Nm comp and telemed

42
telemedicine narendra malhotra jaideep malhotra neharika malhotra bora rishabh bora www.rainbowhospitals.org www.malhotrahospitals.com

TAGS:

description

 

Transcript of Nm comp and telemed

Page 1: Nm comp and telemed

telemedicine

narendra malhotrajaideep malhotra

neharika malhotra borarishabh bora

www.rainbowhospitals.orgwww.malhotrahospitals.com

http://www.rainbowhospitals.org/
Page 2: Nm comp and telemed

What is TelemedicineWhat is Telemedicine

Telemedicine may be defined as the use of computers and telecommunication technologies to provide medical information and services from distant locations

Page 3: Nm comp and telemed

3ITU-T Workshop on Standardization in E-

Health, Geneva, 23-25 May 2003

• Telemedicine comprises all medical actions which extend the action space of health care professional beyond the face-to-face relationship with the patient in the direct surroundings.

• It is medicine at a distance.This includes health care delivery, diagnosis, consultation, treatment, education and the transfer of related data.

Page 4: Nm comp and telemed

Use of information and communication technologies:

i) To provide specialized health care consultation to patients in remote locations,

ii) To facilitate video-conferencing among health care experts for better treatment & care,

iii) To provide opportunities for continuing education of health

care personnel.

Objectives of Telemedicine

Page 5: Nm comp and telemed

Relevance of Telemedicine

Inadequate infrastructure in rural/district hospitals

Large number of indoor/outdoor patients requiring referral for specialized care

Low-availability of Health Experts in district/remote hospitals

Dearth of adequate opportunities for training or continuing Medical Education for Doctors in Rural/Remote Health facilities.

Page 6: Nm comp and telemed

Benefits of Telemedicine (I)Benefits to Patients:

Access to specialized health care services to under-served rural, semi-urban and remote areas,

Access to expertise of Medical Specialists to a larger population without physical referral,

Reduced visits to specialty hospitals for long term follow-up care for the aged and terminally ill patients.

Page 7: Nm comp and telemed

Benefits to Physicians: Improved diagnosis and better

treatment management

Access to computerized, comprehensive data (text, voice, images etc.) of patients – offline as well as real time

Quick and timely follow-up of patients discharged after palliative care

Continuing education or training through video conferencing periodically

Benefits of Telemedicine (II)

Page 8: Nm comp and telemed

Hospital and Insurance Benefits:

Significant reduction in unnecessary visits & hospitalization for specialized care at tertiary hospitals,

Earlier discharge of patients leading to shorter length of stay in hospitals,

Increase in the scope of services without creating physical infrastructure in remote hospitals

Benefits of Telemedicine (III)

Page 9: Nm comp and telemed

9ITU-T Workshop on Standardization in E-Health, Geneva, 23-25 May 2003

Implementation challenge

Page 10: Nm comp and telemed

Telemedicine : The Model Patient under treatment Physician treating the patient A remote telemedicine console

having audio visual and data conferencing facilitiesNodal HospitalNodal Hospital

Referral HospitalReferral Hospital

POTS / ISDN / LEASED LINE / VSAT

POTS / ISDN / LEASED LINE / VSAT

An expert / specialised doctor A central telemedicine server

having audio visual and data conferencing facility

Page 11: Nm comp and telemed

Different types of services Telecardiology

Teleradiology

Telepathology

Telepsychiatry

Early Warning System [ Prevention and control of endemic and infectious diseases ]

Page 12: Nm comp and telemed

ITU-T Workshop on Standardization in E-Health, Geneva, 23-25 May 2003

Benefits of E-Health

• Support for diagnostic (primary diagnostic, collaboration, 2nd opinion)

• Triage for evacuation of patients• Distant education• Enhancement of collaboration spirit• Diminution of isolation• Use of personal computers for health care.

Page 13: Nm comp and telemed

Telemedicine in India•Existing system limited only to private hospital

• CORPORATE Group of Hospitals.

• RN Tagore Cardiac Hospital, Calcutta. (Asia Heart Foundation)

• No Telemedicine system for public health care

•Corporate Sectors Offering Telemedicine Systems• APPOLO & OTHER CORPORATE Groups

• Online Telemedicine System, Ahmedabad.

• WIPRO GE

• SIEMENS

Page 14: Nm comp and telemed

Aim of the Telemedik SystemAim of the Telemedik System• Information management

– Patient information– Medical data (signs, symptoms, test reports, etc..)– Appointment scheduling– Archival and retrieval of patient records

• Low cost solution– Using ordinary telephone line

• Service to large population– Through public health care delivery systems

• Development of knowledge-based system– For decision support– For training and education

Page 15: Nm comp and telemed

Why it is relevant to our society

Poor infrastructure

Non-availability of experts (disparate

distribution)

Low doctor-patient ratio (large population)

Lack of proper medical education Special attention required for Public Health Care System

Page 16: Nm comp and telemed

ITU-T Workshop on Standardization in E-Health, Geneva, 23-25 May 2003

Medical constraints and challenges

• Need and will of cooperation between medical sites;

• Complementary function of involved institutions and organizations;

• Acceptance of technology and change of working environment;

• Interoperability issues ignored.

Page 17: Nm comp and telemed

Major Challenges

•Poor Data Communication Infrastructure.

•A Large Population Catered by Government Hospitals.

•System Features should be scalable.

•Cost of the system should be scalable.

Page 18: Nm comp and telemed

ITU-T Workshop on Standardization in E-Health, Geneva, 23-25 May 2003

Telecommunication constraints

• Minimum requirement is reliable telephone line at 19.2KBit/s

• Simultaneous Internet access recommended

• ISDN permits more advanced solutions like video-conferencing

• xDSL for the future.

Page 19: Nm comp and telemed

19ITU-T Workshop on Standardization in E-Health, Geneva, 23-25 May 2003

Few E-Health Standards applicable

• DICOM (Digital Communication Medicine) for medical imaging

• ITU H320/H120 for video-conferencing• Proprietary systems for “Store-And-Forward”• Proprietary interactive and collaborative systems

Page 20: Nm comp and telemed

Digital Imaging Communications in Medicine (DICOM )

originally the ACR-NEMA developed by American College of Radiology (ACR)

and the National Electrical Manufacturer's Association (NEMA)

provides standardised formats for image capture and storage coupled with a common information model specifying service definitions and protocols for communication

Page 21: Nm comp and telemed

Digital camera

Doctor / Patient

Scanner

Printer

ElectronicsMicroscop

e

ECG Machine

ElectronicsStethoscope

PSTN / Leased Line

/ ISDN / VSAT

Specialist Doctor

Digital Camera

Scanner

Printer

Web Cam

Web Cam

Nodal Center

Referral Center

System Schematic

http://www.miami-med.com/images/ECG-310A.gif
http://www.businesscomputersystem.com/flyerads/Fuji-Digital-Camera.jpg
http://www.linkz.freeserve.co.uk/images/printer.jpg
http://www.businesscomputersystem.com/flyerads/Fuji-Digital-Camera.jpg
http://www.businesscomputersystem.com/flyerads/Fuji-Digital-Camera.jpg
http://www.linkz.freeserve.co.uk/images/printer.jpg
Page 22: Nm comp and telemed

Requirement SpecificationRequirement Specification

Nodal HospitalNodal Hospital

Referral HospitalReferral Hospital

• A patient getting treated• A Doctor• A remote telemedicine console having audio visual and data conferencing facilities

• An expert/ specialized doctor• A central telemedicine server having audio visual and data conferencing facility

POTS / ISDN

Page 23: Nm comp and telemed

Sequence of OperationSequence of OperationPATIENT IN

Patient visits OPD Local Doctor checks up

Patient receives local treatment and not referred to telemedicine system

Patient referred to the Telemedicine system (some special investigations may be suggested)

Patient visits Telemedicine data-entry console.Operator entries patient record, data and images of test results, appointment date is fixed for online telemedicine session

OUT

OUT

Offline Data transferfrom Nodal Centre

Day

One

Page 24: Nm comp and telemed

Sequence of OperationSequence of Operation

Patient 1Patient 2Patient 3Patient 4

.

.

.

Online conference for the patient.

Patient, local doctors at the nodal hospital and specialist doctors at the referral hospital

Patient queue

IN OUT

Day

Tw

o

Page 25: Nm comp and telemed

25ITU-T Workshop on Standardization in E-

Health, Geneva, 23-25 May 2003

Concept of “Store and Forward”

RadiographScanner

PC

DocumentScanner

Page 26: Nm comp and telemed

Hardware ConfigurationHardware Configuration

Digital camera

Referral Hospital

Nodal Hospital

PSTN/ISDN/VSAT link

Scanner

PrinterModem

Modem

Microscope and other medical instruments

Video Conference

Video Conference

Telephone

Telephone

Page 27: Nm comp and telemed

Software ModulesSoftware Modules

Offline Activities

Online Activities

Page 28: Nm comp and telemed

ITU-T Workshop on Standardization in E-Health, Geneva, 23-25 May 2003

Videoconferencing

• Interactive• Well suited for seminars or special case discussion• Less adapted and expensive for routine work• Requires ISDN

Page 29: Nm comp and telemed

29ITU-T Workshop on Standardization in E-

Health, Geneva, 23-25 May 2003

Second opinion telemedicine concept

Telemedicine Center

Digitalisation

Radiologist

Pathologist

Other

Store & Forward Telemedicine

Internet/ISDN/Phone

Medical supervisionPatient Record and

Medical Images

Digitalisation

Private doctorSmall clinic

Page 30: Nm comp and telemed

The Data The Data• Data related to a patient’s personal information• Data related to a patients medical information• Data for patient management in Telemedicine• Data related to the doctors• Data for system management

Page 31: Nm comp and telemed

ImagesImages

Page 32: Nm comp and telemed

Vector DataVector Data

Page 33: Nm comp and telemed

GraphicsGraphics

Page 34: Nm comp and telemed

Video Clip for second opinion

Page 35: Nm comp and telemed
Page 36: Nm comp and telemed

Data related to the doctors

• Doctor’s personal information

• Unique Identification key

Page 37: Nm comp and telemed

38ITU-T Workshop on Standardization in E-Health, Geneva, 23-25 May 2003

Medical information on Internet

• Gives valuable on-line access to huge medical knowledge & databases.

• Lack of quality control-> www.hon.ch

• Language barrier. -> www.etho.org

Page 38: Nm comp and telemed

Nodal Hospital

Referral Centre

Writers Bldg.State

Switching Centre

DM OFFICEDistrict

Switch Centre

2 Mbps Optic

al Link WBSWAN

512 Kbps Leased Line

512 Kbps Leased Line

Schematic Diagram for Proposed Telemedicine using WBSWAN

Page 39: Nm comp and telemed

Telemedicine for Tropical Diseases

Page 40: Nm comp and telemed

…. way forward

1. Hand-holding support to Hospital administration for 3-4 years for stabilization of telemedicine services.

2. Integration of Telemedicine activities with Health Management Information System for regular reporting (preferably web-based)

3. Including Telemedicine activities in the performance appraisal of individuals and institutions.

4. Introducing Telemedicine (concept, technical aspects and implementation arrangements) as part of medical education & continuing medical education.

Page 41: Nm comp and telemed

“ Telemedicine: one small step for IT , a giant leap for Healthcare!” Paraphrasing Neil Armstrong,

Page 42: Nm comp and telemed

At raibbow hospitals Agra , we are in the process of establishing a tele med depttfor second opinions and for reportings

THANK YOU FOR HEARING ME OUT


French telemed 22 jan15 v2

French telemed 22 jan15 v2

Part number: 044991 Dacia Sandero (HB)M6 M8 M10 M12 M12x100/110 M14 M16 M10x1,25 M12x1,25 M12x1,5 9,5 Nm 23 Nm 46 Nm 79 Nm 125 Nm 195 Nm 49 Nm 87 Nm 83 Nm 14 Nm 34 Nm 68 Nm 117 Nm

Part number: 044991 Dacia Sandero (HB)M6 M8 M10 M12 M12x100/110 M14 M16 M10x1,25 M12x1,25 M12x1,5 9,5 Nm 23 Nm 46 Nm 79 Nm 125 Nm 195 Nm 49 Nm 87 Nm 83 Nm 14 Nm 34 Nm 68 Nm 117 Nm

,L~LogicScan Pg. 1.2-3 - TELEMED

,L~LogicScan Pg. 1.2-3 - TELEMED

Ward / Quartier 1...$K $K $K $ $K!C nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm …

Ward / Quartier 1...$K $K $K $ $K!C nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm …

Diagnostics for e-Healthcare James Jackson Managing Director SmartSensor telemed Ltd.

Diagnostics for e-Healthcare James Jackson Managing Director SmartSensor telemed Ltd.

J AME STR HPUB LI C O JK to Grade 8 175 B real y D iv , P ...kprcontentlibrary.kprdsb.ca:8080/docushare/dsweb... · nm nm nm nm nm nm nm nm nm nm nm nm nm n nm nm nm nm nm nm nm nmKenner

J AME STR HPUB LI C O JK to Grade 8 175 B real y D iv , P ...kprcontentlibrary.kprdsb.ca:8080/docushare/dsweb... · nm nm nm nm nm nm nm nm nm nm nm nm nm n nm nm nm nm nm nm nm nmKenner

Lawr enc , KSnm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm Õ" ñ k k k k ñ k s s s s s J^ L a k e View L ake Lake Alvamar K a n s a s r R i v e r Mary's Lake

Lawr enc , KSnm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm Õ" ñ k k k k ñ k s s s s s J^ L a k e View L ake Lake Alvamar K a n s a s r R i v e r Mary's Lake

Academic Advancement Network · homework and example writing efforts of various faculty, postdocs, and grad students involved in the ... COMP COMP COMP COMP COMP COMP COMP COMP COMP

Academic Advancement Network · homework and example writing efforts of various faculty, postdocs, and grad students involved in the ... COMP COMP COMP COMP COMP COMP COMP COMP COMP

Titanium Dioxide, NM-100, NM-101, NM-102, NM-103, NM-104, … · NM-102, NM-103, NM-104, NM-105: Characterisation and Physico- Chemical Properties JRC Repository: NM-series of Representative

Titanium Dioxide, NM-100, NM-101, NM-102, NM-103, NM-104, … · NM-102, NM-103, NM-104, NM-105: Characterisation and Physico- Chemical Properties JRC Repository: NM-series of Representative

SYRIA REFUGEE RESPONSE - reliefweb.intreliefweb.int/sites/reliefweb.int/files/resources/WASH_Presence... · nm nm nmn nm n nm nm nm nmnm n nm nm nm nm nm nm nmn nm nm nmnmn nnm nm

SYRIA REFUGEE RESPONSE - reliefweb.intreliefweb.int/sites/reliefweb.int/files/resources/WASH_Presence... · nm nm nmn nm n nm nm nm nmnm n nm nm nm nm nm nm nmn nm nm nmnmn nnm nm

References Telemedicine Technologiespbrandao/aulas/0910/TeleMed/slides/Telemed-tech… · Telemedicine Technologies 1 ... Nanorobot example ... o heart-rate and pulse oximeter o Led

References Telemedicine Technologiespbrandao/aulas/0910/TeleMed/slides/Telemed-tech… · Telemedicine Technologies 1 ... Nanorobot example ... o heart-rate and pulse oximeter o Led

Telemed HCV HIV Townshend Simsons

Telemed HCV HIV Townshend Simsons

geospasial.bnpb.go.idgeospasial.bnpb.go.id/.../PETA-SEBARAN-PENDIDIKAN-DI-SEKITAR-GUNUNG... · nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm

geospasial.bnpb.go.idgeospasial.bnpb.go.id/.../PETA-SEBARAN-PENDIDIKAN-DI-SEKITAR-GUNUNG... · nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm

Elementary NOTICE · nm nm nm nm nm nm nm nm nm nm nm nm Frey Ford Lewis Hayes Baker Pitner Bullard Acworth Kennesaw Picketts Mill Big Shanty McCallL Primary I 75 OL D 4 1 M A R S

Elementary NOTICE · nm nm nm nm nm nm nm nm nm nm nm nm Frey Ford Lewis Hayes Baker Pitner Bullard Acworth Kennesaw Picketts Mill Big Shanty McCallL Primary I 75 OL D 4 1 M A R S

GO Comp Comp

GO Comp Comp

2013 remote@e telemed

2013 remote@e telemed

l o u g h Legend - Lands of America · 2020. 7. 10. · "nm nmnm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm Þ B u l l T o n g u e C r e e k West E n d S l o u g h B

l o u g h Legend - Lands of America · 2020. 7. 10. · "nm nmnm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm Þ B u l l T o n g u e C r e e k West E n d S l o u g h B

TELEMED ultrasound ArtUs EXT · Open architecture Reliable, expandable, flexible. Delivering TELEMED quality and reliability, you can always expect more with the ArtUs EXT system.

TELEMED ultrasound ArtUs EXT · Open architecture Reliable, expandable, flexible. Delivering TELEMED quality and reliability, you can always expect more with the ArtUs EXT system.

ISTH telemed poster Final 6-01-2015 minor edits

ISTH telemed poster Final 6-01-2015 minor edits

USD 259 District Map...nn n n n n n n n n n n n n n n n n n n nm nmnm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nmn nm nmnm nm nm nmnnm

USD 259 District Map...nn n n n n n n n n n n n n n n n n n n nm nmnm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nm nmn nm nmnm nm nm nmnnm