This paper is about telemedicine which is a relatively new trend in the healthcare sector. It is one of the numerous products of technological advancements and governments all over the world are seeking to improve and modernize their healthcare deliveries through it. It acts as the confluence of information, medicine and telecommunication technology. Telemedicine is projected to emerge as one of the forces which will greatly enhance healthcare delivery. According to Sood and Bhatia (2005), telemedicine has emerged as a technological takeaway for the industrialized nations. The developing nations are equally recognizing the significant role it plays in enhancing healthcare access and improving care. Its significant is more pronounced in countries where there are inadequate and inefficient health care facilities where it serves to bridge the gap between the supply and demand (Sood & Bhatia, 2005). This paper will explain how telemedicine technology works, the problem it's designed to solve, its limitations and a personal assessment of its prospects for its success in the market place. By definition, telemedicine is the provision of healthcare and healthcare information exchange across distances. It may also be shortly defined as medicine at a distance (Wootton & Patterson, 2006). Telemedicine therefore entails the complete range of activities which includes diagnosis, treatment and disease prevention, ongoing education of providers of healthcare and consumers as well as research and evaluation. Telemedicine is divided into store-and-forward and realtime categories. The latter involves synchronous interaction between the concerned parties. The parties may be a patient and a healthcare professional where they interact through video conferencing. Store-and-forward telemedicine category is an asynchronous interaction (Wootton & Patterson, 2006). In this mode, a question may be transmitted by a referrer and then an answer is relayed back by a specialist at his or her own convenient time. A good example is the e-mail. For an effective working of telemedicine system, there must be the personnel and liberal perseverance measures besides technology.
A committed personnel is required in a real clinical situation where for a telemedicine system to work effectively. Both ends of the telemedicine link require the expertise of an individual capable of undertaking clinical components as needed. On one end, there must be individuals capable of handling patient contact needed for the system. This therefore requires them to be trained on the same. The end of the system requires an appropriate personnel and reliable equipments. The technology used should also be reliable to avoid breaking the chain and consequently breaking the link. Lastly, a telemedicine system requires a committed and dedicated person who possesses the perseverance to conquer the inertia characterizing many clinical routines. The individual should also possess the ability to steer the system until it achieves its objectives. He helps in driving implementation and dealing with emerging problems throughout the implementation process (Wootton & Patterson, 2006). There are three categories of technology required for a successful telemedicine link. These are telecommunication link required to send information between the sites, equipment needed to retain the clinical information at every site and the equipment to show the information at the respective sites. The choice of telecommunication network and equipment to be used in telemedicine is dependent on the nature of information to be sent between the respective sites. In this regard, the factors to be borne in mind include quantity of the information to be transmitted, information type and privacy and security issues. Varying clinical situations elicit different kinds of clinical information. Some cases may require transmission of simple information like metabolite concentration while other may require subtle and qualitative information like psychiatric assessments. In this case therefore, it important to assess the clinical needs of any telemedicine task before deciding on the equipment to be used. On the quantity of information aspect, it's important to determine the information quantity which can be transmitted between the telemedicine project sites and the appropriate timeframe which the information must be transmitted to attain the projected clinical goals (Wootton & Patterson, 2006). There are numerous categories of information which are utilized in telemedicine. These are documents, still images, electronic media records, video, video conferencing and audio. Documents include letters, reports and statistical medical records which can be sent in digital form. Electronic media records are replacing paper based records gradually though their effectiveness is still to be honed. Audio information is transmitted over the radio or by telephone. The above modes of information transmission use digital telecommunications. However, normal telephone network can be used in transmitting video pictures though the picture quality will be compromised due to excessive image compression. Decisions on methods of transmission are guided by factors such as service availability, cost, bandwidth, quality and reliability of service. Bandwidth is a communication medium's data-carrying capacity (Wootton & Patterson, 2006). Notably, internet is also used in telemedicine where it offers accessibility advantage. This is because as long as one can assess the internet, reaching the required sites is not a problem. This mode of information transmission is very useful also in instances where a clinician may need to access some data from home prior to giving clinical advice. It plays a very vital role in enabling transmissions in remote areas where communication means are limited. Internet use also provides a VPN (Virtual private Network) which securely links sites. Mobile phones are also being used in information transmission in telemedicine. They are capable of transmitting digital data at relatively low data transfer rates. They also help in connecting with a specific person who is travelling. Other methods of transmissions include satellite, Asynchronous Transfer Mode (ATM), ISDN, Digital subscriber lines (DSL) and microwave (Wootton & Patterson, 2006). After transmission, the information will be displayed on the other end depending on the original format used in its capture. For instance audio information is displayed in sound form. Most importantly, for a telemedicine system to work effectively the users must be sufficiently trained.
Telemedicine is designed to overcome distance barrier in the delivery of healthcare services. It has alleviated the plight of the underserved especially those in remote areas where quality healthcare was initially inexperienced. Telemedicine is also designed to ensure that clinicians share information easily in their efforts to manage unusual medical cases. This will be very hard in absence of telemedicine because it will involve a lot of travelling and appointments. The clinicians can also work together collaboratively for quality healthcare services because they can easily share information amongst themselves. For example a clinician may send a digital image of an X-ray to another specialist through e-mail to help in diagnosis (Smith et al, 2005). It is also designed to help in delivering workshops and lectures to multiple sites suing methods like web casting, teleconferencing and videoconferencing. A pre-recorded tape on a lecture contents may be delivered to a group of students at a site in a remote location. Lastly, telemedicine solves the problem of interviewing international candidates to fill any a medical position. It also designed to facilitate constant contact among regional sites for various kinds of telemedicine activities (Smith et al, 2005). One of the limitations of telemedicine is that not every medical condition is diagnosable through a TV screen or other methods of transmission. Again, many clinicians will be less confident in their diagnosis when working via TV cameras. Others will be held back by the idea of being sued after making a mistake when relying on the information screened. Another limitation of telemedicine is that it can't transmit the sense of touch. This limits the accuracy of certain medical fields like dermatology which prompts touching to make viable diagnosis. The technology is also very costly especially the equipment and their installation (Misra et al, 2005). It's also limited in terms of reimbursement policies (Reed, 2005). The technology also facilitates poor patient-carer relationship because of its distant communication basis. Telemedicine may not be a perfect solution but it has very important benefits. It can be considered as a breakthrough in the medical field. Each new technology has its benefits and limitations and creates some problems alongside the numerous benefits it presents. This is not different with telemedicine. Conclusively, telemedicine is set to expand and gain new dimensions as technology advances. Its popularity is also set to spread as it overcomes some of its limitations. Its reliability is also expected to improve, an important factor in crediting its usefulness. Its popularity in the rural areas especially in the developing countries where quality of healthcare has been very low is poised to spread. Its convenience is expected to win people's confidence despite the limitation of wrong diagnosis. However, future problems relating to data security are also expected to increase under the same impetus of technological advancement. Basically, telemedicine's success in the market place will improve into the future.