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Telemedicine and E-health - ICT to make people better more quickly. Dr Jim Briggs University of Portsmouth Talk given at the ICT Study Day 7th December 2004. Contents. Who am I and where do I work? Definitions Types of telemedicine Case studies E-health Unanswered questions. Who am I?.

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Telemedicine and e health ict to make people better more quickly

Telemedicine and E-health -ICT to make people better more quickly

Dr Jim BriggsUniversity of Portsmouth

Talk given at the ICT Study Day7th December 2004


Contents
Contents

  • Who am I and where do I work?

  • Definitions

  • Types of telemedicine

  • Case studies

  • E-health

  • Unanswered questions


Who am i
Who am I?

  • Dr Jim Briggs

  • Principal Lecturer in Information Systems and Computer Applications

  • Leader of the Healthcare Computing Group

  • Director of the UK Telemedicine and E‑health Information Service (TEIS)


Where do i work

University of Portsmouth

Medium-sized university

Mainly city-centre location

Lots of new student accommodation

Excellent social life

Excellent study facilities

By the sea

30 courses in the computing/IT field

Computer Engineering

Computer Science

Software Engineering

Information Systems

Animation, Games, ET

Mobile/wireless

Website

http://www.port.ac.uk

Where do I work?



Definitions

Telemedicine:

medicine at a distance

cf television, telephone, etc.

E-health:

health services delivered electronically

cf E-commerce, E-learning, E-government, etc.

Definitions


Characteristics of tm systems

Interaction style

real-time (e.g. videoconferencing)

store-and-forward (e.g. email)

Data types

text (e.g. patient's notes)

image (e.g. x-ray)

Equipment

general purpose (e.g. PCs)

specialist (e.g. electronic stethoscope)

http://jhi.sagepub.com/cgi/content/abstract/7/3-4/222

Characteristics of tm systems



Case study 1 cont
Case study 1 cont.

  • Minor Injury Units:

    • replacing "unviable" accident & emergency departments

    • nurse led

    • deal with "straight-forward" problems

  • Linked to central A&E department by video link to provide expert backup

  • http://www.bthealth.com/casestdy/cstudy/case11.htm



Case study 2 cont
Case study 2 cont.

  • ECG, etc. links from ambulance to hospital

  • Expert backup for paramedics

  • Reducing "call to needle" time for rural heart attack patients

    • Dundee study reduced average time from 125 to 52 minutes [Pedley et al; BMJ 2003]

  • Also, advance warning to A&E staff of details of incoming cases

  • http://www.rcsed.ac.uk/fellows/bcpaterson/chest_pain.htm



Case study 3 cont
Case study 3 cont.

  • Overload on specialist dermatologists - long waiting lists for referrals

  • tds Telemedicine Ltd. provides a commercial service

    • specially trained nurses take digital photos

    • specialist software routes to consultant dermatologists (anywhere in UK) for diagnosis

    • consultant can work from home

  • tds replaces local consultant but not totally

  • http://www.tds-telemed.com/



Case study 4 cont
Case study 4 cont.

  • Consortium of 4 big American hospitals

  • Provide "second opinion" service worldwide (20 countries)

    • tele-radiology

    • tele-pathology

    • patient management consultation

  • Local physician remains responsible

  • http://www.worldcare.com/


Case study 5 nhs direct
Case study 5: NHS Direct

  • Biggest telemedicine project in the world

  • Mainly telephone service

  • Expanding to:

    • web

      • online diagnosis for common conditions

      • health encyclopaedia

      • my NHS healthspace (personal info portal): news, reminders, knowledge

    • digital TV

  • http://www.nhsdirect.nhs.uk/


E health the future of health

E-health - the future of health?

Making health care more easily accessible to the patient


The banking metaphor
The banking metaphor

  • Most transactions carried out by the customer

  • Centralisation of specialist services

  • Decentralisation of non-specialist services


Integration of IT into business sectors

Public Services(Health…)

Business Services(Banks)

Integration of IT

Manufacturing

1980

1990

2000

Jean-Claude Healy

May 2000

IT as a gadget

Trojan horse: networks, …

Full Integration of IT into Business (Organisational, Legal) Re-engineering of the system






E health busan s korea
e-health - Busan, S Korea

  • Medical Tourism

    • 2 hours by air for 2 billion people

      • 1% with disposable income = 20 million

    • Cardiac - Cancer - Mental Health

    • Costs can be competitive

    • Popular tourist resort for families



Medico legal ethical issues
Medico-legal/ethical issues

  • Who is (legally) responsible for the patient's treatment?

  • What country's laws apply?

  • Can a correct diagnosis be made by telemedicine?


Economics of telemedicine
Economics of telemedicine

  • Communication is getting faster and cheaper

  • Equipment is getting smaller (more mobile) and cheaper

  • People costs are rising

  • How do we adapt?

  • Who pays?


What makes tm a success
What makes tm a success?

  • Why has telemedicine caught on in some disciplines and some places, but not in others?



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