Telemedicine

Telemedicine is practiced on the basis of two concepts: real time (synchronous) and store-and-forward (asynchronous).

Real-time telemedicine could be as simple as a telephone call or as complex as robotic surgery. It requires the presence of both parties at the same time and a communications link between them that allows a real-time interaction to take place.

Video-conferencing equipment is one of the most common forms of technologies used in synchronous telemedicine. There are also peripheral devices, attached to computers or the video-conferencing equipment, which can aid in an interactive examination.

For instance, a tele-otoscope allows a remote physician to 'see' inside a patient's ear; a tele-stethoscope allows the consulting remote physician to hear the patient's heartbeat. Medical specialties conducive to this kind of consultation include psychiatry, internal medicine, rehabilitation, cardiology, pediatrics, obstetrics and gynecology and neurology.

Store-and-forward telemedicine involves acquiring medical data (like medical images, bio-signals etc) and then transmitting this data to a doctor or medical specialist at a convenient time for assessment offline. It does not require the presence of both parties at the same time. Dermatology, radiology, and pathology are common specialties that are conducive to asynchronous telemedicine. A properly structured Medical Record preferably in electronic form should be a component of this transfer.

Telemedicine is most beneficial for populations living in isolated communities and remote regions and is currently being applied in virtually all medical domains. Telemedicine is also useful as a communication tool between a general practitioner and a specialist available at a remote location.

Remote monitoring solutions have a focus on current high morbidity chronic diseases and are mainly deployed for the First World. In developing countries a new way of practicing telemedicine is emerging better known as Primary Remote Diagnostic Visits whereby devices examine a patient whereby a connected doctor residing in another location virtually examines the patient and treat them.

This new technology and principle of practicing medicine holds big promises to solving major health care delivery problems in, for instance, Southern Africa, because Primary Remote Diagnostic Consultations not only monitor an already diagnosed chronic disease, but they have the promise to diagnose and manage the disease(s) for which a patient will typically visit a general practitioner.