MASINDE PETER.2018/MMED/010/PSFINAL EXAM.QN.4. ASSESS THE ROLE OF COMPUTER SCIENCE IN TELEHEALTH AND TELEMEDICINE IMPLEMENTATION.Abstract: The World Health Organization (WHO) defines telemedicine as The delivery of healthcare services, where distance is a critical factor, by all healthcare professionals using information and communication technologies for the exchange of valid information for diagnosis, treatment and prevention of disease and injuries, research and evaluation and for the continuing education of healthcare providers, all in the interests of advancing the health of individuals and their communities.
It can provide rural health care in the most remote areas.Telemedicine and Telehealth services can be implemented using computer science (information technology) in the form of 3G/4G internet, broad bandwidth, computer communication and mobile network.This paper explains the role of internet, computer communication with Healthcare management in the implementation of Telemedicine and Telehealth. The ISRO (Indian space research organization) supports Telemedicine service using 3G internet in rural area and development of telemedicine service fulfilment 95% using computer communication network.
In development of 22% in Telemedicine service in 2000 using 2G internet service developed up to 95% by using 3G internet in 2014.Keywords: Telemedicine services, Telehealth, internet , computer and mobile communication network , Information Technology ,online health, AIHW(Australian institute of health and welfare),EMR(Electronic medical record),NIC(National informatics system),ISRO(Indian space research organization),INSAT(Indian satellite system),WHO(World health organization). INTRODUCTIONInformation, communication and Technology as a form of computer science enables the implementation of Telemedicine/Telehealth through communication and sharing of medical information in electronic form, and thus facilitate access to remote expertise. A physician located far from a reference center can consult his colleagues remotely in order to solve a difficult case, follow a continuing education course over the Internet, or access medical information from digital libraries. Similarly information technology can be used to facilitate exchanges between centers of medical expertise, at a national or international level. The potential of Telemedicine/Telehealth to facilitate access to healthcare in underprivileged population if absorbed into existing healthcare delivery system is achieved through information and communication technology. A case study, in West Africa (Mali 2003) where telemedicine network was in productive use for 18 months during a pilot project revealed enabling of various collaboration channels, including North-South, South-South, and South-North distance learning and teleconsultations. OBJECTIVE/AIM.The role of information and communication technology (a form of computer science) in Telehealth and Telemedicine implementation.LITERATURE.The implementation of telemedicine/Telehealth systems in Australia is now feasible due to developments in communications and computer technology.(Australian institute of health and welfare, march 2018),Telemedicine involves the linking of doctors, nurses, patients and specialists using telecommunications with additional facilities such as slow scan television and voice conferences. Computer based systems can also provide access to diagnostic images and pathology reports as well as computer based information retrieval systems. Telemedicine has a potential to impact on both medical education and clinical support systems.Aspects of telemedicine are already being implemented in Australia, including Teleradiology systems and direct reporting of pathology results to general practitioners.New technologies are emerging in the use of telemedicine for home monitoring activities. Given the prevalence of conditions such as cardiac disease in the population, there is a need for further study of these developments.Another study in West Africa (Mali 2003) which was conducted over 18 months, the project enabled the development of a functional national telemedicine network, which connects several health institutions in Bamako, Segou and Tombouctou, where medical teams have been trained for the use of Internet-based tools. The medical Web portal was in place. Webcasting systems for distance learning were implemented in Geneva and Bamako. Continuing medical education courses were broadcast on a weekly basis. Several teleconsultations took place, to follow patients that were operated in Geneva and then returned to Mali. The teleconsultation system was also used to select appropriate cases and guide their work-up in order to optimize patient’s evacuation to hospitals in the North or to prepare humanitarian missions. The number of these consultations was limited by the number of partners in the network.Another article published in Indian J community Med.2015 (PMC) revealed that National Task Force on Telemedicine was constituted in September 2005. Presently, Satellite Telemedicine Network is working in India through Indian Satellite System (INSAT) in 439 nodes across the country through 17 Mobile vans.Telemedicine has reduced distance, saved time, reduced the cost of treatment and improved prognosis due to access to standard treatment for rural population to travel to super specialty hospitals in the cities. Critical care monitoring, where it is not possible to transfer the patient, can also be done with the help of telemedicine. It also helps in remote training of medical students/paramedical staff by experts in the field, provides updated health information to health care workers and patients, decreases response time for the management of an epidemic/outbreak or a disaster, and helps in transmission of medical images for diagnosis, exchanging health services, or live education via videoconference.IT network connecting 776 sites in states/district headquarters and premier institutes has been established with the help of National Informatics Centre (NIC) and Indian Space Research Organization (ISRO) for data entry, training, video conferencing, and outbreak discussion.On an average, 20-30 outbreaks were reported every week by the States. A total of 553, 799, 990, and 1675 outbreaks were reported in the year 2008, 2009, 2010, and 2011, respectively. In 2012, 335 outbreaks were reported until 1st April. Apart from this, media scanning and verification cell established in July 2008 at National Center for Disease Control, New Delhi detects and shares media alerts with the concerned states/districts for verification and response.A study published in Teleradiology Africa/Asia 2017 revealed that telemedicine still faces several challenges in Africa including; lack of broadband infrastructure, high maintenance and support costs, poor staffing and training ,user acceptance and cultural factors. Under the Pan-Africa e-network project and its contribution towards Telemedicine implementation, patient-end locations have been set up in 11 Indian super specialty hospitals. These have been connected to 33 patient-end hospitals in Africa. Regular telemedicine consultations have already started in some of the countries. Burundi, Ivory Coast, Djibouti, Eritrea, Libya, Malawi, Mozambique, Somalia, and Uganda were among other countries that formally joined the network. Over 1700 students from several African countries had registered with the Indian universities for the various courses being offered under the tele-education component of the Project.Nearly 700 CME (Continuing Medical Education) lectures were conducted through regular telemedical consultations between the African doctors and the Indian specialists.Methods.Computer communication methodology i.e cloud computing technology supports increasing large number of big data and solve problem of data integration.A project for the development of a national telemedicine network in Mali was initiated in 2001, using internet-based technologies for distance learning and teleconsultations.Results/discussion.It was found that the implementation of telemedicine systems in Australia was feasible(AIHW ,march 2018) due to the great developments in communications and computer technology, evidenced from the implementation of telemedicine aspects including Teleradiology systems and direct reporting of pathology results to general practitioners. And new technologies are emerging in the use of telemedicine/Telehealth for home monitoring activities, given the prevalence of conditions such as cardiac disease in the population.Under the Pan-Africa e-network project and its contribution towards Telemedicine implementation (Teleradiology Africa/Asia 2017), revealed that telemedicine still faces several challenges in Africa including; lack of broadband infrastructure, high maintenance and support costs, poor staffing and training ,user acceptance and cultural factors. Over 1700 students from several African countries registered in Indian universities for the various courses being offered under the tele-education component of the Project.Nearly 700 CME (Continuing Medical Education) lectures were conducted through regular telemedical consultations between the African doctors and the Indian specialists.In India, Indian J community Med.2015 (PMC) IT network connecting 776 sites in states/district headquarters and premier institutes was established with the help of National Informatics Centre (NIC) and Indian Space Research Organization (ISRO) for data entry, training, video conferencing, and outbreak discussion.On an average, 20-30 outbreaks were reported every week by the States. A total of 553, 799, 990, and 1675 outbreaks were reported in the year 2008, 2009, 2010, and 2011, respectively. In 2012, 335 outbreaks were reported until 1st April. In West Africa (Mali 2003) telemedicine network was found to be productive during the pilot study for 18 months and enabled various collaboration channels, including North-South, South-South, and South-North distance learning and teleconsultations.ConclusionTelemedicine still faces several challenges in Africa including; lack of broadband infrastructure, high maintenance and support costs, poor staffing and training ,user acceptance and cultural factors.The implementation of telemedicine systems in countries like Australia, Netherlands, USA with well developed communications and computer technology is now feasible. Programs and centers of excellence related to medical information technology and medical e-Learning should be fostered globally.Recommendations.Longer-term planning is required, and our health care budgets must incorporate telemedicine as part of regular operating expenses.Technical constraints, including connectivity, bandwidth provision, and reliability, also need to be taken care of along with availability of health professionals for correct diagnosis and treatment.The time has come to recruit, much as we do with researchers, for telemedicine expertise.References.Panth M, Acharya AS. The unprecedented role of computers in improvement and transformation of public health: an emerging priority. Indian J Community Med. 2015 Jan-Mar;40(1):8-13. doi: 10.4103/0970-0218.149262. PubMed PMID: 25657506; PubMed Central PMCID: PMC4317987.Geissbuhler A, Ly O, Lovis C, L’Haire JF. Telemedicine in Western Africa: lessons learned from a pilot project in Mali, perspectives and recommendations. 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