Fundamentals of Telemedicine and Telehealth

Cover
FUNDAMENTALS
OF TELEMEDICINE
AND TELEHEALTH
Copyright
List of Contributors
Acknowledgments
Section I: Telecare basics
1
Overview
	In conclusion
2
Rationale, history, and basics of telehealth
	Definitions
	History of telemedicine and telehealth
		The current situation
	Situations where telehealth has a role
		Types of telecare
		The rationale behind telehealth (why)
		Some issues
		The process (how)
	Telehealth services are reshaping healthcare
3
Management of patient healthcare information
	Healthcare-related information flow, access, and availability
	Introduction
	Definitions of EMR and EHR
		Features and functionalities of the EHR
			Ambulatory or outpatient EHR
			Inpatient EHR
	Application of EHRs in telehealth
	Data entry
	Acquiring and utilizing nontextual data—images, sound, and more
		Images
		Recording images
			Digitization of X-rays
		Sound
	Alerts and triggers
	Healthcare data analytics
		Population and public health
		Data-driven decision-making
		Clinical decision support system
		Data analytics in the context of telehealth
			The importance of standardization e
	Analytics approaches
		User-web analytics
4
Technology considerations
	Overview: Infrastructure requirement
		Bringing it altogether is challenging
		Some solutions and devices
	How to ensure effective communication
		Introduction
	Video conferencing (VC)
	Example of video-conference system for emergency care
	Standards and certification
		Messaging and data exchange standards
			Terminology standards
			Document standards
		Coordination, harmonization, and convergence of standards
		Integrating the healthcare enterprise—IHE
		Emerging interoperability standards
			HL7 Fast Healthcare Interoperability Resources—FHIR
		Standard development organizations
			International Standards Organisation (ISO)/TC 215 health informatics
Section II: Working together for health
5
Platforms for collaborative process
	Introduction: Patients as partners in care
		Emergent models of care: From paternalistic models and transaction to participatory care
		Emails and discussion forums
		Social media and networking for distance-based care
	Telehealth platforms
		Teleconsultation and telemonitoring
		Telediagnosis
		Teletracking
		Telehealth services and software platforms
	Computer assisted care
		Currently available AI systems
		Conclusion
6
Patient-centered care
	Introduction
	eHealth in patient engagement
	Patient portal
7
Maintaining and sustaining a telehealth-based ecosystem
	What is a telehealth-based ecosystem?
	Role of telehealth in health system strengthening
	Roles and responsibilities in a telehealth system
		Project management
		Program management
		Site coordination
		Clinical oversight and referral
		Clinical service provision
		Technical support
		Key considerations in staffing a telehealth program
			Project management in telehealth
		Creating workflows and standard operating procedures (SOPs)
	Planning a project
		Appointment roster
		Telehealth project example (prepared for budgeting and account keeping) (taken from an anonymous state government tender)
		Backup systems
	Analytics
		Basic concepts
8
Tele-education
	Introduction
	Distance education in the context of professional work in health
		Introduction
		Myths, advantages, and disadvantages in distance education
		Hybrid teaching
		Teacher and student training
		The health area
	Digital health workforce: de novo skill set
		Training requirements of a digital health assistant (see Box 1)
		Learning objectives
	Use and utility of virtual teaching in education
		Methods of education and the usage of VT
		Requirements for a virtual teaching platform (VTP)
	A case study of e-teaching in cardiology from India
	Conclusion
Section III: Telemedicine
9
Telesupport for the primary care practitioner
	Introduction
	Telemedicine in primary healthcare
		Support to primary care providers
		Referral of patients to specialty care
	Why are doctors reluctant to adopt telehealth
		Doctors are (slowly) adopting telemedicine
			Limitations of teleconsultations from a doctors’ perspective
		Facilitating doctors’ adoption of teleconsultation
	Telemedicine for community healthcare workers
		Purpose of care support
		Fast diagnostics
		Adherence
		Ensuring health equity
	Tele support for nurse practitioners
		Introduction to primary healthcare nurse practitioner role
		Communication in primary care: Telehealth a better solution
		Nurse lead telehealth primary nursing practice development: A new care model 202
		Primary health nursing care scenarios: How to plan telehealth intervention?
		Way forward to establish telehealth nursing services at country level
	Tele support for wounds, ulcers, and lymphedema
10
Telecare within different specialties
	Introduction
	Teleradiology
		Overview
			Concepts and applications
			DICOM versus Non-DICOM
			Secondary capture
			Image transmission
			Speed
			Security
			Availability and integrity
			Image management, viewers, and workflow
			Emergency applications
				Teleradiology optimizes radiologist efficiency and diminishes healthcare costs
				Teleradiology services to remote areas
			Quality and regulation
			Current and future trends
	Telepathology
		Overview
			Concepts and applications
			Telepathology technologies
			Current and future trends
	Teleophthalmology
		History
		Concepts and applications
		Key essential enablers
			Case study 1 147
				Vision center concept and definition
				Operational landmarks
			Case study 2
				Conclusion
	Teledermatology
		Overview
		Concepts and applications
		Current and future trends
	Telecardiology
		Overview
		Concepts and applications
			Digital stethoscope
			Teleechocardiography
			Tele-ECG
			Teleconsultation
			Teleteaching in cardiology
		Current and future trends
	Teleobstetrics/prenatal telemedicine service
		Overview
		Concepts
		Applications
		Global experiences in gestational telemonitoring
		Current and future trends
	Telecare in geriatrics
		Overview
		Applications
	Teleoncology
		Overview
		Concepts and applications
		Current and future trends
	Teleneurology
		Overview
		Concepts and applications
			Teleneurocritical care
			Outpatient teleneurology
			Continuing medical education and research
		Future trends
	Telediabetes
		Concepts and applications
		Current and futures trends
	Telepsychiatry and telemental health
		Overview
		Concepts and applications
		Current and future trends
	Telesurgery
		Overview
		Concepts and applications
			Preoperative preparation
			Operative procedure
			Postoperative care
			Training of a surgeon
			Video-based learning
			Computer-based simulation
			Telementoring of procedures
		Regulation and future trends
	Teleotorhinolaryngology
		Overview
		Clinical applications
		Future trends
	Teledentistry
		Overview
		Concepts and applications
		Future trends
	Teleemergency service
		Preamble
		Concepts and applications
		Current and future trends
	Tele-ICU
		Overview
		Tele-ICU models
		Tele-ICU logistics and resources
		Challenges
		Impact and future trends
	Teledialysis
	Telerehabilitation
		Overview
		Concepts and applications
		Disability and rehabilitation
		Problem statement
		Applying telerehabilitation
		Diagnosis
		Physiatric prescription
		Treatment and monitoring
		Assistive devices
		Referral
		Community-based rehabilitation
11
Telecare during travel and for special situations
	Introduction
	Maritime telemedicine
		TMAS
	Radio Medico Norway
	Telemedicine in commercial aviation
		Incidence
		The influence of space medicine
		The change
		Limitations of telemedicine in aviation
		Legal issues
	Arctic telemedicine
	Telemedicine for prison populations
		Background
		Telemedicine
		Mental health
		Substance abuse
		Communicable diseases
		Emergency care
		Conclusion
	Medical tourism
		In summary
		Introduction
		Reasons for growth of medical tourism
		Pros and cons of medical tourism
		Medical tourism stakeholders
		Telehealth/telemedicine and medical tourism
		Conclusions
	Telehealth in disasters
	In summary
12
Mobile health (mHealth)
	Introduction
		Benefits of mHealth
		Drawbacks and issues
		Hot areas of research
	mHealth in supporting health workers
	Developing apps for mobile devices
		Smart mobile devices
			Native apps versus HTML5 apps
		Developing native apps
		Developing HTML5 apps
		Summary
	Persuasive technology and mHealth
	mHealth evaluation
		The challenge of mHealth evaluation: Merging two independent environments
		The added needs of mHealth evaluation
		Racing against the clock to evaluate mHealth
Section IV: Issues and future of telehealth
13
Medicolegal, ethical, and regulatory guidelines pertaining to telehealth
	Telemedicine law
	Medical ethics and telemedicine
		The doctor-patient relationship
	Licensure
	Jurisdiction
		Quality and standard of care
		Consent
		Confidentiality and privacy
		Authentication
		The ethics of telemedicine
14
Disruptive technologies: Present and future
	Introduction
	Telehomecare
		Overview
		Concepts and applications
		Impact and future trends
	Tele-robotics in healthcare including in surgery
		Neurosurgery
		Safety aspects
	Artificial intelligence and IoT in healthcare
		What is AI?
		AI’s history and evolution
		What is deep learning
		Why the hype?
		Applications of AI in healthcare
	IoT?
		Applications of IoT in healthcare
		Challenges in AI and IoT
	Virtual reality in health
	Blockchain
	Big data
15
Worldwide initiatives
	Australian experience
	Telehealth in Brazil
	Telemedicine/telehealth in Canada
	India case study
	Telemedicine in Africa
		Scope of telemedicine and mobile health networks
		Conclusions
	Summary of learnings
	A final word
Glossary
References
Index
	A
	B
	C
	D
	E
	F
	G
	H
	I
	J
	L
	M
	N
	O
	P
	Q
	R
	S
	T
	U
	V
	W
	X
	Y
	Z
Back Cover