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Telemedicine: An Evolving Healthcare Delivery System

For many people, telemedicine may be an unfamiliar term. Telemedicine is the word that has been coined for “distance medicine.” What this means is that with the use of telecommunications (video and audio), doctors are able to diagnose, and in many cases, treat the patient without having to physically observe the person. Telemedicine is not new; it has been practiced since the 1960s. Researchers have made many positive changes and advancements since its inception, and telemedicine continues to grow in popularity as advancements improve.


The Thin Client:  New Advancement in Telemedicine   


According to Phys.org (2012), Fujitsu Laboratories recently announced improvements in telemedicine with the development of a high-speed “thin client”. Apparently, in low-quality network environments (poor or slow Internet connections), the new technology (thin client) has the ability to respond up to ten times faster to the operation system. In other words, this new technology makes communication between patient and doctor better than previous, especially for people who use hotspots like as coffee shops with Internet access. Also, the thin client offers better service to people who have slow Internet connections or those who are communicating with doctors in another country.


The high-speed thin client application allows for a 90% quicker response time. Not only does this application allow for better communication in low-quality network environments, it will eventually allow for many other uses. New thin client applications are useful for global communication applications with a virtual desktop that allows for interactive product demonstrations at customer locations. These new applications will also secure communication between doctors and patients. In addition, the thin client can provide global training using video and audio equipment.


The Benefits of Thin Client


Telemedicine and online healthcare continues to improve with new medical equipment and devices developed each year. As with other innovations, the thin client offers patients and doctors many benefits. These include:


• Virtual packets of information
• High quality graphics
• Lower operating costs
• Automatic graphic adjustments
• Less megabits need
• Quicker response time
• Clearer audio
• Mobility (virtual desktop can be used with mobile devices)
• Secure transmission (information is more secure)


Telemedicine Beneficial for Patients with Depression and Diabetes


Fortney and colleagues (2007) investigated evidence-based practices with a telemedicine collaborative care model at small clinics without onsite psychiatrists. Deemed the “Telemedicine Enhanced Antidepressant Management” (TEAM) study, the sites were randomized into either an intervention group or usual care group. Over 390 patients with depression were evaluated by telepsychiatrists for treatment response, health status, remission, quality of life and treatment satisfaction. The patients lived in remote areas where healthcare access was not optimal. After careful intervention and analysis, the investigators concluded that collaborative care can be adequately adjusted for primary care clinics without onsite psychiatrists with the use of telemedicine technology.


In 2009, telemedicine researchers Shea and associates examined the effectiveness of online and computer interventions in ethnically diverse elderly patients with diabetes. While telemedicine is promising, it is a largely unproven technology for case management. The investigators sought to discover if patients with less access to care actually benefited from this innovative health delivery method. To study this concept, they conducted a randomized controlled study that compared usual healthcare to telemedicine case management. Over 1,600 patients with diabetes were evaluated, and the primary endpoint assessed over a five year period was hemoglobin A1c and lipoprotein LDL cholesterol laboratory values, as well as blood pressure values. Shea and colleagues found that the telemedicine approach yielded net improvement in laboratory values and blood pressure readings.


As with other conditions, depression and diabetes are chronic disorders, ones that do not usually require urgent or emergency care. Because these conditions can be managed on an outpatient basis, telemedicine is the perfect solution for those who live in remote or rural regions. With the use of the Internet and computer technology, patients can enjoy improved health via telemedicine.


Patients Report Satisfaction with Telemedicine


There will always be people who do not trust the new technology. Many of these individuals fear technological advancements because of the inability to use computers and high-tech devices. In order for the elderly to benefit from telemedicine, they need assistance from others. Many people (not just the elderly) worry about confidentiality, and therefore, avoid the use of innovative practices. Because of these factors, telemedicine is not accepted by all of the patient population.


The younger generation is another story. Many people born during the last three decades are accustomed to the Internet age and adore telemedicine. Who wants to bring a sick child to the doctor’s office in the middle of a snowstorm? If telemedicine will allow the child to receive healthcare, why risk the trip? The Internet frees people from excessive wait times, lost work hours, and travel expenses.


Over the past 40 years, telemedicine researchers conducted regarding patient satisfaction. The longer telemedicine is around, and the more advancement and progress made, the more patients come to accept it. According to research, many people trust it, and in many cases, patients even prefer online healthcare to the traditional medical visits (Mair, 2000).


Final Thoughts


Obviously, some medical situations are not suitable for telemedicine. Traditional healthcare is best for emergency situations that involve life-threatening conditions such as a heart attack or stroke. However, for minor illnesses and less complex disease processes, telemedicine is a beneficial service that continues to evolve.


References


Fortney, J.C., Pyne, J.M., Edlund, M.J. (2007). A Randomized Trial of Telemedicine-based Collaborative Care for Depression. Journal of General Internal Medicine, 22(8): 1086 – 1093.


Mair, F. (2000). Systematic review of studies of patient satisfaction with telemedicine. BMJ, 320: 1517.
doi: http://dx.doi.org/10.1136/bmj.320.7248.1517

Phys.org (2012). Fujitsu develops high-speed thin client technology for 10-fold improvement in responsiveness.

Shea, S., Weinstock, R.S., Teresi, J.A. et al. (2009). A Randomized Trial Comparing Telemedicine Case Management with Usual Care in Older, Ethnically Diverse, Medically Underserved Patients with Diabetes Mellitus: 5 Year Results of the IDEATel Study. Journal of the American Medical Informatics Association, 16(4): 446 – 456.

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