The wave of rapid evolution that is driving disruptive change in consumer electronics and the internet is also sweeping across the technology-driven field of telemedicine. Adapted off-the-shelf consumer technologies—from digital cameras to inexpensive computers and smartphones—are synergizing with ubiquitous connectivity, maturing consumer media consumption and social networking standards (like video streaming and chat), open source software, and maturing software development standards to open up broad, new avenues for development of telemedical systems. The resulting gear varies in capability but is invariably cheaper, easier to implement and often far more portable than earlier, specialized counterparts (where such precursor devices existed at all).
The following survey of studies is a sampling of ongoing developments as these trends accelerate.
REFERENCES
INTRODUCTION
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TECHNICAL
Bonnardot L, Rainis R. (2009) Store-and-forward telemedicine for doctors working in remote areas. J Telemed Telecare. 15(1):1-6. [PMID: 19139214]
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Wang CH, Jiau HC; et al. (2009) A novel indexing architecture for the provision of smart playback functions in collaborative telemedicine applications. Comput Biol Med. Dec 28. [Epub ahead of print] [PMID: 20042186]
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CLINICAL
Cardozo L, Steinberg J. (2010) Telemedicine for Recently Discharged Older Patients. Telemed J E Health. Jan 11. [Epub ahead of print] [PMID: 20064067]
Chiao L, Sharipov S; et al. (2005) Ocular Examination for Trauma; Clinical Ultrasound Aboard The International Space Station. J of Trauma Injury, Infection, and Critical care. Mar;58(5):885-889.
Chambers SK, Girgis A; et al. (2009) Beating the blues after cancer: randomised controlled trial of a tele-based psychological intervention for high distress patients and carers. BMC Cancer. Jun 17;9:189. [PMID: 19531265]
Ciemins EL, Holloway B; et al. (2009) Telemedicine and the mini-mental state examination: assessment from a distance. Telemed J E Health. Jun;15(5):476-8. [PMID: 19548827]
Dalfra MG, Nicolucci A; et al. (2009) The effect of telemedicine on outcome and quality of life in pregnant women with diabetes. J Telemed Telecare. 15:238-242. [PMID: 19590029]
Dyer D, Cusden J; et al. (2008) The clinical and technical evaluation of a remote telementored telesonography system during the acute resuscitation and transfer of the injured patient. J Trauma. Dec;65(6):1209-16. [PMID: 19077603]
Froehlich W, Seitaboth S; et al. (2009) Case report: an example of international telemedicine success. J Telemed Telecare. 15(4):208-10. [PMID: 19471034]
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Helck A, Matzko M; et al. (2009) Interdisciplinary expert consultation via a teleradiology platform–influence on therapeutic decision-making and patient referral rates to an academic tertiary care center. Rofo. Dec;181(12):1180-4. Epub 2009 Oct 26. [PMID: 19859862]
Holtz B, Whitten P. (2009) Managing asthma with mobile phones: a feasibility study. Telemed J E Health. Nov;15(9):907-9. [PMID: 19919198]
Ishioka P, Tenório JM; et al. (2009) A comparative study of teledermatoscopy and face-to-face examination of pigmented skin lesions. J Telemed Telecare. 5(5):221-5. [PMID: 19590026]
Kanthraj GR. (2009 ) Authors’ willingness for second-opinion teledermatology in difficult-to-manage cases: ‘an online survey’. J Eur Acad Dermatol Venereol. Dec 10. [Epub ahead of print] [PMID: 20015171]
Martínez-Ramos C, Cerdán MT, López RS. (2009) Mobile phone-based telemedicine system for the home follow-up of patients undergoing ambulatory surgery. Telemed J E Health. Jul-Aug;15(6):531-7. [PMID: 19566396]
Morin PC, Wolff LT; et al. (2009) Record media used by primary care providers in medically underserved regions of upstate New York was not pivotal to clinical result in the Informatics for Diabetes Education and Telemedicine (IDEATel) project. Inform Prim Care. 17(2):103-12. [PMID: 19807952]
Murakami Y, Silva RA; et al. (2009) Stanford University Network for Diagnosis of Retinopathy of Prematurity (SUNDROP): 24-month experience with telemedicine screening. Acta Ophthalmol. Nov 20. [Epub ahead of print]. [ PMID: 19930212]
Nilsson M, Rasmark U; et al. (2009) The physician at a distance: the use of videoconferencing in the treatment of patients with hypertension. J Telemed Telecare. 15(8):397-403. [PMID: 19948706]
Park MJ, Kim HS, Kim KS. (2009) Cellular phone and Internet-based individual intervention on blood pressure and obesity in obese patients with hypertension. Int J Med Inform. Oct;78(10):704-10. Epub 2009 Jul 29. [PMID: 19643661]
Patricoski C, Kokesh J; et al. (2003) A comparison of in-person examination and video otoscope imaging for tympanostomy tube follow-up. Telemed J E Health. Winter;9(4):331-44. [PMID: 14980090]
Pervez MA, Silva G; et al. (2010) Remote supervision of IV-tPA for acute ischemic stroke by telemedicine or telephone before transfer to a regional stroke center is feasible and safe. Stroke. Jan;41(1):e18-24. Epub 2009 Nov 12. [PMID: 19910552]
Piron L, Turolla A; et al. (2009) Exercises for paretic upper limb after stroke: a combined virtual-reality and telemedicine approach. J Rehabil Med. Nov;41(12):1016-102.[PMID: 19841835]
Ramaekers BL, Janssen-Boyne JJ; et al. (2009) Adherence among telemonitored patients with heart failure to pharmacological and nonpharmacological recommendations. Telemed J E Health. 2009 Jul-Aug;15(6):517-24. [PMID: 19566401]
Rossi MC, Nicolucci A; et al. (2010) Diabetes Interactive Diary: a new telemedicine system enabling flexible diet and insulin therapy while improving quality of life: an open-label, international, multicenter, randomized study. Diabetes Care. Jan;33(1):109-15. Epub 2009 Oct 6. [PMID: 19808926]
Sargsyan AE, Hamilton DR; et al. (2005) FAST at MACH 20: clinical ultrasound aboard the International Space Station. J Trauma. Jan;58(1):35-9. [PMID: 15674147]
Silva CS, Souza MB; et al. (2009) Teledermatology: diagnostic correlation in a primary care service. An Bras Dermatol. Oct;84(5):489-93. [PMID: 20098851]
Switzer JA, Hall CE; et al. (2010) A telestroke network enhances recruitment into acute stroke clinical trials. Stroke. Mar;41(3):566-9. Epub 2010 Jan 7. [PMID: 20056929]
Qaddoumi I, Bouffet E. Supplementation of a successful pediatric neuro-oncology telemedicine-based twinning program by e-mails. Telemed J E Health. Dec;15(10):975-82. [PMID: 19929233]
Weinlich M, Nieuwkamp N; et al. (2009) Telemedical assistance for in-flight emergencies on intercontinental commercial aircraft. J Telemed Telecare. 15(8):409-13. [PMID: 19948708]
Whitten P, Mickus M. (2007) Home telecare for COPD/CHF patients: outcomes and perceptions. J Telemed Telecare. 13(2):69-73. [PMID: 17359569]
Wilbur DC, Madi K; et al. (2009) Whole-slide imaging digital pathology as a platform for teleconsultation: a pilot study using paired subspecialist correlations. Arch Pathol Lab Med. Dec;133(12):1949-53. [PMID: 19961250]
van den Brink JL, de Boer MF; et al. (2006) Quality of life during the first 3 months following discharge after surgery for head and neck cancer: prospective evaluation. J Otolaryngol. 2006 Dec;35(6):395-403. [PMID: 17380834]
HUMAN
Al-Kadi A, Dyer D; et al. (2009) User’s perceptions of remote trauma telesonography. J Telemed Telecare. 15(5):251-4. [PMID: 19590031]
Agha Z, Schapira RM; et al. (2009) Patient satisfaction with physician-patient communication during telemedicine. Telemed J E Health. Nov;15(9):830-9. [PMID: 19919189]
Agha Z, Roter DL, Schapira RM. (2009) An evaluation of patient-physician communication style during telemedicine consultations. J. Med Internet Res. Sep 30;11(3):e36. [PMID: 19793720]
Anderson JG. (2004) Consumers of e-Health: Patterns of Use and Barriers. Social Science Computer Review, Vol. 22, No. 2, 242-248.
Buck S. (2009) Nine human factors contributing to the user acceptance of telemedicine applications: a cognitive-emotional approach. J Telemed Telecare. 15(2):55-8. [PMID: 19246602]
Hoerbst A, Kohl CD; et al. (2010) Attitudes and behaviors related to the introduction of electronic health records among Austrian and German citizens. Int J Med Inform. Feb;79(2):81-89. Epub 2009 Dec 23. [PMID: 20031482]
Lai AM, Kaufman DR; et al. (2009) Evaluation of a remote training approach for teaching seniors to use a telehealth system. Int J Med Inform. Nov;78(11):732-44. Epub 2009 Jul 19. [PMID: 19620023]
Lee JY, Du YE; et al. (2010) Parental perceptions toward digital imaging and telemedicine for retinopathy of prematurity management. Graefes Arch Clin Exp Ophthalmol. Jan;248(1):141-7. Epub 2009 Sep 23. [PMID: 19774354]
López AM, Graham AR; et al. (2009) Virtual slide telepathology enables an innovative telehealth rapid breast care clinic. Semin Diagn Pathol. 2009 Nov;26(4):177-86.[ PMID: 20069779] (also used in Fields of Practice)*
Mahapatra AK, Mishra SK; et al. (2009) Critical issues in medical education and the implications for telemedicine technology. Telemed J E Health. Jul-Aug;15(6):592-6. [PMID: 19659416]
Maybury T, Farah CS. (2009) Perspective: Electronic systems of knowledge in the world of virtual microscopy. Acad Med. Sep;84(9):1244-9. [PMID: 19707064]
Nageba E, Fayn J, Rubel P. (2009) A knowledge model driven solution for web-based telemedicine applications. Stud Health Technol Inform. 150:443-7. [PMID: 19745351]
Sandberg J, Trief PM; et al. (2009) A qualitative study of the experiences and satisfaction of direct telemedicine providers in diabetes case management. Telemed J E Health. Oct;15(8):742-50. [PMID: 19780691]
Sevean P, Dampier S; et al. (2009) Patients and families experiences with video telehealth in rural/remote communities in Northern Canada. J Clin Nurs. Sep;18(18):2573-9. [PMID: 19694885]
Shachak A, Reis S. (2009) The impact of electronic medical records on patient-doctor communication during consultation: a narrative literature review. J Eval Clin Pract. Aug;15(4):641-9. Epub 2009 Jun 10. [PMID: 19522722]
Shirts BH, Gundlapalli AV, Jackson B. (2009) Pilot study of linking Web-based supplemental interpretive information to laboratory test reports. Am J Clin Pathol. Dec;132(6):818-23. [PMID: 19926571]
van den Berg N, Meinke C, Hoffmann W. (2009) Possibilities and limitations of telemedicine in general practitioner practices. Ophthalmologe. Sep 4. [Epub ahead of print] [PMID: 19730867]
Varkey P, Schumacher K; et al. (2008) Telemedicine in the work site: a study of feasibility, and patient and provider satisfaction. J Telemed Telecare. 14(6):322-5. [PMID: 18776079]
Visser JJ, Bloo JK; et al. (2009) Implementation of a broadband video consultation service for children with posture and movement disorders. J Telemed Telecare. 15(6):269-74. [PMID: 19720762]
Vuononvirta T, Timonen M; et al. (2009) The attitudes of multiprofessional teams to telehealth adoption in northern Finland health centres. J Telemed Telecare. 15(6):290-6. [PMID: 19720766]
Weaver JB III, Mays D; et al. (2009) Profiling Characteristics of Internet Medical Information Users. JAMIA 16:714-722 doi:10.1197/jamia.M3150. [PMID: 19567794]
Whitten P. (2006) Will we see data repositories for telehealth activity in the near future? J Telemed Telecare. 12 Suppl 2:S65-71. [PMID: 16989677]
Whitten P, Mickus M. (2007) Home telecare for COPD/CHF patients: outcomes and perceptions. J Telemed Telecare. 2007;13(2):69-73. [PMID: 17359569]
Electronic Health Record by the Healthcare Information and Management Systems Society. http://www.himss.org/ASP/topics_ehr.asp . Accessed on February 12, 2010.
Richards, E. Public Health Law Map. http://biotech.law.lsu.edu/map/thetelemedicinephysicianpatientrelations.html . Accessed on February 13, 2010.
Rural Consult. Overview of Telemedicine Physician Liability. https://www.ruralconsult.com/docs/liability_letter.pdf . Accessed on February 13, 2010.
COST
Bergmo TS. (2009) Can economic evaluation in telemedicine be trusted? A systematic review of the literature. Cost Eff Resour Alloc. Oct 24;7:18. [PMID: 19852828]
Dávalos ME, French MT; et al. (2009) Economic evaluation of telemedicine: review of the literature and research guidelines for benefit-cost analysis. Telemed J E Health. Dec;15(10):933-48. [PMID: 19954346]
Grant B, Morgan G; et al. (2009) Remote Diagnosis of Congenital Heart Disease: The Impact of Telemedicine. Arch Dis Child. Nov 29. [Epub ahead of print] [PMID: 19948507]
Kokesh J, Ferguson AS; et al. (2009) Traveling an audiologist to provide otolaryngology care using store-and-forward telemedicine. Telemed J E Health. Oct;15(8):758-63.[PMID: 19780694]
Latifi R, Hadeed GJ; et al. (2009) Initial experiences and outcomes of telepresence in the management of trauma and emergency surgical patients. Am J Surg. Dec;198(6):905-10. [PMID: 19969150]
Rand ER, Lappan CM; et al. (2009) Paging the worldwide cardiology consultant: the Army Knowledge Online Telemedicine Consultation Program in cardiology. Mil Med. Nov;174(11):1144-8. [PMID: 19960820]
Wang F. (2009) The role of cost in telemedicine evaluation. Telemed J E Health. Dec;15(10):949-53; discussion 954-5. [PMID: 19929429]
Gates MA. (2007) Telemedicine: Healthcare Goes Anywhere. For The Record. Apr 2(19):7, 18. http://www.fortherecordmag.com/archives/ftr_04022007p18.shtml . Accessed on February 2, 2010.
Vastag B. (2007, June 1) Telemedicine’s Adolescent Angst. H&HN Technology. http://www.hhnmag.com/hhnmag_app/jsp/articledisplay.jsp?dcrpath=HHNMAG/Article/data/06JUN2007/0706HHN_FEA_Technology&domain=HHNMAG . Accessed on February 11, 2010.
APPENDIX
Fields of Practice: Current Examples
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Bosch RF, Krause-Allmendinger H; et al. (2009) Telemonitoring of implantable devices. Practical aspects and ongoing studies. Herzschrittmacherther Elektrophysiol. Dec;20(4):179-84. [PMID: 19941146]
Doarn CR. (2003) Telemedicine in extreme environments: analogs for space flight. Stud Health Technol Inform. 97:35-41. [PMID: 15537228]
Favero L, Pavan L, Arreghini A. (2009) Communication through telemedicine: home teleassistance in orthodontics. Eur J Paediatr Dent. Dec;10(4):163-7. [PMID: 20073540]
Frisch S, Zittermann A; et al. (2009) A randomized controlled trial on the efficacy of carbohydrate-reduced or fat-reduced diets in patients attending a telemedically guided weight loss program. Cardiovasc Diabetol. Jul 18;8:36. [PMID: 19615091]
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Health Management Technology. Telehealth Network Connects Rural Nebraska. http://healthmgttech.com/index.php/solutions/hospitals/telehealth-network-connects-rural-nebraska.html . Accessed on February 5, 2010.
INNOVATORS
AMD Global Telemedicine. www.amdtelemedicine.com. Accessed on February 2, 2010.
American Well. www.americanwell.com. Accessed on February 18, 2010.
Cenegenics Medical Institute. www.cenegenics.com . Accessed on March 9, 2010.
Doctors Telehealth Network. www.doctel.net. Accessed on February 3, 2010.
GE VScan. http://www.gehealthcare.com/vscan/ and http://www.medgadget.com/archives/2010/02/ges_vscan_worlds_smallest_portable_ultrasound
_now_available_worldwide.html . Accessed on February 22, 2010.
Hello Health. www.hellohealth.com. Accessed on February 2, 2010.
ICSI. www.icsi.org. Accessed on February10, 2010.
Moca. www.mocamobile.org. Accessed on February 18, 2010.
NASA Telemedicine. www.ipp.nasa.gov/innovation/Innovation53/telemtec.htm and www.nttc.edu. Accessed on February 16, 2010.
NuPhysicia. www.nuphysicia.com. Accessed on February 18, 2010.
Project ECHO. www.echo.unm.edu. Accessed on February 18, 2010.
TeleMedic Systems. www.telemedicsystems.com. Accessed on March 12, 2010.
Telemedicine.com Inc. www.telemedicine.com. Accessed on March 15, 2010.
New York Times on Dr. Klaus Phanareth. Accessed on February 1, 2010.
Reuters on Dr. Howard Stark. Accessed on February 1, 2010.
EXPLORING THE CURRENTS OF TELEMEDICINE ONLINE
Galactic Pub. www.galacticpub.com/telemedicine . Created February 18, 2010.