UNIVERSITY OF TECHNOLOGY, JAMAICA

College of Health Sciences

School of Public Health & Health Technology
Course of Study:
Master of Public Health

Telemedicine

Lecturer: Dr. Winston Davidson

Semester: Spring 2010
Presented by:
Melissa Peart
0906876
1. What is meant by the term Telemedicine? (2 marks)

The term 'telemedicine' derives from the Greek 'tele' meaning 'at a distance' and the present word
'medicine' which itself derives from the Latin 'mederi' meaning 'healing'. The simplest definition
of telemedicine is that it uses multimedia (voice, video and data) technology to deliver medical
services; the simplest example is the telephone. Further defined, it is the delivery of health-care
services, where distance is a critical factor, by health-care professionals using information and
communication technologies for the exchange of valid information for diagnosis, treatment and
prevention of disease and injuries, and for the continuing education of health-care providers as
well as research and evaluation, all in the interests of advancing the health of individuals and
their communities. Telemedicine is an application, not a technology, although the term is often
misapplied which involves the exchange of information in real time (called synchronous) or
information that has been forwarded to be analyzed at a later time (asynchronous.)

2. List the three categories of Health Tourism (4 marks).

There are three categories of Health tourism: wellness tourism, medical tourism and Retirement/
Convalescent Health Tourism.
1. Wellness Tourism- Wellness tourism is the sum of all the relationships and

phenomena resulting from a journey and residence by people whose main

motive is to preserve or promote their health. They stay in a specialized hotel
which provides the appropriate professional knowhow and individual care.
They require a comprehensive service package comprising physical
fitness/beauty care, healthy nutrition/ diet, relaxation/meditation and mental
activity/ education.
2. Medical tourism- the provision of 'cost effective' private medical care in
collaboration with the tourism industry for patients needing surgical and other
forms of specialized treatment. The term refers to traveling to other countries
to obtain medical, dental, and surgical treatment while touring and
experiencing the attractions of the countries visited.
3. Retirement/ Convalescent Health Tourism- tourism aimed at providing
affordable health care for retirees at an affordable cost.
3. List the seven steps in the Mendes-Davidson model for building a comprehensive

electronic health record system for patient care. (6 marks)

The seven steps in the Mendes-Davidson model for building a comprehensive electronic health
record system for patient care are:
1. Doctor on Call. Mobile Devices; IP Telephony: this step involves being able
to visit a doctor, get an examination and then get an electronic medical records
and data sent to another doctor for another diagnosis or treatment plan. This
also allows patients to get second opinions or other treatment on the spot from
other doctors, without having to physically travel to those other doctors.
Specialist can receive electronic medical records through telemedicine and
actually hear about a patients medical history and current condition from the
primary physician and the patient, instead of receiving data through the mail.
2. ISP: Routine Internet connectivity in the city/area of service should be
provided by a local (national) Internet Service Provider (ISP) by means of
existing telephone lines or fiber- optic cable networks for the large data
transmission requirements of telemedicine.
3. Web Sites provide direct consumer outreach and services over the Internet.
Under telemedicine, these include those sites that provide direct patient care.
4. Health Ecosystems Development-EHR Capture/Store Use of Web Portals- to
share and to access to clinical information (protocols of care, guidelines, etc.)In the context of health care, this offers a wide array of resources and services.
These may include: e-mail, forums, search engines and on-line educational
modules. This is often divided into insecure and secure areas. Insecure areas
are often used for access by the general public and may include patient
education information. Secured areas are usually reserved for Stakeholder
access or electronic commerce activities. Digital can provide a full range of
Web services, custom designed to meet the patients needs.

5. STREAMING Media - the user can view/hear (video and/or audio streams):

the data as it is being transmitted live and on-demand delivery instead of

waiting for file transfer completion, and this is obtained without complex file
systems. The specialist is not in the same hospital where the patient is (where
data production is done); transmission of the exam result to the regular doctor
of the patient (radiology exam); Some specialists from many hospitals, maybe
with complementary competences, want to confront their diagnosis (to check)
in difficult cases, either in presence or absence of the patient. In this case,
streaming media allows broadcast of simultaneous medical images (with high
resolution) and clinicians to video/audio conference (with high frame rate) to
each other (multiple user broadcast). Moreover, in cardiology, remote
auscultation of a patient (heart sound) may be achieved either through audioonly or audio + video stream. This can be used for medical education (videoconference), or high resolution/low frame rate video streams for diagnosis or
remote consulting. With this new treatment mode is the doctor that goes
(electronically) to the patient and not vice versa. The instruments used allow
for tele-consultation, therapy at distance, remote analysis diagnosis, remote
education, consultation between colleagues and sanitary institutions.
6. Remote Server- collects patient readings from biomedical devices used by
patients in their homes or other settings outside of a clinical facility and then
transmits them for storage and examination by health-care professionals. Once
available on the server, the readings can be used in numerous ways by home
health agencies, clinicians, physicians, and informal care providers. And
because the data is automatically recorded directly from the patient's
biomedical sensor devices, physicians see an accurate representation of the
patient's day-to-day condition
7. Virtual Health Tele-medicine-Virtual Health Services Providers New Health
Cadre Training Programme/Services- data that might be configured differently
at different locations, but that is mapped into a common format at the time the
record is required by a group of people (and the social structure that they
collectively create) who use telecommunication with the purposes of
collectively conducting activities related to health care and education.
4. Will the application of information and communication technology advance the quality

and quantity of health care? Gives four reasons why you think this will be so or will not
be so? (8 marks)
I do believe that the application of information and communication technology will advance the
quality and quantity of health care especially in developing countries. Presently, advances in
information and communication technologies have raised expectations for health, coverage,
service delivery and data management even in the remote rural communities. This has the
potential to impact upon almost every aspect of the health sector especially for public health
where information management and the communication processes are hinged, and are aided or
limited by the availability of information and communication technology. In addition, beyond the
formal health sector, the ability of impoverished communities to access services and engage with
and demand a health sector that responds to their priorities and needs, is importantly influenced
by wider information and communication processes which are mediated by information and

communication technologies.
Technologies such as telemedicine would aid these countries in:
Improving the quality of health care
Simplifying access to health care
Decreasing costs- For patients by:
I. Cutting down on journeys to major health centres or for
specialist
consultation
II. Reducing the length of stays, and therefore cost of hospitalisation
For healthcare providers by:
I. Reducing operating costs
II. Reducing travel cost and time for specialist visiting other hospitals.
III. Reducing costs of training
Providing new ways for educating and training both for doctors and patients.
For doctors1. Limiting the amount of guess-work done in treating an illness
2. Preventing either wrongful medication or over-medicating of
patients seeking their assistance as well as the use of wrong
procedures such as surgeries etc. and the development of the
god- complex (feeling as if they are already knowledgeable in
medical procedures and need no further training).
For patients1. Helping them to present the problem in a manner that will be
understandable to the health practitioner (as what is said comes
closest to what is being experienced by the patient).
2. Helping them to understand conditions with which they have
been diagnosed and the proper approach to be taken in achieving
a state of wellness.
This would be done through better data management and transfer, better management of
diseases, and better knowledge transfer as facilitated through the use of telemedicine. Primary
reasons for encouraging this would be the fact that: the doctor to patient ratio is very high which
minimizes the amount of time spent in diagnosing and treating ailments; access in some areas to
local health services is very difficult; there is a shortage of high-level hospital infrastructure; and
the geographic distribution of existing hospitals and health services is very sparse forcing
patients at times to travel at great lengths in seeking solutions.
.