24x7-Aug-2006

Yours truly is quoted in an article in 24x7 Magazine on the need to ensure the integrity of data transmitted via telemedicine. In my mind, telemedicine refers to a connection between health care facilities, where remote resources like specialists, can diagnose and evaluate therapies for patients located at remote facilities. Remote monitoring entails monitoring a patient's physiological, behavioral and emotional condition, as well as interactions with caregivers, from the patient's location to the provider.

Over the years, telemedicine has become pervasive.

It is used in cardiology, dermatology, HIV/AIDS, home
care, mental health, pharmacy, radiology, rehabilitation, prison-based and
school-based services, and trauma and emergency care. Existing and
experimental applications include patient consultations, disease
management, education, electronic medical records for rural health systems,
remote surgery, and specialist referral services.

And the benefits have become well recognized.

Telemedicine has been found to increase cost
efficiency, reduce transportation expenses, improve patient access to
specialists and mental health providers, improve quality of care, and
create better communication among providers. But to do all this, the
systems on which the information is captured, transmitted, and viewed must
have their security and integrity maintained at all times, and on both
ends.

The big challenge in telemedicine is ensuring that the quality of the data captured at the remote location is identical to the data reviewed at the "mother ship." This can be especially challenging with image management applications that require calibrated monitors at both ends of the telemedicine system.

Equipment can drift; monitors do go off calibration.
An off-label use, or a system put together by the health care provider,
should have the process defined to ensure proper configuration,
performance, and operation of the system based on a risk analysis done by
the health care provider. Industry standards, such as DICOM, help to ensure
integrity at the other end. “The industry is hoping there is
consistency,” [Jeff] Bronke [MSBME, Baystate Health System’s supervisor of clinical
engineering] says.

Clinicians, IT and biomedical engineer must work together with the vendor(s) in order to maintain the diagnostic confidence of any telemedicine system. There's lots of good info in the story - check it out.