March 24 2023
Reading time 12 minutes
Telemedicine is a field of healthcare that uses technology to provide medical care, transfer information and support educational tasks1. Portable devices help can make this a quick and accurate process, despite geographic and economic barriers.
Researchers divide the services provided using telemedicine into several types2:
Medical information is transmitted in real time. This includes video chat consultations where the patientconnects the hospital remotely. In another case the patient could be located in a clinic equipped with diagnostic equipment and medical staff. The nurse performs the examination, and the doctor evaluates the results remotely.
The doctor or patientcollects information about the illness; various test results, diagnostic images (such as CT scans or radiographs). The data is transferred to another specialist for evaluation.
Remote monitoring. The state of health is assessed over a long period of time using direct video surveillance or studying the results of remotely collected diagnostics.
Information systems find their application in various areas, such as cardiology, endocrinology, dermatology, neurology, psychiatry. Telemedicine allows to3:
monitor the patient’s condition after surgical interventions, for example, after the installation of pacemakers;
improve medical carefor chronic kidney disease, diabetes, bronchial asthma;
provide remote rehabilitation programs;
provide regular counseling for mental health problems.
Digitalized healthcare systems consist of several components 4:
Points of emergency medical care. They are based on ambulances, rural medical centers, ships and come equipped with telemedicine technologies that allow the exchange of data with the hospital.
Intensive care units. The condition of seriously ill patients is monitored and the information is shared with other specialists.
Telemonitoring at home. The patient has diagnostic devices connected to the telemedicine system at home. The readings are measured and sent to the doctor.
Uses its own information systemto interact with other members.
Communication channels. Communication standards and protocols ensure the transfer of secure data.
Telemedicine improves the quality and accessibility of medical care, allowing the healthcare system to significant amount of resources5.
A mobile telemedicine complex combines software, diagnostic equipment and medical procedures. It is distinguished by portability: it is capable of transferring data at a distance and providing qualified medical care to remote areas6.
Diagnostic complexes can be based on ground transport. For example, mobile clinics from Mayo Clinic are based on blue vans serving in several US states and equipped with the necessary medical equipment. Services include preventive check-ups, immunizations, testing for acute and chronic diseases7.
Technology provides continuity for medical care services7:
Mobile teams use the electronic health record (EHR) to learn about past appointments and add new data.
Telemedicine allows quick connection with other experts of the clinic.
Some consultations, such as pacemaker checks, are virtual.
Telemedicine is essential in regions where access to specialized medical care is no readily available. For example, India uses van-based mobile diagnostic systems with the support of the Center for the Development of Advanced Computing (C-DAC)8.
Each van is equipped as a high-tech clinic: with a computer, a videoconferencing system, medical equipment for instrumental and laboratory research. Patients can consult with a doctor via real-time video link, transmit diagnostic images, and work under EHR. Mobile telemedicine complexes are used for early detection of oncology and eye diseases8.
Ambulances are also equipped with telemedicine technologies. This is important when conducting urgent examinations away from the hospital. Portable systems required for this include a wireless modem or router, a power source, and a tablet with a mount. The ambulance team conducts a video consultation with a specialized doctor in order to make a decision on further transportation of the patient or adjust treatment tactics9,10.
Telemedicine is an important assistant on ships, where medical specialists can diagnose and treat seafarers in a remote format. Mobile telemedicine complexes, such as the Marine Doctor software developed by Italian scientists, bridges the gap between sea and land11:
Information about the sailor is entered into the system: height and weight, temperature, blood pressure and pulse, observed symptoms.
If necessary, an image, such as a photo of the injury, can also be included.
The doctor, located on land, analyzes the sent data and gives recommendations in the response message.
In severe cases, life-saving equipment can be requested to transport and disembark patients on shore 11.
The medical bag is first mentioned in the writings of Hippocrates around 350 BC. Over the millennia, its appearance and contents have changed, but the purpose has remained the same: it is held by the doctor to keep the necessary tools and medicines easily accessible12.
A mobile telemedicine complex that is installed inside a case pays tribute to traditions, adjusted for the achievements of our time. It includes instruments for measuring key clinical indicators and device support for information systems.
Compact telemedicine is in demand if the patient is located far from places where primary health care is available. Technological cases are essential part of NASA space programs for providing remote assistance to astronauts. The development has also been useful on Earth, for conducting diagnostics in rural areas of developing countries13.
Over the past decades, the potential range of tasks for mobile telemedicine complexes have expanded significantly. An example is the MDDC FAP from SberMedAI, which has been successfully piloted in 24 regions of the Russian Federation and has helped to conduct over 6,000 studies.
MDDC FAP is a hardware diagnostic complex enclosed in a secure case. It’s form makes it easy to transport.
The main part of the mobile telemedicine complex is a tablet computer that provides access to the MDDC FAP. Medical Digital Diagnostic Center (MDDC) is an information system that combines algorithms based on artificial intelligence (AI). Synchronization with MDDC expands diagnostic capabilities and speeds up data exchange between specialists.
The program interface includes several sections:
Patients. EHRs are displayed as a list. To find the one you need, enter your full name or SNILS insurance account number in the search line.
In this section, the doctor can add, delete and close appointments.
Here you can add new diagnostic procedures and view test results.
The MDDC FAP includes medical equipment for primary examination:
Urine analyzer. For express analysis, a special device and test strips are used.
Measures blood pressure and heart rate.
Blood analyzer. Assesses the level of cholesterol in the blood. For analysis, the kit includes a lancet and test strips.
Measures blood glucose levels.
ECG recorder. The doctor turns on the device, connects the sensors and launches the program on the computer. The ECG recording process is displayed on the screen. The AI creates a preliminary description of the electrocardiogram. The specialist verifies the AI’s conclusion AI and leaves recommendations.
The device measures body temperature.
Pulse oximeter. Measures the level of blood oxygen saturation.
Thermometer and pulse oximeter readings are entered manually. The data of other devices are automatically loaded into the information system.
The final stage of work with the MDDC FAP is creating a conclusion. Here, the doctor can use AI-based algorithms. For example, the TOP-3 service analyzes EHR and anamnesis data and offers the 3 most likely diagnoses according to ICD-10. The algorithm helps to draw a more accurate conclusion, saving time.
Mobile telemedicine complex allows monitoring at home. Tracking symptoms helps to control the illness and prevent possible complications. Telemonitoring is used in various conditions14:
high blood pressure;
weight loss and gain;
chronic obstructive pulmonary disease;
apnea (suspension of breathing) during sleep;
Benefits of using telemonitoring15:
saves time and resources that might have been spent traveling to the hospital;
improves access to medical carefor people with chronic diseases and older patients;
provides convenient way of service – video conferencing and devices that transfer data automatically.
The mobile telemedicine complex for home monitoring consists of two parts16,17,18,19,20:
Represented by special software or web applications. The patientaccesses it from his computer or smartphone. In some cases, the patient receives a tablet computer or a special case. Communication with the doctor is maintained through the program. One has to fill in a digital health diary, noting their indicators or symptoms and connect to video consultations.
Includes sensors and devices for measuring blood pressure, glucose levels, taking ECG and other indicators. Data is loaded into the system automatically or entered manually.
Smart watches are increasingly claiming the role of a mobile telemedicine complex. The device can evaluate heart rate, physical activity, posture, sleep quality. Special applications allow patients to collect, transfer and analyze data. Tracking biosignals improves the quality of medical care for neurological and cardiovascular diseases, as well as diabetes21.
A specialist can conduct consultations by phone, e-mail, via videoconference or using a special program on a computer or smartphone1.
Wireless technologies are used for data transmission in telemedicine22:
cellular mobile communications under 3G, 4G and 5G standards;
Wireless LAN: WLAN/IEEE 802.11 standard;
wearable computer network WBAN;
broadband wireless access: WiMAX/IEEE 802.16 standard;
cognitive radio network CRN.
Significant attention in telemedicine is paid to information security. It is important to ensure the confidentiality and integrity of data processed using a mobile telemedicine complex23. Various protection mechanisms are used, including multi-factor authentication, search for system vulnerabilities and data encryption24.
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Leo DG, Buckley BJR, Chowdhury M, Harrison SL, Isanejad M, Lip GYH, Wright DJ, Lane DA; TAILOR investigators. Interactive Remote Patient Monitoring Devices for Managing Chronic Health Conditions: Systematic Review and Meta-analysis. J Med Internet Res. 2022 Nov 3;24(11):e35508. doi: 10.2196/35508. PMID: 36326818; PMCID: PMC9673001.
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