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Telehealth and Mhealth

More details on Telehealth, Telemedicine and Mobile Health
doctor and nurse discussing over digital tablet
© University Malaya

In this lecture, we will review Telehealth, Telemedicine and Mobile Health.

World Health Organization (WHO) defines Telemedicine as “the delivery of healthcare services, where distance is a critical factor, by all healthcare professionals using information and communications technologies for the exchange of valid data for the diagnosis, treatment, and prevention of disease and injuries, research and evaluation, and for the continuing education of healthcare providers, all in the interests of advancing the health of individuals and their communities. “Telemedicine is the practice of employing technology to provide medical care remotely. For example, a doctor in one location employs a telecommunications network to care for a patient at a different place.

In Telemedicine, electronic media such as video, image, audio, chat, whiteboard, desktop sharing, email, and SMS are used for the sort of interaction between the participants. Both synchronous and asynchronous communication between the participants is possible in Telemedicine. For example, as in video discussions, the exchange of messages occurs instantly or with little delay in synchronous communication. Asynchronous communication involves the exchange of messages across a variable period, such as when emails are sent and received. While synchronous communication often requires more technology and infrastructure, asynchronous communication typically requires fewer computational resources. Due to the nature of using ICT, the literature describes Telemedicine as a possible source of numerous advantages. For example:

  • The improvement of Healthcare in difficult-to-reach areas
  • Improved healthcare quality in underdeveloped nations where competent specialists are fewer or unequally distributed.
  • Outsourcing services that save money, such as remote reporting or using intensive care unit monitoring centres.
  • Giving patients more control over their health and enhancing their education

Telemedicine has many benefits for developing countries. Telemedicine is a good candidate for improving local healthcare services due to several limitations (financial, infrastructure, training, distance). Due to this, several non-governmental organizations and humanitarian organizations are working to bring telemedicine options to low-income nations. Developing countries receive international support from several humanitarian telehealth networks, which include: Réseau en Afrique Francophone pour la Télémédecine (RAFT) Network; PAN African e-Network; Swinfen Charitable Trust; Africa Teledermatology Project; Institute of Tropical Medicine (TM) Telemedicine; Pacific Island Health Care (PIHC) Project; Partners Online Specialty Consultations; Balkans e-Health Network; and Teletrauma. However, several factors hinder the implementation of Telemedicine.

  1. Legal factors
  2. Sustainability factors
  3. Cultural and language factors
  4. Contextual factors.

Access to Healthcare in rural places is yet another crucial issue for Telemedicine. In rich and developing nations, effective measures support rural communities. However, rural areas are more regulated environments where it is feasible to adjust the local routine. Therefore, the technologies created to serve the specific local better may cause many successful deployments.

Challenges

A. Legal

  • Payment for services
  • Participants’ liability for negligence
  • Informed Consent Required
  • Minimal Documentation Required
  • Audit, Certification
  • Credentialing

B. Sustainability

  • There is still no evidence that Telemedicine is economical,
  • Developing nations require government support to keep their telemedicine programs running.

C. Culture/language

Language and cultural differences must be accommodated via solutions.

D. Regional variables.

Limitations such as a lack of energy, inadequate training, high staff turnover, endemic diseases, and the unavailability of specific medical procedures must be addressed through solutions.

M-health

Mobile Health or mHealth is a broad term used to define mobile devices and other wireless technology in medical care. The use of mobile devices is mainly to inform consumers about preventative Healthcare. However, mHealth is also utilized for managing chronic diseases, tracking epidemic outbreaks, supporting treatment, and disease surveillance. There is not a single definition of mHealth. Therefore, WHO describes mHealth or mobile health as “medical and public health practice supported by mobile devices, such as mobile phones, patient monitoring devices, personal digital assistants (PDAs), and other wireless devices .” Due to the facility of use of mobile technologies, mhealth is popular and has the following benefits:

  • They are less expensive than fixed lines.
  • They are easier to use than other Internet interfaces
  • They can connect with sensors to gather information vital to the assessment and provision of Healthcare.

By introducing new channels and tools to healthcare providers and patients, mHealth has the potential to transform the way Healthcare is provided.

© University Malaya
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