Telemedicine. Steven D. Johnson, M.D., M.S. President Voyageur Radiology. The World is Flat Thomas F riedman. How advancing technologies and changing market dynamics are creating new services, products and more importantly a platform and virtual culture to allow innovation.
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Steven D. Johnson, M.D., M.S.
President Voyageur Radiology
How advancing technologies and changing market dynamics are creating new services, products and more importantly a platform and virtual culture to allow innovation.
The development of new technologies may arise from existing technologies in one field applied to a new field or the convergence of several technologies to create a new technology.
Magnetic resonance of nuclei discovered in the 1950s
Explosive growth in the study of Molecular structure in chemistry and biochemistry
In the 1970s Paul Lauterbur discovered how to spatially localize magnetic resonance signal
New field of medical imaging born
Current state of art of telemedicine
Barriers to service
“The use of telecommunications and information technologies in order to provide clinical health care at a distance.”
African villagers used smoke signals to warn people to stay away from villages infected with serious diseases.
Australians used two-way radio’s in the early 1900’s to communicate to flying medical services.
Similarly the advent of the Internet age and personal computers has redefined Society in the 21st century.
Information is now freely available to remote regions with social networking including oral and video communications transmitted across the globe and often independent of international borders.
The ability to provide medical services to ever growing numbers of people, in wider and more remote locations, with greater knowledge based sophistication of services is one of the challenges of our Era.
Teleradiology is greater than 50% of all telemedicine
“Store and forward” telemedicine
Distributed client/ server applications
Data in server, local or cloud
work list can route data to appropriate reading
radiologist, distributed model
Work rule driven software
Data transmitted twice
Thin client data viewing technology
Viewing software resides on servers
Remote PC monitor systems view via internet
The image data on the server where the viewing
software also resides
Transmission of image to server for storage and routing out to interpreting network radiologists.
Radiologist interpretation transmitted back to facility and primary care provider for treatment decision
Add software $
“Zero footprint client”
Tech support upgrades
Care facilities of any type
Now possible due to increasing sophistication of technologies and data transfer bandwidths
Technology communication platforms
Patient service requirements
Medical service provider level of training and knowledge
Geographic locations of all the above
Through a technology called telepresence, it creates the illusion that students miles apart are in the same classroom.
Interactive television isn't new. Schools have been doing distance learning for years. But the Ojibwe language telepresence classroom at Deer River High School goes well beyond a simple TV monitor and a camera.
At a pair of long desks, teacher Gerald White and eight high school students recently recited Ojibwe phrases. They faced three huge, high-definition screens at the front of the room. In an identical classroom 25 miles away in Remer, Minn., a classmate was in a room with the same furniture, tan walls and carpet. She also recited Ojibwe phrases, giving the impression that they were all a few feet from each other.
White is the only Ojibwe language teacher within the seven districts that comprise the Itasca Area Schools Collaborative. He said telepresence technology makes him a more effective teacher.
Frozen section specimens
Primary histopathology diagnosis
Subspecialty pathology expert diagnosis
Using audio, visual, and data communication exchange medical information about skin and skin conditions to provide diagnosis, consultation, and treatment.
Burn & sunburn
Cold cough and allergy
Deer tick bite
M-F 8-8 weekend/holidays 9-5
Cough, cold & Flu
Sinus, ear & eye infections
Acne skin conditions
Urinary tract infections
Register and choose a M.D.
Webcam, chat or phone, videoconferencing
Internet or telephone
Home or office no appointment
Compliments traditional healthcare
New designs of service :
Technology capabilities on line?
Skype: Voice over Internet provider
Webcam video transmission ( real time)
Any formatted digitized data ( Images)
Streaming Video ( view data before all is sent)
The environment of telemedicine is moving from its infancy to being a more mature and important component of medical service.
The instrumental components that have allowed the initiation of telemedicine will inevitably expand and become more sophisticated. The continued technological, organizational, and political components that will foster telemedicine will be complex and likely evolving over time.
To understand, anticipate, or envisioning of the future requires a look at where we have been and where we are today.
Phone from home, call the Doctor , get the receptionist, get appointment, still sick, maybe call back from Nurse, time delay of hours?
Lacks timely service
servers (data centers) (cloud)
viewing and interpreting technology
Efficiency of service
Quality of service
Equipment Add on Apps