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TELEMEDICINE SYSTEM, CHOISE |
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Telemedicine is conceptually a process of remote communication of two or
more physicians to provide medical services of higher quality to their
patients.
In the last decade of the twenty's century the
development of telemedicine was primarily characterized by numerous
experiments attempting to apply different computer and telecommunication
technologies to solve various medical problems. The onset coincides with
the advent of modems enabling to transmit various medical information
through telephone lines. First were transmitted data of
electrocardiographs and other similar medical, so-called telemetric,
units, it was gradually followed by transmission of images. Replacing of
low speed telephone channels with the high speed ones resulted in
attempting to use business videoconferencing in medicine and also made for
the progress of various digitalization systems of medical information.
Electronic mail and Internet started to be used.
The ways all these
experiments were performed had very much in common. At first a
telecommunication technology was developed and then it was attempted to be
applied to one or other communication technologies to use for medical
matters. This phase is getting over now, when a certain experience in
telemedical consultation has been gained and it has become evident that
only those systems that are specially designed for particular medical
requirements, including all types of diagnostics and treatment, and basing
on these requirements use adequate modern computer and communication
technologies can have a true practical impact on its realization.
Because
of this, while forming a telemedicine system it is required to base on the
medical requirements, rather than the reverse. Telemedicine systems must
become an organic part of diagnostics and treatment and in doing so they
must be in no conflict with any requirements of ergonomics, or human
engineering.
Currently there are no and there cannot be any
standards for telemedicine systems. The assertion that a telemedicine
system must meet the ITU requirements of a H.320/323 type and other
similar requirements are based on the out-dated approach and attempts to
apply pure engineering standards to the telemedicine systems as the basic
ones. The work on the standards is just starting and because of this the
telemedicine systems must have open interface enabling to change the
available data formats depending on particular requirements and thus to
adapt the systems to the protocols of medical data exchange and storage
being newly developed. In addition, the telemedicine systems must be
easily connectable to the medical equipment being newly developed and
because of this they must have open interface to enable such connections.
How
the general approaches are being developed may be illustrated by systems
for telepathology, the field of telemedicine having the largest practical
experience. One of the pioneers of the telepathology, German professor
K.Kayser, writes in his book on telepathology (Telepathology.
Telecommunication, Electronic Education and Publishing in Pathology.
Springer-Verlag Berlin Heidelberg) published this year that "by now, no
imaging standards required for telepathology have been defined yet".
Mr.Kayser mentions only imaging standards, for the other aspects of
telemedicine, its organizational, financial, documentation, law and other
issues no platform on which the standards might be developed has ever been
worked on. This is also true in regard to other types of medical
diagnostics and treatment.
Relying on the practical experience in
providing telemedicine consultation we have worked out the basic criteria
the telemedicine systems must meet at this point of telemedicine
development.
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