The creation of telecommunication technologies and networks is a compound element of a general direction in the health care informatization today. The doctor has to have an opportunity to access the experience of the colleagues. This target can be achieved through the integration of the telecommunication technologies in the clinical and hospital automated information systems at each stage of diagnostics, treatment, and rehabilitation. It is possible when all the specialists work at the same medical institution but rather problematic in the case of a very specific issue, which requires a consultation with the high-quality experts. Here, telemedicine and teleconferences can enormously help. With the help of the modern information and telecommunication technologies, it is obviously easy to exchange radiological pictures of the higher quality and resolution, as well as results of laboratory analyses, electrocardiogram measurements, and many other data. For example, the pictures of a computer tomography or magnetic resonance imaging can be sent to a distant location in few seconds only. Medical experts from all over the world have an opportunity to communicate and share information with each other in the real-time settings. This paper discusses the telecommunication technology and its role in providing the patient care. It also studies the difficulties in telemedicine adoption, researches telepsychiatry as a way of curing patients with mental diseases, and assesses Personal Health Record, its benefits and challenges of its adoption.
Telemedicine is a usage of telecommunication technologies for providing medical information and medical care for patients, who are situated distantly from the medical personnel (What is telemedicine?, 2012). Today, this term is used as a general notion for all the consultations and diagnosis provided at distance (Castelli, 2012). Telemedicine is an auxiliary means for all the therapeutic and surgical specialties. This concept includes numerous elements ranging from the telephone system to the high-speed systems of a broadband transmit circuit with the use of optical fibers, satellites, or different combinations of technologies of the land and satellite communications.
Telemedicine is a method of the remote provision of services in the field of medical care with the help of special equipment. The technology gives a chance to engage qualified doctors to help their colleagues in dealing with a specific patient or a case in medical practice regardless of the distances. It opens unique new opportunities for the medical organizations.
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Telemedicine allows attracting a bigger number of patients who want to receive full medical service without leaving for another city or country. The organization of telecommunication technologies allows clinics to introduce and advance a new practice of assistance to patients according to the chosen specializations. The services can be provided in these areas in the form of teleconsultations with the leading experts from other medical institutions. The expansion of a number of services increases the authority and prestigiousness of the clinic; thus, the clinic can offer a new service according to the program of payment or insurance medicine.
The telecommunication technology allows enlarging the patients’ inflow and retention. It is more favorable to the patient to register and pay for reception in the local telemedical center than to travel to another region. In such a manner, he or she can receive an equivalent medical service provided from the nearby city. The center allows giving help to the clients on-site rather than sending them to other clinics. As it ensures a stable inflow of patients, it promotes an increased profitability of the medical institutions.
The telecommunication technology increases the educational potential of the healthcare workers. Nothing attracts the patients more than reputation, qualification, and profound knowledge of the doctors. However, it is sometimes very difficult to hold the qualified practitioners on places. With the help of the telecommunication technology, however, it is possible to provide them with new practice and possibilities. The clinic can also enlarge the potential of own employees through their engagement in unique master-classes (broadcast of the operations in the international clinics), interactive lectures, and symposiums. Moreover, it is possible to provide services in training of the doctors from other clinics, which need to improve own skills. Teletraining will allow avoiding additional costs not only of the business trips for the experts but also of inviting highly-paid doctors-lecturers from the center. Moreover, it is often almost impossible for the medical practitioners to leave their practice and travel to another city or country.
The World Medical Association realizes that in the future, telemedicine will surely play a more significant role in nursing (Clinical Solutions, 2009).
The World Medical Association realizes that, besides the technical difficulties associated with the development and employment of the telehealth systems, there is a number of legal and ethical challenges generated by this new practice. Therefore, the WMA recommends the doctors to use the following principles as the main elements in creating an effective telehealth system or network (Clinical Solutions, 2009).
When the patients having depression are in a critical condition and cannot reach a hospital, they can be helped by the means of telepsychiatry. It is a remote method based on using the computer technologies and video monitoring (American Telemedicine Association, 2012).
The telecommunication technologies have provided the doctors with the new ways of collecting information and satisfying medical necessities of a patient at a distance. The great deal of nursing information can be transferred now by means of phone, including encephalograms, electrocardiograms, photos, x-ray pictures, and medical documentation of all types. Such information can be gathered and sent from the patient’s house or doctor’s office to the chief nursing center for further interpretation and consultation concerning the treatment. The fast convey of the nursing information allows the patients to get the most exhaustive and modern nursing care while staying in their houses and familiar social environment.
In recent research, the patients, who received treatment by means of telepsychiatry, reported to be completely satisfied as the symptoms of their disease passed away as quickly as if they had a personal communication with the psychiatrist (“What is telemedicine?” 2012).
Doctor Paul Raskin, the psychiatrist at the Health Clinic in Baltimore, Maryland, and his team investigated the chronic patients with depression who had passed 8 therapeutic sessions within 6 months (American Telemedicine Association, 2012). Fifty-nine patients received treatment by means of telepsychiatry; the others were treated in the traditional way at home (American Telemedicine Association, 2012). In both cases, the indicators on the Depression Scale showed no essential difference. In the group under supervision of telepsychiatry, 49% of the patients recovered completely; in the group receiving the treatment at home, 43% of the patients recovered (“What is telemedicine?” 2012).
These results specify that for the elderly and disabled people who need qualified help but cannot physically leave the house or live too far, as well as the patients with agoraphobia, telepsychiatry can become an effective alternative. There are some websites, which can be useful to the patients who need a psychiatric help: the website of General Hospital Psychiatry, the website of the Community Health Systems Resource Group, and the American Psychiatric Association’s website.
I recommend these sites to be used for the consultations with a psychiatrist. The subsequent supervision of the online telepsychiatry has the same efficiency, as well as an internal consultation. When using the telecommunication technology, one can switch off the video camera if he or she feels shy or does not want the doctor see the face. The person just stays at home, relaxes, and enjoys the consultation; this peculiarity can give good results in the mental treatment. The research of Zurich University showed that the online psychiatry consultations are the same effective as the hospital ones are (Clinical Solutions, 2009). According to the data provided by the Canadian research, a patient spends, at least, 10% less on the telepsychiatry in the mental health services (American Telemedicine Association, 2012).
I think the best criteria for a reputable website are feedback from the patients, who have already passed a treatment with the online specialists. I can recommend reading responses or comments of the patients who had such an experience. One can always find them on every telemedical website.
However, telemedicine has some limitations. The lack of face-to-face communication and human interaction can cause some specific mistakes in diagnosing, as well as being not able to select an optimum tactics of treatment, control the condition of a patient after treatment, operation, or specific therapy.
Personal Health Record (PHR) contains electronic information on the health of a person received from various sources; it conforms to the national standards of compatibility (interoperability). The patient maintains, manages, and provides access to this health information.
The electronic medical records can bring many advantages to both the doctors and their patients, but the benefits depend on the way of how these records are used. The Centers for Disease Control and Prevention (Centers for Medicare & Medicaid Services, CMS) together with the Office of the National Coordinator for Health Information Technology, ONC have accepted the Meaningful Use Regulations, which manage the use of PHR and allow receiving incentive rewards by the health workers and hospitals complying with the criteria established by the standards (American Telemedicine Association, 2012).
The benefit of using PHR lies in providing patients and health workers with the full and exact medical information for a purposeful use. Moreover, it allows the patients to play an active role in the medical care.
One more benefit of PHR is a simplification of communication with the doctors and reduced risks of the medical mistakes. Nevertheless, both the application developers and users need to understand the problems of confidentiality and safety associated with the existing PHR.
However, there are essential political, technological, and social barriers interfering with the realization of potential advantages of the electronic medical records. An infrastructure problem, in particular, is a serious issue for the developing world. Both the citizens and medical institutions have no quality ICT and telecommunication, necessary for accessing the electronic medical records.
The biggest problem is the functional compatibility. Until enough medical institutions do not adhere to the same standards of electronic medical records, the system will not be able to provide an expected profitability and improvement of quality of the medical and sanitary service. Besides, because of the personalized electronic medical records, there are fears concerning the data security and personal privacy. In terms of safety, the systems have to satisfy the tough authentication standards for the identification and confirmation of the identity of a person trying to access the records, as well as the service providers, having access to these records. As soon as all the information is stored in a digital format or is conveyed through a telecommunication network, the data security is a not less important requirement.
The use of the modern information and telecommunication technologies allows ensuring a general availability and high-quality standards of the medical care organization for the general population. They are an effective tool for providing the necessary medical services and controlling epidemic situations, first of all, in the rural areas and remote areas with the underdeveloped healthcare structure, shortage of medical institutions and medical personnel, as well as in the emergency situations. The development of telecommunication technologies in providing different services has an essential impact on all the areas of practical activities of a person. Today, the telemedical services offered via the Internet are promptly developing in the pharmacological, consulting, and expert areas. The use of telemedical practice allowed not only increasing the efficiency of medical diagnostics and treatment but also introducing new perspective directions of its development. Today, the need for the development of telemedicine is recognized by all the leading countries of the world.
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