The Future of Telehealth

By: Keith Hearne

"Imagine a world where no matter who you are or where you are, you can get the health care you need when you need it."

- Quote from opening page of the Office of Advancement of Telehealth website An appealing idea; the notion that if you are in a remote place and are in need of medical assistance or need access to medical knowledge that you can get it when you need it, no matter where you are. Fortunately telehealth is already more then a notion. Indeed in some places it is alive and well and in use.
So what is telehealth? Telehealth is the use of electronic information and telecommunications technologies to support long-distance clinical health care, patient and professional health-related education, public health and health administration. And with the latest movement in mobile communications to the third generation (3G) technology; where Internet and mobile technology are converging, it's possible that telehealth just may be able to offer that little bit more.
First generation (1G) mobile communications systems started in the early to mid 1980s, offering simple wireless voice services based on analog technology. These systems provided low quality voice services, were very limited in capacity and did not extend across geographic areas. Our current mobile phone services work on digital second generation (2G) systems, which were developed in Europe (mainly Global System for Mobile Communication (GSM)) and the U.S. to provide better voice quality, higher capacity, global roaming capability as well as lower power consumption. 2G systems also offer support for services like short messaging (SMS).

However, the low transmission (bit) rate of 2G systems (9.6kbps for GSM) cannot meet demands for new and faster non-voice services on the move. 3G systems aim to solve the problems encountered with 2G, by promising global roaming across 3G standards, as well as support for multimedia applications by using Universal Mobile Telecommunications System (UMTS) technology. UMTS technology will also offer increased bandwidth and better Quality of Service (QoS). With the UMTS technology, telehealth will take on a whole new life and offer much more efficient medical services.

Telecommunications and Internet services currently facilitate telehealth by allowing the transfer of patient and other related medical data between health care professionals. However consultation and treatment are the major areas of health care at the moment. In the coming years we will see our current mobile communications systems extended with UMTS technologies, and as a result we should see consultation and treatment being provided virtually in any location where access to a mobile communications system is available. This kind of technology should offer dramatic improvements to areas like emergency and home treatment, as well as routine check-ups. This will lead to considerable cost savings to different stakeholders in the healthcare system. For hospitals it will mean reduced cost and bed stay; GPs will have greater reach of consultancy services; and most importantly for the patients, telehealth will mean independence and fewer doctors' visits.

Let's take a couple of scenarios where UMTS technology and teleheath will be able to offer us improved medical assistance.

Patient Monitoring: We are already seeing new integrated technologies being introduced to the mobile market place, with the latest mobile phones offering a still camera, allowing you to take still pictures and send these to friends. With improved integration we will see mobile devices that offer live feed video streaming via inbuilt cameras. With this in mind patient monitoring could be easily implemented by a GP. With monitoring equipment being set up at the patient's home or on the move, the GP can keep an eye on the patient's progress without having to be there.
Emergency Care: Imagine a person was in a car accident and he or she was physically uninjured but a fellow passenger had some trauma and injury. Miles from the nearest hospital or doctor, the person, however, has a mobile device with phone and live feed capabilities. She can ring the doctor who can provide invaluable on the spot advice for the person to administer, possibly saving the victim's life. This can be extended to doctors advising nursing staff or ambulance staff while en route to hospital.
Consultations and Call Out: It's 3:00am and you're woken by your 3 year old daughter who is crying, feverish, coughing heavily and complaining of an upset stomach and you don't know what to do. It's a fairly common situation where you have to call a doctor out to your house late at night or early in the morning. But what if the advice needed could be administered over your video/phone? The doctor can see the patient through a live stream and determine whether the situation warrants a house call and if not can give detailed information of treatment over the phone. Once the consultation is at an end you can even pay for the treatment using your mobile UMTS device.

All the technologies needed for mobile health care or telemedicine are already in place. With the expansion of UMTS and 3G technologies in the coming years, we will see these types of services extended and greatly improved. UMTS technology will also see the ability to pay for access to services through your mobile. This ability to handle payments will be a catalyst to bring healthcare services to the mobile world.

These are just a few of the possibilities of telehealth that we may see come into operation with the introduction of UMTS technology. One thing is clear though that the advancement of telehealth will more than likely come into all of our lives in the coming years, making our medical systems more efficient and more patient friendly and will provide a vehicle to improve healthcare service delivery.

See also:
http://telehealth.hrsa.gov/
http://telehealth.net/
http://www.health.nsw.gov.au/
pmd/telehealth/about/about.htm