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Telemedicine and E-health - ICT to make people better more quickly

Telemedicine and E-health - ICT to make people better more quickly. Dr Jim Briggs University of Portsmouth Talk given at the ICT Study Day 7th December 2004. Contents. Who am I and where do I work? Definitions Types of telemedicine Case studies E-health Unanswered questions. Who am I?.

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Telemedicine and E-health - ICT to make people better more quickly

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  1. Telemedicine and E-health -ICT to make people better more quickly Dr Jim BriggsUniversity of Portsmouth Talk given at the ICT Study Day7th December 2004

  2. Contents • Who am I and where do I work? • Definitions • Types of telemedicine • Case studies • E-health • Unanswered questions

  3. Who am I? • Dr Jim Briggs • Principal Lecturer in Information Systems and Computer Applications • Leader of the Healthcare Computing Group • Director of the UK Telemedicine and E‑health Information Service (TEIS)

  4. University of Portsmouth Medium-sized university Mainly city-centre location Lots of new student accommodation Excellent social life Excellent study facilities By the sea 30 courses in the computing/IT field Computer Engineering Computer Science Software Engineering Information Systems Animation, Games, ET Mobile/wireless Website http://www.port.ac.uk Where do I work?

  5. Telemedicine and E-health

  6. Telemedicine: medicine at a distance cf television, telephone, etc. E-health: health services delivered electronically cf E-commerce, E-learning, E-government, etc. Definitions

  7. Interaction style real-time (e.g. videoconferencing) store-and-forward (e.g. email) Data types text (e.g. patient's notes) image (e.g. x-ray) Equipment general purpose (e.g. PCs) specialist (e.g. electronic stethoscope) http://jhi.sagepub.com/cgi/content/abstract/7/3-4/222 Characteristics of tm systems

  8. Case study 1: Cornwall MIUs

  9. Case study 1 cont. • Minor Injury Units: • replacing "unviable" accident & emergency departments • nurse led • deal with "straight-forward" problems • Linked to central A&E department by video link to provide expert backup • http://www.bthealth.com/casestdy/cstudy/case11.htm

  10. Case study 2: ambulance links

  11. Case study 2 cont. • ECG, etc. links from ambulance to hospital • Expert backup for paramedics • Reducing "call to needle" time for rural heart attack patients • Dundee study reduced average time from 125 to 52 minutes [Pedley et al; BMJ 2003] • Also, advance warning to A&E staff of details of incoming cases • http://www.rcsed.ac.uk/fellows/bcpaterson/chest_pain.htm

  12. Case study 3: dermatology

  13. Case study 3 cont. • Overload on specialist dermatologists - long waiting lists for referrals • tds Telemedicine Ltd. provides a commercial service • specially trained nurses take digital photos • specialist software routes to consultant dermatologists (anywhere in UK) for diagnosis • consultant can work from home • tds replaces local consultant but not totally • http://www.tds-telemed.com/

  14. Case study 4: WorldCare

  15. Case study 4 cont. • Consortium of 4 big American hospitals • Provide "second opinion" service worldwide (20 countries) • tele-radiology • tele-pathology • patient management consultation • Local physician remains responsible • http://www.worldcare.com/

  16. Case study 5: NHS Direct • Biggest telemedicine project in the world • Mainly telephone service • Expanding to: • web • online diagnosis for common conditions • health encyclopaedia • my NHS healthspace (personal info portal): news, reminders, knowledge • digital TV • http://www.nhsdirect.nhs.uk/

  17. E-health - the future of health? Making health care more easily accessible to the patient

  18. The banking metaphor • Most transactions carried out by the customer • Centralisation of specialist services • Decentralisation of non-specialist services

  19. Integration of IT into business sectors Public Services(Health…) Business Services(Banks) Integration of IT Manufacturing 1980 1990 2000 Jean-Claude Healy May 2000 IT as a gadget Trojan horse: networks, … Full Integration of IT into Business (Organisational, Legal) Re-engineering of the system

  20. Are hospitals a thing of the past?

  21. New sources of "health" 1

  22. New sources of "health" 2

  23. New sources of "health" 3

  24. e-health - Busan, S Korea • Medical Tourism • 2 hours by air for 2 billion people • 1% with disposable income = 20 million • Cardiac - Cancer - Mental Health • Costs can be competitive • Popular tourist resort for families

  25. Some questions left unanswered

  26. Medico-legal/ethical issues • Who is (legally) responsible for the patient's treatment? • What country's laws apply? • Can a correct diagnosis be made by telemedicine?

  27. Economics of telemedicine • Communication is getting faster and cheaper • Equipment is getting smaller (more mobile) and cheaper • People costs are rising • How do we adapt? • Who pays?

  28. What makes tm a success? • Why has telemedicine caught on in some disciplines and some places, but not in others?

  29. Which is the future of health? www.teis.nhs.uk

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