With the widespread availability of the Internet in many countries, medical science and practice have developed new strategies to meet patients' needs. One such approach is telemedicine, which aims to improve patient care and the efficacy of treatments through the use of electronic means to transfer medical data from one place to another.

At advanced levels, it can include the use of telecommunication components such as teleconferencing, but at a basic level it includes medical record keeping, data processing, and phone or email consultation. Telemedicine is helpful in reducing the time needed to consult a specialist in underserved areas with small populations or densely populated areas lacking resources.

Telemedicine has already been applied to a range of different areas of medical practice and also has been shown to be as effective as face-to-face medical care, at least for the diagnosis and treatment of some pathological conditions. Research suggests it is time- and cost-effective for both patients and healthcare professionals and has the potential to be utilized on an even larger scale.

The first forms of telemedicine used telephones and radio, but with the development of modern telecommunication and information technologies, this has been supplemented with the electronic transmission of medical, imaging and health informatics data from one site to another. As technology continues to improve, tools such as digital stethoscopes and portable ultrasound equipment will expand the scope of telemedicine.

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On the plus side, telemedicine can reduce waiting times, benefit patients in isolated or remote areas, and allow healthcare professionals in multiple locations to share information and discuss patient issues. In addition, it reduces administrative costs, infection risk, and the need for outpatient visits while enabling remote prescription verification, drug administration oversight, and the improvement of the medical reimbursement process. Furthermore, it can facilitate medical education by allowing students to observe experts and share best practices.

Telemedicine does have some downsides, including the cost of purchasing and running the equipment, as well the costs of training the personnel who will use it. In addition, it reduces face-to-face interaction with a medical professional, carries an increased risk of error, and has the potential for sensitive information to be unprotected. Telemedicine consultations often take longer than a traditional consultation, and vital treatment cannot be started immediately as it could at a clinic.

A team led by Dr Tommaso Iannitti of the University of Sheffield, UK, recently conducted a review of the telemedicine consultation role in medical practice. They concluded that telemedicine is "an important cost-effective tool providing at least the same quality of medical care as face-to-face consultation in numerous medical fields.

"It allows rapid consultation among specialists, and erases geographic distance," they write in the journal, Patient Preference and Adherence. "Telemedicine opens new horizons for medical consultation, increases benefits for patients, and allows rapid exchange of information and techniques. Information and communication technology provides medical care to patients who have poor access to hospitals, and ensures continuity of care and optimal use of available health resources.

"For this reason, in terms of costs and benefits, private and public health institutions need such a network to optimize their resources," the experts believe. "The use of telemedicine opens new perspectives for the growing number of patients seeking a medical second opinion for their pathology, since they can remotely access medical resources that would otherwise require enormous costs and time."

Conversely, in a 2009 editorial, Dr. Erika Yoo and Dr. R. Adams Dudley of the University of California, San Francisco, highlight the difficulties of evaluating telemedicine. They write, "Given the heterogeneity of systems and the hospitals adopting them, it is unlikely that any single study can definitely address the benefits of telemedicine. Rather, literature syntheses will be the most important approach." Future studies should include more description of the care given with and without telemedicine, they add.

References

Di Cerbo A, Morales-Medina JC, Palmieri B, et al. Narrative review of telemedicine consultation in medical practice. Patient Prefer Adherence 2015;9:65-75.

Yoo EJ, Dudley RA. Evaluating telemedicine in the ICU. JAMA 2009;302:2705-2706.

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