Tele Medicine.docx

Contents 1.Introduction – . .................................................................................................................................... 2 2.Definition – .......................................................................................................................................... 2 3 . Related concept – .............................................................................................................................. 2 4. Technology and equipment for telemedicine ..................................................................................... 3 5. Types of Telemedicine process – ........................................................................................................ 4 6. Technology involved – ........................................................................................................................ 4 7. Methods of transmission in Telemedicine – ....................................................................................... 4 8. Types of connectivity .......................................................................................................................... 5 9. Application of telemedicine ................................................................................................................ 5 10. Impact on education ......................................................................................................................... 5 11. Advantages of Telemedicine ............................................................................................................. 6 12. Drawback in telemedicine practice................................................................................................... 7 13. Ethical consideration on telemedicine.............................................................................................. 7 14. Telemedicine in India ........................................................................................................................ 8 15. Telemedicine in Chhattisgarh ........................................................................................................... 8 16. Barrier in Telemedicine practice ....................................................................................................... 8 17. Future ................................................................................................................................................ 9 18. Summary ........................................................................................................................................... 9 19. Conclusion ......................................................................................................................................... 9 20. Bibliography ...................................................................................................................................... 9

TELE MEDICINE 1.Introduction – The term tale medicine derives from the Greek word ‘tale;’ meaning at a distance and the word medicine is come from Latin word mederi which means health. Tele medicine is a rapidly developing application of clinical medicine where medical information is transferred through the phone or the internet or sometime other network for the purpose of consulting and sometime remote medical procedure or examination.

2.Definition – Telemedicine uses technology to transmit electronic data about clients to persons at distance location. Two –way audiovisual 1communication allows an international expert to examine and consult on a client case from thousands of miles way. (According to kozier and Erbs) Telemedicine or tale health is an emerging technology that is used to empower patient outcome. In telemedicine electronic medical records and video tale conferencing are used by health care providers. (According to Helen Harkreader Mary Ann HOGAN) The discovery of health care services, where distance is a critical factors by all health care professional using information and communication technology for the exchange of valid information for diagnosis ,treatment and prevention of disease and injuries research and their communities. (According to W. H. O.) Telemedicine is the exchange of medical information from one location to another using electronic communication which improves patient health states. (According to https//w.w.w.medicine com.mobileart)

3 . Related concept – Telecommunication - Telecommunication is the associated transmission of signals over a distance for the purpose of communication. Information technology – Information technology refers to a system. The electronic integration of providers – programs, and networked computer utilized to retrieve manage process and disseminate, information by means of telecommunication

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Tele diagnosis - Telediagnosis is a determination of the nature of a disease at a site remote from the patient on the basis of transmitted telemonitoring data or closed – circuit television communication. Telehealth – Telehealth is the utilization of telecommunication technology to link two or more end –user sites by any interactive electronic means for the purpose of transfer and/or exchange of information and data in any health –related application. E – Health – E – Health is the process of providing health care via electronic means in particular over the internet. E- Monitoring – It utilizes home monitoring devices such as a typical blood pressure monitoring. Uses – HIN, DM, CHE, and COPD.

4. Technology and equipment for telemedicine The basic telecommunication connectivity between the patient and the doctor may be wired or a wireless one

Telecommunication connectivity

wired

Wireless -

• • • •

Telephone line ISDN line Internet Cable connection

• Satellite • Wireless

Wired – Telephone line ISDN line, internet cable connection. Wireless – Satellite connection, wireless internet.

Necessities of Telemedicine –

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PIR (Personal Information Records) PHR (Personal Health Records) EMR (Electronic Medical Record) DICOM (Digital Imaging and Communication in Medicines) PACS (Picture Archival and Communication system) AES (Advanced Encryption Standard).

5. Types of Telemedicine process – 1 2

Technology involved Application adopted

6. Technology involved – Real time or synchronous – Real time telemedicine could be as simple as complex as telemedical videoconference and telerobic surgery.vedioconferencing equipment is one of the most common form of technology used in synchronous telemedicine. Store and forward telemedicine or asynchronous – It involve acquiring medical data and then transmitting this data to a doctor or medical specialist at a convenient time later for assessment offline. Application adopted – -

Telepathology Telecardiology Teleradiology Teleophthalmolog Telesurgery

7. Methods of transmission in Telemedicine – -

Store and forward Remote monitoring Interactive services

Store and forward telemedicine –Involve acquiring medical data and then transmitting the data to a doctor or medical specialist as a convenient time for assessment offline. Dermatology, pathology, and radiology are common specialities that are conductive to asynchronous telemedicine. Remote monitoring – Also known as self monitoring, testing, enables medical professional to monitor a patient remotely using various technological devices. This method is primarily used for managing chronic disease or specific condition such as heart disease, diabetic mellitus and asthama.these service can provide better satisfaction to patient and may be cost effective.

Interactive telemedicine – Interactive telemedicine services provide real time interaction between patients and provide to include phone conversations, online communication and home visit. Many activities such as history review, physical examination, psychiatric evaluation and ophthalmology assessment can be conducted.

8. Types of connectivity Point to point communication – In networking the point to point is a data link protocol commonly used to establish a direct connection between two nodes over terrestrials and satellite link. E.g.- SGPGIMS lucknow is connected to the medical college of Orissa through point to point connectivity via satellite link and district hospital. Point to multiple point communication – Is a term that is used in the telecommunication technology for prevention, promotion and to provide health location to multiple locations. E.g. two district hospital of Uttaranchal state are linked to SGPGIMS via ISDN link

9. Application of telemedicine Telemedicine care –It is the use of information and communication technology for prevention and to provide health care facility across a distance. It can be divided in the following activities – -

Teleconsultation Tele follow-up.

Tele education – Tele education should be understood as the development of the process of distance education, based on the information telecommunication technologies that make interactive, flexible and accessible learning possible for any potential recipient. Disaster management –Telemedicine play an important role to provide health care facilities to the victim of natural disaster such as earthquake, tsunami etc. Telephone health care – Tele medicine technology can be applied to provide health care for elderly and patient with the chronic illness.

10. Impact on education -

Faculty members keeping in touch with classes while attending conference.

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Guest lecture brought in classes from other institution. Faculty member participating in thesis defences at other institute. Admistration of right schedules collaborating on budget preparation from different part of campus.

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Researchers answering question about grant proposals from agencies or review committees.

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Student interview with an employer in other cities. Teleseminars.

11. Advantages of Telemedicine -

Changing of life style Acceptance of disease High quality of care Therapy guidance and control Budget relief and optimizing time management District guidance and training of patient Optimizing the therapy using guidelines Higher cost effective Lower medication costs Transparency of cost and services quality assurance Reduced period of hospitalization Disease management Higher quality of life Improved compliance.

Benefits for patient – -

Facilitate patient and rural practioners access to specialist health services and support. Lessens the inconvenient and cost of patient transfers. Early detection of disease. Medical education in form of teleconferencing.

Benefits for doctors – -

Excellent opportunity to share knowledge between physicians all over the world. Joint consultant with expert physician and surgens for the better management of complicated cases. Local doctors can be update the anytime. Medical education in form of teleconferencing.

Benefits for government – -

Reduce the rush to medical facilities in cities. Improved monitoring facilities at rural centres Increased reliance on government health care system.

12. Drawback in telemedicine practice -

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A large number of people are difficult to manage in a single teleconferencing with individuals attempting to interact and present their point of view. Cost can be high – cost are incurred in equipment varying sites for connection transmission and moderator training substantial agency staff and time to coordinate and lead is likely. Teleconferencing take time to organizing Staffing need can be significant – staff time and resources may be significantly less than if personnel have to travel to several meeting at distance location. Teleconferencing reduced opportunities for face to face contact between participants and proponents of plans or projects. The conference of technical failure when trying to establish a conference or during a conference.

Difficult for complex interpersonal communication such as negotiation or bargaining.

13. Ethical consideration on telemedicine To address these ethical responsibilities, hospital, clinics, and insurers should develop policies for telemedicine that reflect the ethical guidance of organizations such as the AMA, the American and International Medical Informatics Associations, and the American Telemedicine Association. Policies should entail a variety of additional considerations: Professional conduct and relationships. Key people treating a patient and making decisions about care should have a good relationship with the patient and with each other, at least comparable to what that patient would have with care in-person, so as to establish trust and allow clinicians to understand patient and community values, and the patient’s living situations, behavioural health considerations, and ways of dealing with medical issues. Privacy, patient safety, and human values. Procedures are needed to thoroughly test all software, hardware, and communication channels; to improve notoriously poor cyber security, privacy, and confidentiality practices as more patient-related data is communicated and stored; and to inform patients of security and privacy risks prevent replacing clinical judgment, patient autonomy, and human values Involving patients and protecting their autonomy. Patients should be involved in designing telemedicine services to prevent assumptions that patients will be informed, cooperative, and compliant; to avoid intrusive, difficult-to-use applications; and to serve all patients, including those who are disabled and aged, and those who are not fluent in English. Patient involvement would help promote shared Weighing the benefits. Policies should consider whether telemedicine services are becoming low-cost means of servicing the poor or high-cost care available only to those who can afford them. How does telemedicine compare with more effective, and more cost-effective, ways to improve health?

14. Telemedicine in India -

Existing system limited only to private hospital. APOLO group of hospitals. RN Tagro Cardiac Hospital, Calcutta Online Telemedicine system, Ahmedabad WIPRO GE SIEMENS

15. Telemedicine in Chhattisgarh RAIPUR: In an attempt to provide timely and quality healthcare to patients, particularly gynaecological and surgical, in district hospitals, the Chhattisgarh government is all set to start telemedicine services, linking specialists from medical colleges to the doctors in districts via videoconferencing through Skype. As per the plan, the government proposes to link the five medical colleges in the state to the 27 district hospitals. However, initially this would begin in Raipur, enabling e doctors and other staffs in the district hospitals to seek advice from surgeons and gynaecologists through video conferences for complicated cases. Presently, the state has five medical colleges including Raipur, Bilaspur, Jagdalpur, Rajnandgaon and Raigarh. These would be connected to 27 district hospitals across the state. -

16. Barrier in Telemedicine practice Physician / Patient acceptance –Physician patient and have unique technology resources available in improve the patient physician relationship. It have been found that patient no difficulty in accepting telemedicine program. Availability of technology –The basic system need hardware , software and telecommunication link and can be recovered by nominal change to the patient and student in case of tele- education which would be much less than the physician travelling. Areas to the nearest health centre may not be early to poor i Accessibility – The accessibility of people living in remote and rural areas to the nearest health centre may not be early to poor infrastructure of road and transport. Reliability – Some health care professionals have about the quality of images transmitted for tele- consultation tele diagnosis. Funding issue – The insurance companies have to decide whether the cost of tele – health are should be reimbursed or not. Lack of trained manpower – Lack of training facility regards to application.

Legal and ethical –In case of a cross – border tele- consultation which country litigation laws will be applied in case – those of the country in which the patient is living or those of the remote physician.

The bottlenecks in the growth of telemedicine Indicate communication services in India – -

Lack of health infrastructure and services. Shortage of computer survey health care personnel. Lack of training facility regard with application.

17. Future -

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Home facility can be used for monitoring of personal health and early warning for speedy remedial action.VAirtual consultation rooms distant places can be set-up with equipment for body exam with teetile sensor. Tele –monitoring can be utilized for education and training including robotic surgery.

18. Summary – Telemedicine has a variety of applications in patient care, education, research, administration and public health. Clinician, health services researchers and others have been investigating the use of advanced telecommunication and information technologies to improve health care.

19. Conclusion –Telemedicine is about the practice of giving health care by using internet, video conferencing and so on. There is no need for the doctor and the patient to meet. Telemedicine must include audio visual and also data communication. If one of this element does not fulfil, it cannot being regard as telemedicine in our country. 20. Bibliography 1 2 3 4

Kour Brar Navdeep. Textbook of Advanced Nursing Practice. Edition third. Publication: Jaypee. Page no. 190-200. Erb and Kozier. Textbook of Foundation of Nursing. Concept, process and practice. Edition 8th .Publication: Pearson. Page no.152 P. Basheer, Shebeer. Textbook of Advanced Nursing Practice. Edition 2nd, Publication: Emmess. Page nu. 116-122.s Perry potter. Textbook of Foundation of Nursing. Edition 6th. Publication: Mosby. Page no. 152

5 6 7 8 9 10 11 12 13

Helen Harkreader Mary Ann Hogan. Textbook of fondamentals of nursig caring and clinical judgement. Edition 2nd. Publication: Saunders. Page nu. 1126. Lippincott Textbook of Basic Nursing. Edition 9th. Publication: Wolters Kluwer. Page nu. 22, 403, 1553, 1597. Judith M. Wilkinson. Leslie S. Treas. Textbook of fundamental of nursing. Edition 2nd. Publication: Davis. Pagenu.1006-1007. Http//www, the hindu.com/2008/01/22 stories. http//evisit.com, what is telemedicine. Searchealthit. Techtarget.com, defining. Health Magagin Elets Techno media. Journals sagepub.com. https://www.ncbi.nlm.nih.gob.

Bibliography S BOOKS

1 2 3 4 5 6 7

Kour Brar Navdeep. Textbook of Advanced Nursing Practice. Edition third. Publication: Jaypee. Page no. 190-200. Erb and Kozier. Textbook of Foundation of Nursing. Concept, process and practice. Edition 8th .Publication: Pearson. Page no.152 P. Basheer, Shebeer. Textbook of Advanced Nursing Practice. Edition 2nd, Publication: Emmess. Page nu. 116-122.s Perry potter. Textbook of Foundation of Nursing. Edition 6th. Publication: Mosby. Page no. 152 Helen Harkreader Mary Ann Hogan. Textbook of fondamentals of nursig caring and clinical judgement. Edition 2nd. Publication: Saunders. Page nu. 1126. Lippincott Textbook of Basic Nursing. Edition 9th. Publication: Wolters Kluwer. Page nu. 22, 403, 1553, 1597. Judith M. Wilkinson. Leslie S. Treas. Textbook of fundamental of nursing. Edition 2nd. Publication: Davis. Pagenu.1006-1007

.WEBSITES 8 9 10 11

Http//www, the hindu.com/2008/01/22 stories. http//evisit.com, what is telemedicine. Searchealthit. Techtarget.com, defining. Health Magagin Elets Techno media.

JOURNAL 12 Journals sagepub.com. 13 https://www.ncbi.nlm.nih.gob.

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GOVERNMENT COLLEGE OF NURSING JAGDALPUR

PRACTICE TEACHING ON SUBJECT

TELE MEDICINE ADVANCE NURSING PRACTICE

SUBMITTED TO

SUBMITTED BY

MADAM MS. SHRADHA ASHAWAN ASSISSTANT PRO. HOD.(CHN)

DELESH SAHU MSC NURSING 1SYEAR

GOVT. COLLEGE OF NURSING JAGDALPUR

GOVERNMENT COLLEGE OF NURSING JAGDALPUR

TOPIC PRESENTATION ON – QUALITATIVE RESEARCH DESIGN SUBJECT -

RESEARCH AND STATISTICS

SUBMITTED TO MADAM MRS VASHITA PADHIAR

SUBMITTED BY DELESH SAHU

ASSO. PRO.

MSC NURSING 1ST YEAR

MENTAL HEALTH NURSING

GOVT COLLEGE OF

GOVT. COLLEGE OF NURSING JAGDALPUR

NSG.JAGDALPUR