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In a recent episode of House, the successful FOX TV show, Dr. House and his medical staff used video conferencing to aid a fellow doctor located at the South Pole to diagnose her symptoms after she falls gravely ill. Dr. House uses his laptop from home and an endpoint in the hospital to help Dr. Milton diagnose and treat herself, and eventually save her own life.

Spoiler from FOX for the House episode “Frozen”.

Video conferencing to the aid of telemedicine

Telemedicine - performing clinical medicine from afar, while medical information is transferred via telephone, internet or other means of communication, for the purpose of consulting, examining, or performing medical procedures remotely - has been around since the 1920s. In the past, telemedicine was simply two doctors discussing a case over the phone, or exchanging medical files via fax or e-mail. But now, high definition video conferencing equipment enables real applications in healthcare.

“HealthPresence“, for instance, is a Cisco Telepresence system tailored for healthcare that is used by the Scottish Centre for TeleHealth (SCT). It uses a small telepresence room, a range of medical equipment and a handheld camera. The medical professional responsible for the system can conduct the appropriate tests on a patient under the guidance of an expert doctor, even if this expert is a world away (video)

Cisco HealthPresence in SCT. Source: Cisco

Data and images taken by the medical professional are sent over the conferencing link in real-time to the expert doctor. The handheld camera can be used to zoom in on the patient’s body when needed. SCT claims that the visual quality is good enough to diagnose patients accurately in many cases. The head of SCT, Gordon Peterkin, says that “in 10 years’ time, we would like this to be ubiquitous and the standard method of treatment”.

I have discussed here before how video conferencing can practically change lives. The hearing impaired can communicate with the hearing world, rural areas are now closer to the metropolis. And now patients with disabilities or those living in remote areas can receive expert medical observations and the same quality of treatment as any other patient anyplace else.

Telemedicine Video Conferencing in an Ohio Children’s Hospital. Source: Cisco

Since specialists are in short supply in many remote regions, telemedicine is increasingly filling in where “traditional” treatment leaves off. Video conferencing for medical applications is now frequently used in domains such as dermatology, cardiology, wound care, neurology, drug screening and more. Remote surgery (Telesurgery), remote ultrasonography and remote specimen analysis are all being conducted in many hospitals around the world. The efficacy of treatment seems to be almost the same as face-to-face, says Dr. Umar Latif of the Dallas VA Medical Center, who has been offering psychiatric sessions over video for patients in remote areas.

Unified medicine? Why not…

Of course, telemedicine should not stop at video conferencing. Unified communication can, and should, be the next big thing in medicine as well. Doctors will be able to communicate with patients and colleagues anywhere using any means they choose (mobile, VoIP, e-mail, IM). They can use presence to locate domain experts in real-time and save valuable time; they can use their handheld device (be it a smartphone, pocket PC, laptop) to examine x-ray images, blood tests, even real-time physical indicators.

Unified communication can also serve as a means for training young doctors and nurses in small, remote hospitals where relevant experts are absent. By watching medical operations via video conferencing, by receiving guidance from remote experts and watching streamed lectures by experts elsewhere, medical staff can now specialize in various medical areas that do not necessarily exist in their geographical location.

Illustration source: NIST

Great examples for the penetration of UC into telemedicine are already out there:

• Health First, a not-for-profit health care provider in Florida, uses videoconferencing and data collaboration to knit multiple sites into one community and broadcast company-wide meetings across the organization.
• German private hospital chain Asklepios is installing web-based video conferencing equipment for all its medical doctors, so that they can get additional support or expertise from colleagues.
• Hospitals in Canada teamed up to develop a “virtual emergency room” that will allow each partnering hospital to access a roster of medical experts, thereby increasing the ability to diagnose, treat and follow up on patients.
• Two-way video links between the University Medical Center in Tuscon, Arizona and the city’s 17 ambulances allows ER doctors to treat patients while they are being rushed to hospital, including telemetry, remote x-ray and ultrasound, and more.

UC can also change the treatment and conduct of patients. A patient should be able to choose a medical expert regardless of physical distance. A patient should also be able to conduct various medical tests at home and send the data to experts via the internet. The patient’s medical history should be stored digitally and transferred to any location in real-time when needed.

(CC)

Telemedicine? Think standardization!

In other words, telemedicine will facilitate the practice of medicine both for physicians and patients. No wonder that a recent Frost & Sullivan Survey on the European telemedicine market found that this market generated revenues of around $118 million in 2007 and could reach twice that amount by 2014.  “Technological developments have the potential to not only alleviate the current growing pains”, says Frost & Sullivan research analysts Janani Narasimhan.

These technological developments involve mainly high bandwidth infrastructure, which is available for professional and personal use in many countries, and high definition video conferencing systems, which enhance the ability to develop effective telemedicine systems. High bandwidth, high definition video conferencing is vital because details are critical in clinical medicine; much more so than those CP layouts.

Frost & Sullivan officials say that the main hurdles telemedicine faces are the acceptance of the new technologies by physicians and the pressing need for standards in this industry. Sounds familiar, doesn’t it?! Just like with other innovations in regard to unified communication (presence, telepresence or video conferencing), standardization and acceptance of new technologies are vital for a successful revolution (or evolution, if you insist…).