telemedicine support
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Medical Informatics & Applications
Telemedicine SupportsTelemedicine Supports
Dani IswaraHealth Management Information System
Field Epidemiology Training ProgramPublic Health Science
Faculty of Medicine Gadjah Mada UniversityYogyakarta, Indonesia
RIGHT Seminar, Jan 10, 2009, Med Fac-UAJ, Jakarta
AccessAccess QualityQuality Cost-benefitCost-benefit
→ → Health outcomesHealth outcomes
SustainabilitySustainability
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Telemedicine...Telemedicine...
TelemedicineTelemedicinestationstation
NetworkDataData
Application
→ Not-so-new technology
Ax, physical,lab exam, Tx
Non/web-based
A/synchronous
Push/pull
Cable, wireless
Mobile
Hospital,Clinic,Private,Pharmacy
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What is Telemedicine?What is Telemedicine?
Telemedicine (telemedisin = kedokteran jarak jauh)● Medical/clinical services● Long distance (geographics; regional,
national, international)● Information & communication technology
(ICT)
Telehealth (health care), telecare
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What is Telemedicine offered?What is Telemedicine offered?
● Efficient● Effective● Interactive● Collaborative● Ubiquitous
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What is Telemedicine for?What is Telemedicine for?
Types of telemedicine● Teleconsultation
● Telephone, SMS, web, email, forum, blog● Teleconference (videoconference)
● Tele-education● Telemonitoring (chronical ds, drugs/labs
monitoring)● Teleradiology, telesurgery, telecardiology,
telepathology, telepsychiatry, teledermatology
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Telemedicine in IndonesiaTelemedicine in Indonesia
SMS Gateway (ITB; 2006):
Reporting & monitoring → disaster, TB, lepra
Dasar-dasar Implementasi Telemedicine
(Johan Harlan; PSIK Univ. Gunadarma; 2007)
Standard formats → txt, XML, MPEG, JPEG, pixel, ICD 10, HL7?
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Telemedicine in Indonesia (2)Telemedicine in Indonesia (2)
Since 2005:
Videoconference equipments
VoIP equipments
Internet
KepMenKes No. 857 Tahun 2007Pengembangan Jaringan Komputer Online
Sistem Informasi Kesehatan Nasional(Siknas Online)
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Barriers of TelemedicineBarriers of Telemedicinedeveloping countriesdeveloping countries
Cultural problems
Inapropriate 'experts'
Regulations
Human resources
Technologies
Reimbursements
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Cost Impacts of TelemedicineCost Impacts of Telemedicine
● Chronic ds● Outpatient
consultation● Length of stay
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SampleSample
Position Statements of TelemedicinePosition Statements of Telemedicine
Internet Prescribing“Store and forward providers should take care regarding direct prescribing for patients via electronic communications. Most states have regulations that discourage or prohibit practitioners from prescribing for patients that they have not seen face to face. In many cases, the wording of these regulations is such that a live and interactive consultation would meet the requirements for a “face to face exam”. Since most store and forward providers are working in collaboration with a provider at the point of care, this should not inhibit patient care. The dermatologist should take care to recommend as opposed to prescribe.”
American Academy of Dermatology (2004)
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SampleSample
Statement on TelecomunicationStatement on Telecomunicationin Medicinein Medicine
Physician-Patient Relationship
"If a patient receives professional advice or treatment, even gratuitously, there is prima facie evidence that a physician-patient relationship exists."
The American College of Obstetricians& Gynecologists (ACOG)
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SampleSample
Guidelines for the Surgical Practice Guidelines for the Surgical Practice of Telemedicineof Telemedicine
Telesurgery (Remote Surgery)
"Appropriate Use:
Demonstration and/or teaching technique or procedures...
-- using inanimate trainers as the objects of the procedure.
-- using animate model for purposes of testing technology.
-- on patients under strict guidance of an IRB and only when a qualified surgeon is present to intervene in a timely fashion if
technical difficulties arise."
Society of American Gastrointestinaland Endoscopic Surgeons (SAGES); 2004
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SummarySummary
Telemedicine is only a tool
Potentiality of telemedicine
Patient safety first
Guidelines & standards
Researches & evidences
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Thank You...Q & AThank You...Q & A
You are free to share (copy, distribute, transmit) & adapt this work under the similar license Creative Commons AttributionNoncommercialShare Alike 3.0 Unported
(CCANCSA 3.0 Unported)
Dani Iswara
daniiswara@gmail.com
http://daniiswara.net/
Last updated: January, 2009
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