Prologue to Telemedicine

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Prologue to Telemedicine Arun Raj Kunwar, M.D. Aide Professor SUNY Upstate Medical University Syracuse, NY kunwara@upstate.edu

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Disclosures No budgetary affiliations or enthusiasm for anything that will be examined No business intrigue

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What is TM Use of broadcast communications to give therapeutic data and administrations Health conveyance/meetings by means of utilization of media communications - Telephone between two suppliers - Fax - Video gathering - Robotic innovation

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Types of Technology Store and forward - Digital pictures are put away and sent - Digital X-beams, advanced photographs, EKG faxes - Mainly utilized for non-emanant cases however accomplished for some new cases as well - Can be sent to anyplace on the planet

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Store and Forward Teleradiology, the sending of x-beams, CT outputs, or MRIs (store-and-forward pictures) is the most well-known use of telemedicine being used today - Most radiologists are remaining home amid accessible if the need arises Telepathology/Teledermatology

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Two-way Interactive Television (IATV) Face-to-face discussion Provides a continuous interviews through videoconference Usually tolerant with their essential supplier gets immediate counsels to master in far off webpage Can straightforwardly include persistent

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IATV Widely utilized for urban-rustic area where access to care is troublesome - the patient does not need to go to a urban territory to see an authority - accessibility of pro administrations not accessible before

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IATV: Videoconferencing hardware New ones are more straightforward, less expensive and simple to utilize New projects now utilize desktop videoconferencing frameworks Attachment of peripherals to make it more intelligent, for example, connection of stethoscope and otoscope, glucose observing

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Often Combination Interactive Store and forward Audio-video still pictures Web to exchange information/other web application Web based/got to wellbeing records Electronic medicines Wireless innovation in crisis/ambulances

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Application: TM Health mind conveyance Health calling instruction Health organization Public wellbeing Business Libraries School training

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Benefit of TM Breaks down boundary to separation/get to Improves nature of care - By direct patient conferences/discussions to essential care - By giving simple access to training May prompt to diminishing social insurance cost

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Application Urban to country for claim to fame/inaccessible care Mental human services to Jail populace Hospice mind Consults to class nurture Home telehealth and checking of unending malady Chronic coronary illness

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Application Distant wellbeing educating/checking (video recording of exams) Telesurgery applications for war zone by means of utilization of robot Teleradiology Telepathology Most of the restorative strength are utilizing some type of telemedicine

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TM: Experience SUNY Upstate Child Psychiatric Consultations To Binghamton General doctor's facility - Child Psychiatry is a disjoin deficiency forte - BGH has been not able enroll a youngster specialist for quite a while

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TM: Experience BMG runs a Child Psychiatry inpatient unit with an assistance of grown-up specialists Child Psychiatrist situated at SUNY Upstate at Syracuse counsels by means of videoconferencing Typically incorporates, survey of the case, chatting with patients, families and treatment suggestions

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Barrier to Telemedicine Equipment and foundation : - Most phone don't give enough transfer speed - Increasing online application making it easier - high transmission capacity media communications get to required for more refined uses ( Rural availability need )

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Barrier to Telemedicine Licensing issues : Many states won't permit out-of-state doctors to practice Reimbursement : Many private safety net providers won't pay for it. In a few states new laws that repays in same rate as up close and personal

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Barrier to Telemedicine Fear of negligence suits doctors Acceptance of the innovation and absence of hands-on collaboration with patients (most patient fulfillment studies to date discover patients overall happy with long separation mind) Privacy issues Worry about depersonalizing medicinal services

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Heath Care in Nepal Percentage of national spending plan in health:                                     6.2 Percentage of the present five-year arrange distribution in health:        6.0 GDP around 5% (Nepal Millennium Development Goals: Progress Report 2005)

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Nepal 24.1 percent of the populace win not exactly a dollar for each day 31 percent of the populace is living beneath destitution line (Nepal Millennium Development Goals: Progress Report 2005)

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Nepal: Basic Health Indicators Hospital beds per 10,000 populace 4.26 2001/02 Number  Physicians per 10,000: 2 Nurses for every 10,000 populace: 2  Urban populace (%)14. 2001 (Nepal Millennium Development Goals: Progress Report 2005)

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Population Distribution Due to the daintily scattered populace profile in the bumpy and precipitous districts, the openness to wellbeing offices is still an issue Nepal

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Telemedicine: Nepal has extensive rustic populace with restricted access to medicinal care Most of the social insurance specialists and doctors are situated in urban territories for the most part Kathmandu

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Telemedicine in Nepal Regional clinics are in a matter of seconds associated through web for wellbeing data get to Limited utilization of innovation for training

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Ministry of Health Telemedicine Project in Developmental stage. ?Associate all wellbeing post focus

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E-Network Research and Development Mahabir Pun have begun the telemedicine program in three towns as a pilot extend. Nangi, Ramche and Tikot, all of Myagdi District Myagdi District .

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(Note: ngi – Nangi, rmc – Ramche, tkt – Tikot are the towns where telemedicine program has been set up)

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TM: Nepal Om Hospital & Research Center (P.) Ltd and Apollo healing facility in New Delhi - Consultation Dr. Mohan Raj Pradhan HealthNet Nepal - Store and forward technique: achievability concentrate on

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Center for Nyaya Health Achham Nyaya Health is a 501(c)(3) not-for-profit association attempting to enhance the wellbeing of poor groups in Nepal through the arrangement of medicinal and general wellbeing administrations http://www.nyayahealth.org/about.html

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Center for Nyaya Health Achham Nyaya Health exercises in Achham is a four-bed, five-room facility concentrating on essential care, maternal and kid wellbeing, HIV, and tuberculosis Plans to create Telemedicine to give restorative administrations at two destinations in Achham

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Center for Nyaya Health Achham: TM Plan Email-based correspondence with experts seeing complex patients as issues emerge Voice-construct correspondence with pros in light of complex patients, possibly even in crisis situations Communication from clinicians at the middle center with Community Health Workers in the towns, for help with triage and treatment

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Center for Nyaya Health Achham: TM Plan Cytopathological appraisal of Pap smears for cervical disease, by means of transmission of pictures through computerized microscopy; Interpretation of complex ultrasound or X-beam pictures for direct patient care, preparing, and quality affirmation; Reading of complex microscopy slides for patient care, preparing, and quality confirmation;

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Center for Nyaya Health Achham: Along with TM Microfinancing Selling of products/advancement of business thought web

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Shahid Gangala National Heart Center Dr. Jyoti Bhattarai Kunwar as of late got supported by International Diabetes Foundation To analyze the viability of diabetes care by means of TM in country wellbeing post Vs treatment obviously

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Nepal TM: Goals Connecting all rustic wellbeing presents on Internet Providing direct counsels for patient care Some claim to fame are effectively received - Psychiatry - Dermatology - Diabetes administration - Preventive wellbeing instruction

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Nepal TM: Goals Partnering with driving universal gatherings for master and second sentiment - Johns Hopkins Medicine International runs worldwide "Medical Second Opinion" benefit Also for training

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Nepal: Health Profession Education Most of the addresses are recorded and can be gotten to from inaccessible webpage Live address bolsters Case examinations Can prompt to sparing in cost of go for wellbeing specialists

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Nepal TM: Barrier Lack of any law/control Rural and even urban availability/data transmission confinements Funding

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Other employments of TM to improve human services in Nepal Electronic therapeutic records Google wellbeing administration

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TM Nepal: Application Electronic solution Known to decrease drug mistake/sparing critical cost/enduring

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Nepal TM: Business Application Out sourcing Medical translation Software advancement/Medical records Medical meetings MDweblive.com Patient instruction

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Q&A

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