face to face consultations, Real Time telemedicine is becoming universally accessible as mobile health apps allow anyone around the world with a mobile device and stable internet connection to talk to a doctor any time. Psychiatry and nursing utilize real time telemedicine to diagnose and treat patients remotely via live video or telephonic connections between patients and medical professionals. An important device of real time telemedicine is the teleclinic, a self-contained unit with various sensors and devices that remotely connects patients to doctors and other healthcare professionals who can then diagnose and treat a patient in real time.
However, with mobile applications and other wearable devices, access to doctors in real time doesn’t require teleclinic but just a stable internet connection and a device that can be connected to the internet.