At the end of the day, we all realize that an apple, most of the times, is not enough and the doctor can’t be kept away for too long. But what if a specialist doctor is actually not near? This is where Telemedicine or ‘the use of advanced Telecommunication technologies to exchange health information & provide health care services across geographies and demographics’ comes into picture.

Computer Systems that enable us to do so have been termed as PACS (Picture Archiving and Communication Systems) and essentially are networked computers dedicated towards storing, retrieving, distributing and presenting the medical images and records.

Typical technical requirements to establish such a system would be:

1. Broadband communication
2. High resolution display devices
3. High end video camera (optional)
4. Video-conferencing equipment (depends on above)
5. Highly skilled technologist
6. Equipments e.g. Surgical Robotics

Guidelines for the IT Aspect
A typical Telemedicine Solution must have following properties:

1. Interoperability
2. Compatibility
3. Scalability
4. Portability
5. Reliability

Having massive implementations, there is a need of maintaining databases. Telemedicine databases comprise of:

1. Blood Bank inventories
2. Case histories
3. Different diagnostic test results
4. List of doctors with their specializations & experiences
5. Data about the consulting doctors.
6. List of hospitals with which video conferencing can be done.

Typical information to be transmitted over networks constitutes:

1. Images
2. Written advices, Textual information etc.
3. Video (Live/Recorded)

So is there any research mechanisms required for Telemedicine? Well, yes. And they typically include Algorithm/software development & hardware customization for Telesurgery, Telehealthcare for surgical patients, distant surgical education. Emphasis is on faster data transfer and quick and accurate diagnosis.

Typical algorithms that System Architects in Telemedicine would be interested are:

• Dynamic Programming
• Greedy Algorithms
• Elementary Graph Algorithms
• Minimum Spanning Trees
• Single Source Shortest Paths
• All pairs Shortest paths
• Maximum Flow
• Sorting Networks
• Algorithms for Parallel Processing
• String matching
• Approximation algorithms

Typical Imaging file formats that are of special interest in Telemedicine constitute:

• DICOM standard, the de-facto standard in Medical Imaging
• JPEG and JPEG2000
• MPEG1, MPEG2, MPEG4 Video formats along with other online streamable video formats.

Though cost factor & some legal concerns need to be addressed, as a conclusive remark for this article, it can be confidently said that Telemedicine provides benefits for:

• The surgeon (doesn’t have to move around) – Quick access to current scans, ready availability of Patient History, recording of prescription and print facility of the overall diagnosis – with all this in few minutes makes it a very viable mode of Patient Care.
• Patient and Family (ready availability of specialists) – They don’t have to maintain old reports at their end or run around to gain access to Specialists.
• The Hospital (reduced hiring costs) – With easy access to outside specialists, they needn’t have an in-house specialist for all possible departments.
• Health care delivery agencies / Governments (scale of business) – With access to multiple specialists, the scaleup magnitude of Telemedicine can be very high.

Telemedicine is here to stay and is surely going to help reduce costs across domains and add benefits across boundaries.

- Divya Rathore

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