Telehealth and TelemedicineTelehealth and Telemedicine
Jayantha U. Weerasinghe (Faculty of Dental Sciences, Peradeniya)
Academic Sessions - SLMA and Ruhuna Clinical Society - 2002
Telehealth and Telemedicine
• Telehealth
• Telemedicine
• exchange of material offline
• Real-time (online) image transfer
• commercial software available
• SAGA and Peradeniya Activity
Telehealth
• Telehealth is using technology to provide medical care over distance
• non-clinical services such as distance medical education and research
• It will allow information to be received by remote centres
TelemedicineTelemedicine
• Telemedicine typically involves medical personnel using images, video and audio facilities either non-real-time (off line) or real-time (on line) for remote consultations.
• An expert physician far away can guide the local medical personnel in treatment planning remotely
TelemedicineTelemedicine exchange of material offline
Store and Forward method• Local physician sending digital images of
pictures, x-rays, and other patient information directly to the computer of a specialist.
• After reviewing that information, the specialist then sends the diagnosis back to the local doctor, who treats the patient and provides follow-up care.
TelemedicineTelemedicine- - non realtimenon realtimestore and forward method
Usage
• Teleradiology
• Telepathology
• Teledermatology
Telemedicine- non realtimestore and forward method
Advantages• Minimum resources needed• Regular email attachments could be used
Disadvantages• Time delay in response• Limitation of image quality and size• Cross checking and feedback will take more
time
TelemedicineTelemedicine real-time (online) image transfer
• Exchange of high quality still images, video clips between the remote center and the experts using videoconferencing equipment.
• experts outside will be able to guide the remote center in realtime
Telemedicine : real- timeAdvantages
• Used in many areas of medicine, surgery, dentistry• accessibility of expert help in remote areas• Saves time of an expert in frequent travel to remote
areas• permits Continuing Education and training for
practitioners in remote areas
Disadvantages
• Non availability of appropriate technology and adequate bandwidth in the network
• Lack of funds for equipment and software• Lack of technical help
Basic requirementsBasic requirements
Requirements: Videoconferencing equipment • A Digital Video (DV) camcorder (IEEE1394 interface)
OR Digital camera with USB connection• microphone and speakers• Desktop/ Laptop computerInternet access - leased line/ Local Area NetworkDedicated software
Shortcomings of commercial software
Eg:- Messenger. CuSeeMe, Netmeeting,, freetalk,
• Poor quality of images at low speed networks
• not suitable for medical collaboration activities– image manipulation, tele-pointing facility on the image canvas, shared-
board
• clinicians would prefer a user-friendly operating environment specifically designed for medical applications.
Sri Lankan Experience of high quality medical image and
voice transfer through internet
Between
Medical School & Faculty of Engineering
SAGA University-Japan
And
Faculty of Dental Sciences - Peradeniya
Department of Oral Surgery
Faculty of Dental Sciences,
University of Peradeniya
Previously used method - Store and ForwardStore and Forward
• Images of patients- photographs and radiographs were exchanged
• Non real time method
• Disadvantages-– Delay in receiving and responding– Delay in decision making at the remote centre
since they await advice from the expert outside– limitations of commercial email software for
sending large data files
SAGA Medical School
SAGA University
(Engineering)
Faculty of Dental Sciences- Peradeniya
http://turkey.fu.is.saga-u.ac.jp/education/project/Collabo1.asp
Realtime image transferRealtime image transferusing a dedicated software
Dedicated SoftwareDedicated Software developed by SAGA
• Connections made by ‘dialing’ IP address• Voice transfer full duplex• Image transfer with following facilities
– Sender and receiving windows– Shared board facility for image canvas– Accessing shared files on each computer– Transfer of powerpoint presentations and
playback– Recording facility of the images received– User-friendly
Software OverviewSoftware Overview
Image transmission Voice transmission
IP
PreviewTransmitReceivingwindows
Shared Board
WEBFile transfer
Transmit from
Remote centre
Receiving from
Expert centre abroad
Software Overview• Transmission of Video as a Series of JPEG Images• interactive full-duplex voice• Image quality and image rate can be adjusted• User Friendly Graphic User Interface• Shared Board Facility
Shared Board Facility
• Both parties can use markers on the same image canvas
• Allow common base for discussions• Text typing facility
Marker from expert
Marker from local team
WEB Facility
• File transfer facility• Powerpoint presentations can be
transferred and run as a lecture from the remote location
• Ideal tool for CME
presentation
Advantages of the System
Eeconomical and freely available components,Operated in both low speed and high speed
networks User-friendly easy to install and operate
image software has a Graphical user interface customized for medical personnel with facilities such as shared board, transmitting powerpoint files and multiple image windows.
Application of the technique
• Between Faculty of Dental Sciences Peradeniya and SAGA Medical School
• An interactive session for JICA trainees in SAGA was conducted
Application of the technique locally
Tested between Faculty of Dental Sciences Peradeniya and
• Faculty of Medicine Peradeniya
• Genetics Unit, Faculty of Medicine- – University of Colombo
• Community health and Family Medicine - – University of Kelaniya
Summary• System developed for Real-time
Telemedicine which has been tested locally with a dedicated software designed in JAPAN
• It is suitable for low speed networks
• It could be used for Information exchange and Continuing Education sessions
Telehealth and TelemedicineTelehealth and Telemedicine
Thank You!Japan
Professor Nobumichi Sako - former President of Saga University
Mr. Minoru Tanaka - Chairman of NetCom Saga Association
Venture Business Laboratory (VBL) - Saga University
Prof Takeshi Katsuki - Oral & Maxillofacial Surgeon,
SAGA Medical School
Sri Lanka• Prof N A de S Amaratunga - Dean, Faculty of Dental Sciences, Peradeniya
• Dr. Nimal Ratanayaka- Director of the Internet/communication unit, Faculty of Engineering, Peradeniya
• Dr Toru Nagao- JICA Chief Advisor, Faculty of Dental Sciences
• Mr. Ranjith Abeyratne- Technical Officer, Faculty of Dental Sciences
• Dr Kumara Mendis - Dept of Community Medicine and Family Health Faculty of Medicine, University of Kelaniya