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1. VIDEO1

2. TELE MEDICINE
Ms. Alisha Rijal
Msc. Nursing First Year

3. OBJECTIVES
 Introduction
 Definition
 Key terms
 History
 Mode of action
 Types
 Indian perspective
 Applications
 Merits/ demerits
 Introduction
 Definition
 Principles
 Scope of practice
 Application
 Merits and demerits
TELEMEDICINE TELENURSING

4. INTRODUCTION
 Tele medicine: refers to use of Tele communication for diagnosis
and treatment of disease
• Emergent mode of delivery of health care at distance
• Telemedicine provides healthcare where there is none and
improves the health care where there is some

5. CONTD…
 One way to bring / provide access to quality health care to
under-served rural & urban masses
 It is part of medical specialty
 Use of it rapidly increasing

6. DEFINITION
The practice of medicine over a distance where the patient
and doctor interact remotely, usually using a computer and
computer- mounted camera.
- (Medical Dictionary for the Health Profession and
Nursing)

7. CONTD…
Tele medicine is the use of electronic information and
communications technologies to provide and support health
care when distance separates the participants …
- (Institute of Medicine, 1996)

8. CONTD…
The use of two way television communication by which two or
more physicians can consult on a patient. The consulting
physicians have access to the diagnostics information as well
as the ability to view and question the patient directly before
making a diagnosis or offering a professional opinion.
- (Mosby’s Dental Dictionary)

9. CONTD…
Tele communications Technology
+
Medicine

10. KEY TERMS USED
 Tele health
 Home tele health
 Tele monitoring

11. KEY TERMS CONTD….
 Tele pharmacy
 Tele psychiatry
 Tele radiology
 Tele pathology

12. HISTORY OF TELE MEDICINE
 Earlier, African villagers
 1900s

13. CONTD…
 1906
 1920s

14. CONTD…
 1924

15. CONTD…
 1955
 1967

16. CONTD…
 1970s satellite telemedicine via ATS-6 satellite
o 1971

17. CONTD…
 1972 TV

18. CONTD…
 1989
 1990
First consult, June 1990

19. CONTD…
 2001:
 2002:

20. CONTD….
 2003:
 2004:
 2005:

21. CONTD….
 2006

22. PRINCIPLES OF TELE MEDICINE
1. Telemedicine applications and sites should be selected
pragmatically, rather than philosophically
2. Clinician drivers and telemedicine users must own the
systems
3. Telemedicine management and support should be from the
‘bottom up’, rather than from the ‘top down’
4. The technology should be as user-friendly as possible

23. CONTD…
5. Telemedicine users must be well trained and supported, both
technically and professionally
6. Telemedicine applications should be evaluated in a clinically
appropriate and user-friendly manner
7. Information about the development of telemedicine must be
shared

24. MODE OF ACTION

25. District Client Station
Point to point System
Patient end
Doctor end

26. Point-to-Multipoint System Configuration
Doctor-End Doctor-End Doctor-End
Server Patient-End
Super Specialty Hospital Rural/District Hospital

27. POINT TO MULTIPOINT SYSTEM

28. TYPES OF TELE MEDICINE

29. REAL TIME TELE MEDICINE
 Synchronous
 Simple to complex
 Requirements:
 Both party at a time
 Communication links
 Peripheral devices
 Video

30. STORE AND FORWARD TELE MEDICINE
 Asynchronous
 Generally simple
 Requirements:
 Only patient needed at a time
 A structure medical record in electronic form

31. TELE MEDICINE INITIATIVES IN INDIA
 India characterized by low penetration of healthcare services
90% of secondary & tertiary healthcare facilities in cities and
towns away from rural India where 68% of population lives.
• Primary health care facilities for rural population highly
inadequate.

32. CONTD…
 Around 75% of qualified consulting doctors practice in urban
centers and 23% in semi urban areas and 2% from rural areas
whereas majority of the patient come from rural areas.
 Hospital bed 1000 people is 0.19 in rural and 2.2 in urban areas.

33. CURRENT EFFORTS
 Many programs worldwide using variety of telemedicine
technologies
Some of them are:
• Dept. of Information Technology
• Indian Space Research Organization
• Apollo Hospitals
• Asia Heart Foundation
• State governments

34. TELE MEDICINE APPLICATIONS
 Telemedicine

35. TELEMEDICINE
BENEFITS AND CHALLENGES
35
“It is an amazing invention, but who would ever want to use one”
Rutherford Hayes, 1882
on the using telephone for the first time

36. MERITS AND DEMERITS OF TELEMEDICINE
 Video 2

 metacards

37. BENEFITS
PATIENT PERSPECTIVE
37
Access: Time, Travel, Expense
Health Provider Collaboration
Enhanced Communications
TV & Computer Applications common and non-threatening
Added attention may enhance confidence that all that can be done is being done
Increase patient s’ satisfaction with care

38. BENEFITS
PROVIDER PERSPECTIVE
 Communication/Collaboration with specialists
 Improves professional education
 More efficient and effective use of medical and technological
resources
 Life Long Learning
 Saves time, travel to outreach clinics

39. DEMERITS
 leaflets

40. TELE NURSING

41. INTRODUCTION
 Nurses acting as critical link
 Began long ago as telephone and fax as communication
tools
 Changes the method of services delivery but not the nature
of nursing practice

42. DEFINITION
The practice of nursing over a distance using
telecommunication technology .
(National Council of State Boards of Nursing NCSBN,
1997)

43. CONTD…
 Tele Nursing as a subset of tele health in which the focus is on
the specified profession’s practice.
-- (American Nursing Association)

44. PRINCIPLES OF TELE NURSING
 leaflet

45. SCOPE OF PRACTICE
 Home care
 Case management
 Telephone triage

46. APPLICATIONS OF TELE NURSING
 Available in the home, hospital
 Interactive video system
 Helps to be active participation in care
 Accurate information provided
 Continuing of care
 Cost effective

47. ADVANTAGES
 Increase public access to health care
 Provide access in rural areas
 Decrease wait times
 Decrease unnecessary hospital visits
 Decrease Healthcare costs
 Increase continuity of care
 Increase patient compliance with aftercare
 Immediacy of information provided to clients to help them meet
needs

48. DISADVANTAGES
 Decreased face-to-face interaction
 Risk of decreasing quality of care
 Concerns with security
 Concerns with maintaining confidentiality

49. CONTD…
 To step outside their scope of practice

50.  SUMMARY
 JOURNAL ABSTRACT RELATED TO TELEMEDICINE
 CONCLUSION
 BIBILOGRAPHY