In our experience, the description that better defines Telemedicine is "the use of computers, the Internet, and other communication technologies to provide remote patient healthcare."
Actually, the scope of telemedicine ranges from a simple telephone medical advice to state-of-the-art robotic surgery that may be performed in universities or great cruise ships on the open sea or in satellites orbiting the earth.
Telemedicine is the use of communications technologies to provide expert medical and/or technical support across distance to basic medical staff at remote locations.
Internet-based communications enable three of the basic elements of medical diagnostics: text messaging that can be used by any physician to summarize a patient's clinical assessment or exam; image transfer that allows remote graphical visualization; and voice (by phone line or the Web) used as an option in many cases.
Telemedicine is particularly useful in:
Telemedicine might be easier to practice in low population density areas, which may serve as laboratories to develop proper methods of delivery and where the impact on the population and training of human resources to deliver healthcare services may be more easily assessed.
Our successful telemedicine practice in Maniapure (Centro La Milagrosa) has been recently shared with public (and private) outpatient healthcare centers, where physicians thereof could benefit from specialist medical guidance provided by major healthcare centers within the country (or abroad).
Nevertheless, for telemedicine to be successfully expanded to such healthcare centers, Internet connection and computer hardware are required to enable communication between consulting and consulted physicians.
Patients must be the final beneficiaries of any healthcare- related project. Therefore, beneficiaries are individuals who are ill or who may become ill, that is, any patient or any member of society.
Profits shall be obtained from optimizing all levels of healthcare, from primary healthcare provided in distant communities to tertiary and quaternary healthcare provided by major healthcare centers where severe, complicated medical cases are dealt with high-end, expensive technology.
Major healthcare centers should not deal with common and benign diseases, even if such diseases cause high patient anxiety making patient feel he/she is suffering from a severe illness.
To provide quality healthcare services, every link of the healthcare chain must operate properly. Primary healthcare network should at least account for the minimum resources required to deliver basic healthcare, including enabled communication with higher-level healthcare providers.
Telecommunication is an essential resource to avoid over- demand, an even a crash, of the tertiary or quaternary healthcare systems.
Communication between lower-level healthcare centers and their pertinent supervisory healthcare agencies enables higher quality clinical and paraclinical diagnosis, allowing accurate and effective treatment adjustment.
By improving communications among primary healthcare providers and major healthcare centers, healthcare delivered in rural or distant medical facilities is optimized. In rural or distant healthcare facilities, a great number of diseases or pathologies are treated without referring patients to major healthcare centers; nevertheless, patients with a doubtful diagnosis or a confirmed diagnosis requiring specialist medical care are referred to healthcare centers that account for the medical and technical resources required to deliver proper patient treatment, which through telemedicine could have patient's medical chart and preliminary medical evaluation and further exam results (such as laboratory tests and auxiliary studies) in advance of patient?s arrival.
In Venezuela, referral of a patient from a rural or semi-rural area to a major city has an enormous impact on the family in terms of family economics and care for it involves high financial expenses and regular family care disruption. For example, if the mother of an ill child has other children, she is forced to travel with her ill child, leaving behind all other children.
In such cases, usually the children that stay home miss school while their mother is away with her ill child. Most likely it will take days (or even weeks) for the ill child to receive medical attention in any quaternary or referral healthcare facility of the public healthcare system as they currently do not operate at an optimum level.
Venezuela has an important network of type 1 and 2 outpatient healthcare facilities (ambulatorios rurales), in addition to the public and the private healthcare system, all of which account for good-quality facilities and healthcare professionals in numbers that closely approach the recommendations of the World Health Organization in terms of infrastructure and human resources, which is very hard to achieve.
Bringing a large number of these healthcare facilities to full operation, including Internet-based communication, would enable medical and paramedical staff motivation and on-going training and patient care optimization at relatively low costs.
Any healthcare system has the potential to operate under a cost-effective approach, whether it be the existing government healthcare system or the private healthcare system.
As described above, the government healthcare system accounts for infrastructure in operating conditions and/or potentially recoverable at relatively low cost plus highly professional human resources, but such human resources lack training on currently available communication technology, which is essential for optimization of existing healthcare levels.
As to private medical practice, there is a great number of physicians working on their own in private offices or grouped in small private "clinics" usually with no access to information on medical advances or breakthroughs or with no contact with subspecialist physicians or even unaware of the medical standards and guidelines established by the ruling agencies. Internet-based communications would offer such private practitioners (in the form of a payable service) access to major government and/or private healthcare centers and their specialist medical staffs, many of whom would for sure have a large experience on the illness object of advice. As in the government healthcare system, seemingly complex cases could then be treated locally and referred cases would be given a more effective attention.
Health worker (physician, nurse, paramedic or "simplified medicine" peer) working in the type 1 primary healthcare facility performs patient evaluation and orders locally-available paraclinical tests. In case no diagnosis may be reached, medical advice must be requested at the relevant supervisory type 2 healthcare facility by radio or satellite communication. Type 2 facility provides complimentary information and/or reaches a final diagnosis, thereby solving the case locally. Otherwise, comprehensive medical advise should be requested via Internet using text messages, image transfer and/or voice, as the case may be. Extremely distant type 1 healthcare facilities could use Internet-based satellite communication.
The Virtual Triage Center or Call Center is an office with a healthcare specialist (initially a physician) equipped with an Internet-connected computer with in-site access to medical reference papers, a database of associate specialist physicians and government and/or private national and/or international healthcare centers, and virtual libraries, who will provide medical advice and case follow-up until case is closed.
This is the highest level before which medical advice or guidancemayberequestedandisprovidedbyspecialistor subspecialist physicians or specialty healthcare centers upon submission of difficult cases, images or other document that enables diagnosis. Initially, medical advice given on an optional basis would be delivered within 24 hours, the final goal being real-time or videoconference medical advice when required.
For more information, we invite you to visit Tele-Salud
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