Catálogo de publicaciones - libros

Telemedicine concept originated from attempts to deliver healthcare services to patients located some distance from providers. Consecutive inventions brought by technological progress like the telephone and telegraph were early adapted in the healthcare domain. First examples of such applications come from the 1920s. In subsequent decades, more advanced systems were developed and first definitions of telemedicine were shaped in the 1970s. For a long time, telemedicine was available to a few centers able to establish expensive infrastructure. As a result of the digital revolution and explosion of the Internet which occurred in the 1990s, the cost of equipment and connections feasible for telemedicine decreased considerably. Furthermore, the concept of e-health as a diversified environment for various types of electronic transactions in healthcare was formed. Nowadays, the e-health domain is an important element of the information society. However, there are still many problems related to legal and ethical aspects of healthcare services based on electronic transmission. The use of telemedicine and e-health applications is a source of fears associated with potential risks, malpractice and liability. On the other hand, potential and evidenced benefits from specific solutions, e.g. in chronic care or in second opinion provision, start to prevail over skepticism.

From the variety of fixed and mobile access techniques, according to assumed selection criteria, one can determine which technology to choose. Looking at both incumbent and emerging solutions, each medical party and patient may obtain as many benefits as necessary. When the scenario requires mobile telemetric of patients’ health, GSM or WLAN connections might be chosen. When medical specialists have to perform videoconference or live surgery coverage, they may utilize broadband techniques like xDSL or IP networks (LAN/WAN).

Telemedical services have begun to play a more and more important role in our everyday life. As a discipline which unites medical and computer sciences, telemedicine is very demanding and telemedical applications need to be built with deep knowledge and understanding of both domains. The chapter depicted the most important requirements of such systems and emphasized the importance of choosing the proper architecture for them.

The chapter presented applications developed or co-developed at the Department of Computer Science within the confines of a few telemedical projects. They address the issue of remote access to medical information. Applications have been received with interest by the South Poland medical environment and participants of medical conferences showing that there is substantial acceptance and demand for such services.

Telemedical systems contain and provide information that is extremely sensitive. Disclosing or damaging that information in an unauthorized way may be catastrophic both for organizations and patients. In order to assure the security of telemedical systems, suitable security policies, security architectures and security mechanisms must be applied. Additionally, a secure and safe working environment must be guaranteed. The rules for setting up such an environment are described (for example) in HIPPA.

Best-practice telemedical systems should satisfy such evaluation criteria as TCSEC or ITSEC. Conformity with these standards helps achieve a well-protected and secure system.

The application of wireless systems in the e-health domain is very promising, although it is at the same time a very challenging task. Even though current modern mobile technologies are ready to fulfill any requirements of such systems, much has to be done on the medical side. The chapter shows that the implementation of a system similar to the one described in the conceptual part is desired not only on an experimental scale but at least all over the continent. Establishing such a network requires international effort and standardization of medical data exchange, medical procedures and legal agreements across the globe. Cost-effective environment construction is also a challenging requirement. While this seems to be a very long-term process, mobile medicine will definitely play a very important role in the future.

The increase in prevalence of chronic disorders in modern societies has resulted in increasing organizational and financial pressure on healthcare systems. The challenge of adequate care delivered to patients with chronic conditions, who want to remain in their social context, promotes the search for effective models of care. Adequate use of information and communication technology may be an appropriate response to this challenge. Chronic patients require repetitive interactions with the healthcare system. High-quality care adhering to evidence-based medicine strategies must be delivered to a vast population of patients in a continuous manner. The experience from studies and pilot implementations of information technology tools in specific groups of patients suffering from chronic diseases indicates that considerable benefits may be gained related to improved cost-effectiveness and simultaneously maintained quality of care. It seems that e-health strategies may help to fulfill two contradictory requirements — provision of high-quality medical services and preservation of the cost-effective approach. Available evidence supports the use of e-health solutions for care delivery. The results of trials based on the use of integrated IT-enhanced model of care with focus on patient empowerment and better interdisciplinary team communication demonstrated improvement of such outcome measures like hospitalization rate, frequency of ambulatory visits and level of quality of life in populations of chronic patients. However, it must be emphasized that a new model of care based on the effective use of e-health solutions cannot be implemented without adherence to legal, ethical and psychosociological requirements existing in the healthcare environment.

This chapter has analyzed the importance of specific medical studies and computer-based support for them. Main standardization organizations were presented, such as AICC, ADL, IMS and others. Some distance learning platforms were described including two case studies of solutions from AGH University of Science and Technology.

Telemedical services have begun to play a more and more important role in our everyday life. As a discipline which unites medical and computer sciences, telemedicine is very demanding and telemedical applications need to be built with deep knowledge and understanding of both domains. The chapter depicted the most important requirements of such systems and emphasized the importance of choosing the proper architecture for them.

The chapter presented applications developed or co-developed at the Department of Computer Science within the confines of a few telemedical projects. They address the issue of remote access to medical information. Applications have been received with interest by the South Poland medical environment and participants of medical conferences showing that there is substantial acceptance and demand for such services.

The functionality of health telematics networks presented in the chapter requires dedicated, reliable computer networks with huge throughput and guaranteed QoS. Detailed technical requirements are also described in other chapters in this book, but it is not the case that they are the main reason for the very slow development and sparse dissemination of such services.

Many sociological, ethical, technical and legal issues have to be overcome to bring such services to a proper level. In the authors’ opinion, existing solutions present an opportunity to surmount technical problems, while other issues still remain unsolved. Another very sensitive problem is appropriate selection of information and its presentation to the right access groups — general public, hospital staff, individual doctors etc. Hence, organisational and legal problems appear more troublesome than technical ones.

This chapter has analyzed the importance of specific medical studies and computer-based support for them. Main standardization organizations were presented, such as AICC, ADL, IMS and others. Some distance learning platforms were described including two case studies of solutions from AGH University of Science and Technology.