The backbone of effective telemedicine

But the delivery of health services, remotely, is subject to a major proviso--not all technologies are conducive to sustain uninterrupted telemedicine services of a high quality.

Explaining this further, Gupta elucidates, “There is a wide array of conferencing products available (see box) from leading global brands. Most of these are at the cutting edge and can be easily customised to suit one’s need/budget. But, essentially, video-conferencing products that are based on standard definition technology prove to be limiting in the field, since these are associated with glitches such as inconsistent video and audio quality, narrow viewing angles, and the lack of readability of shared documents.”

According to Gupta, the way forward is for hospitals to adopt high definition video conferencing systems that assure a smoother video and audio quality, and enable wider display possibilities as well as a higher resolution that is essential to accurately share medical records.

If you think of the boy in Congo, Dr Nott would not have had to rely solely on text messages to perform the complex operation had telemedicine facilities been available at the hospital in Rutshuru. He could then have been guided in real time by his colleague, perhaps making for better post-surgery results or a back-up opinion and guidance in case he faced a complication during surgery.

In fact, {quotes}high definition telemedicine systems offering high visual acuity are essential to the success of guided medical care and critical in the case of remotely assisted life-saving surgeries.{/quotes}

On the other hand, in these times of economic recession, telemedicine also emerges as a means to optimise the use of scarce medical resources. Rather than have doctors sit idle, hospitals geared to cater to a higher patient load can offer consultations to distant patients, albeit for a lower cost. Of course, success and profits lie in the numbers of patients served.

Making technology accessible

While high definition video conferencing technology is taking current telemedicine systems to the next level, there are certain constraints. Shivasankar Krishnamurthi, country manager, LifeSize (India) observes: “Alongside offering high quality video, an ideal telemedicine solution should be cost-effective and simple to use so as to ensure its wide deployment.”

Krishnamurthi seeks to emphasise the fact that a single telemedicine system consists of an interface between hardware, software and a communication channel to spatially bridge two geographical locations. The doctor and patient, or doctor and assisted doctor, must feel as though they are face-to-face. But for telemedicine to make significant inroads across India, it must be deployed on a large scale. One or two systems will not make a difference to the millions of people living in India’s rural areas. Hospitals must be able to establish a network covering many remote rural hospitals and health centres. And that can be an expensive proposition.

Krishnamurthi cites the availability, quality and cost of bandwidth as another challenge in deploying this technology. In India, bandwidth infrastructure is still an expensive resource. Yet without adequate bandwidth, doctors cannot reach out to distant villages to offer remote diagnostic and medical consultancy services. In this context, he shares the need for a high definition telemedicine system to be capable of delivering high quality audio and video across all available bandwidths, and especially at low bandwidths.

Until that happens, telemedicine will be unable to deliver health services to the masses, notwithstanding its immense potential.