Telemedicine

1. Telemedicine Presented By: Brittany Harpster & Lyndsey Haller

2. OBJECTIVES • Describe TeleMedicine • Describe the types of Telemedicine • List Advantages/Disadvantages • Legal/Ethical Issues • Statistics

3. TeleMedicine Transfers Medical Information through technology • Transfer By: • Telephone/Cell Phone • Internet • Video Conferencing • Satellite

4. Telemedicine may be as simple as two health professionals discussing a case over the telephone, or as complex as using satellite technology and video-conferencing equipment to conduct a real-time consultation between medical specialists in two different countries.

5. Types Of Telemedicine • Two Concepts: • Real Time(synchronous) • Store-and-Forward (asynchronous).

6. Real Time Telemedicine • It requires the presence of both • parties at the same time and a communications link between them that allows a real-time interaction to take place. Video Conferencing equipment is one of the most common forms of technologies used in Real Time telemedicine

7. Video Conferencing Equipment • Tele-Otoscope-allows a remote physician to 'see' inside a patient's ear • Tele-stethoscope- allows the consulting remote physician to hear the patient's heartbeat

8. Store-and-Forward Telemedicine • Involves acquiring medical data (like medical images) and then transmitting this data to a doctor or medical specialist at a convenient time for assessment offline • Advantages of this method are that it does not demand the presence of both parties at the same time and does not usually require expensive equipment

9. Necessary Equipment for Store and Forward • Camera- to take the picture of the medical problem • A Way of Transmitting the image via Cell Phone, PDA, Email

10. Store and Forward Software What does CapSure do?With CapSure, you work with real-time video on your computer. It captures and converts raw data into the high-quality .jpg or .png formats. Create session folders and file names - CapSure automatically numbers the snapshots and remembers where they’re stored so you don’t have to spend time searching for missing files. You can even publish a session on a server or share a real-time image with a client. Best of all, CapSure provides you with a virtual environment that allows you to work the way you want to work. What is CapSure?CapSure is a remarkable store-and-forward software designed specifically for the professional inspection and imaging world.

11. Mission statement: Telehealth is used to provide total solutions for the needs of healthcare facilities. Telehealth is… the delivery of health-related services and information via telecommunications technologies. Telehealth allows patients to be seen when traditional health care cannot be given due to distance, location, or lack of medical centers. Telehealth is a broader view of telemedicine, which views specifically on curative measures. It combines preventive, promotive, and curative aspects. Seeing telehealth in action: http://www.youtube.com/watch?v=MmKNv9detu8 Definition of Telehealth/Telemedicine and Research Information

12. Clinical Information System • The Clinical System is best used for Telemedicine and Telehealth software. • Clinical information systems consist of information technology that is applied at the point of clinical care. • This includes medical records for immediate access, clinical data from assessing the patient, and viewing laboratory/diagnostic studies for instant results. • This system also involves being about to access the data from any device at the office, hospital, or home. ***See Reference Page for sources

13. Clinical System Review • Telehealth is used by physicians, nurses, and can be a way of communicating to specialists as well. • This system is used to assess, diagnose, and document. It is for preventive and curative aspects of healthcare. • Telehealth software can all come together in a mainframe, where all the medical centers that use this program can securely store all patient information for it to be easily accessed from anywhere or any technological product. • Though, the telehealth system uses other configurations under and within the mainframe. These configurations include but are not limited to: • Minicomputer • Microcomputers • Point of care • Local area networks • Other systems

14. Clinical System Review • There are many data standards used within telehealth so it can be used internationally as well as from one hospital to another. • Some standards used would be the ANSI, International Standards Organization, Workgroup for electronic data exchange, etc. • Two disease and procedure systems used with the telehealth program would be the HCPCS and SNOMED. • Nurses as well as many other medical personnel use this program. Therefore, nursing systems are implimented. • Some systems such as NANDA, NIC, NOC, and ICNP are used for international and national standard classifications.

15. Advantages of Telemedicine • Helped to make doctor’s offices and medical facilities as close to one another as the nearest computer screen. • Can be used in the remotest parts of the world or in places as close as a correctional facility, helping to eliminate the dangers and costs associated with the transportation of prisoners to a medical center • Allows a surgeon to be in 2 places at once. • Allows homebound to receive treatment.

16. Disadvantages 1. many states wont allow out-of-state physicians to practice medicine unless they’re licensed in that state • 3. The Centers for Medicare and Medicaid (CMS) have placed restrictions on the amount given in reimbursements for telemedicine procedures, and many private insurance companies will not reimburse at all for this technology. 2.underlying fears of malpractice suits for physicians engaged in telemedicine because there is a lack of hands-on interaction with patients. 4. Technological problems. Telephone lines and rural areas not having cable.

17. Ethical/Legal Issues Security, privacy and confidentiality, in telemedicine consultation, Are the concerned Ethical Issues. • Advocate for safe and effective use of telehealth technology. • Serve as well informed resources for consumers and technology developers for the safe use of technology to meet healthcare needs. • Monitor outcomes of care resulting from telehealth nursing practice. • Ensure confidentiality and patient privacy in all telehealth encounters.

18. Definitions of Telehealth Nursing • Telehealth nursing is the practice of nursing over distance using telecommunications technology (National Council of State Boards of Nursing(NCSBN), 1997). • Telehealth nursing is the delivery, management, and coordination of care and services provided via telecommunications technology within the domain of nursing (American Association of Ambulatory Care Nursing (AAACN), 2004). • Telehealth nursing is the use of telecommunications technology in nursing to enhance patient care. It involves the use of electromagnetic channels (e.g., wire, radio, and optical) to transmit voice, data, and video communications signals. It is defined as distance communications, using electrical or optical transmissions, between humans and/or computers (Skiba, D.J. & Barton, A.J., 2000).

19. Functions And Responsibilities of the Informatics Nurse Telehealth nurses are committed to: 1. Leveraging technology and nursing expertise to provide quality nursing care, to delivering nursing expertise to those who need care, and to improving health and patients’ outcomes. 2. appropriate, effective, proficient, and safe use of telehealth technologies/medical devices 3. Enhanced communication skills 4. Adhere to existing regulations of the jurisdiction in which they practice, including licensure and regulatory requirements.

20. Summary Telemedicine is a growing new way of medicine that may be the new way of the future. It brings medical offices, Doctors and specialists that may be oceans apart together as if they were in the same facility. It allows homebound to get medical treatment. It allows a surgeon to be in 2 places at once. There are many advantages and disadvantages to telemedicine. The advantages outweigh the disadvantages and the disadvantages will soon be resolved. Telemedicine is the way of the future!

21. References • Sonnenberg, F. (2007). Clinical System. Retrieved December 1, 2008, from Clinical Information System Web site: http://informatics.umdnj.edu/clinical/information_systems.htm • Ebbers, M. (2005, July). Mainframe Computers. Retrieved December 1, 2008, from Wikipedia Web site: http://en.wikipedia.org/wiki/Mainframe_computer • Gibson, H. (2008). Medicine + Technology + Telecommunications. Retrieved December 16, 2008 from Todays Caregiver: http://www.caregiver.com/channels/tech/articles/telemedicine.htm. • Antoniotti, N. (2008). Telehealth Nursing. Retrieved December 16, 2008 from American TeleMedicine Association: http://www.americantelemed.org/files/public/membergroups/nursing/telenursingwhitepaper_4.7.2008.pdf.