" (Doukas, Maglogiannis and Kormentzas, 2006) The following illustration shows the evaluation Platform Architecture.
Figure 3
The Evaluation Platform Architecture
Doukas, Maglogiannis and Kormentzas (2006) state that the patient state vital signs are monitored through a PDA device attached to the patient and transmitted to a computer for evaluation through wireless access or Bluetooth. Additionally the patient site is monitored through use of a camera. The software that has been developed is used to monitor the patient status as well as the network status and determines the proper coding of the data collected on the patient. Doukas, Maglogiannis and Kormentzas states that two patient states have been identified as (1) normal; and (2) urgent. (2006) Sensors used to monitor patient data include those of: (1) ECG, BP (non-invasive blood pressure); (2) PR (Pulse Rate); (3) HR (Heart Rate) and (3) Sp02 (Hemoglobin Oxygen Saturation). (Doukas, Maglogiannis and Kormentzas, 2006) The following illustration lists the data level thresholds which indicate the status of patients.
Figure 4
Patient Data Coding According to Network Quality and Patient Status
When patient status is normal there is no transmission of real time data unless otherwise ordered by the physicians. Information containing vital signs average values are included in daily status reports. In the event of an emergency it is stated that "the real time data transmission mode is activated, alerting the monitoring physicians regarding the patient status and allowing thus efficient remote care (e.g., medication advise, urgent patient transfer to hospital, etc.)." (Doukas, Maglogiannis and Kormentzas, 2006)
The work of Kodandaram (2009) entitled: "Telemedicine: Healthcare for the Future" states that many countries including the country of India are short of 600,000 doctors, 1 million nurses, and 200,000 dental surgeons to achieve 1:10,000 doctor-patient ratio." (Kodandaram, 2009) It is reported that 72% of India's population still live in rural locations, 75% are dispensaries, and 60% of hospitals are located in urban areas. However, the government of India reports having launched a national health insurance scheme and one in which the home clinic has been integrated. States is that the idea of being treated from one's home is "very comforting and is proving to be cost effective." (Kodandaram, 2009)
This idea is driven by the aging population of India and the increased demand in remote locations as well as by advancing technology with forecast to reach $18 billion by 2015. It is stated to telemedicine will soon play a role that is important. The different forms and uses of telemedicine are based on the type of service:
(1) Teleradiology: Provides primary diagnosis of medical images such as x-ray technology; (2) Teleconsultation: General practice consultation through an audio-video conference and exchange of patient information for routine chronic disease management like diabetes, high blood pressure, etc.) non-emergency review, and prescription refills;
(3) Telecardiology: Observation of a chronic heart patient through monitoring of blood pressure, electrocardiograms (ECG), pulse, etc.;
(4) A cardiologist can review the data and advice on the condition and initiate any emergency care if required; (5) Teledermatology: Remote diagnosis of a patient's skin condition;
(6) Teleophthalmology: Remote ophthalmology consultations and diagnosis of various eye conditions;
(7) Telepathology: Viewing laboratory specimens located at a remote laboratory through a camera-based microscope. (Kodandaram, 2009) Sensor drives used in telemedicine application include such as "...temperature sensors, blood pressure monitors, weighing machines, pulse oximeter (SPO2), ECG, etc."
Kodandaram (2009) states that a key requirement for consideration in telemedicine is the consideration of the need to provide a telecommunication technology that is both "reliable and cheap." (Broadband installations are reported to have grown and government and non-government organizations are stated to be "taking the lead by sponsoring satellite links."
Kodandaram (2009) states that bandwidth availability is "not a big challenge for other telemedicine disciplines involving images. Today, bandwidth availability is"... not a big challenge for other telemedicine disciplines involving images. To transfer patient information to the hospital server, applications have to be HL7 (health level seven) compliant. Being HL7 compliant, patient health records can be electronically maintained (electronic medical record -- EMR). It also allows for sharing of patient data across hospitals and systems, allowing interoperability of applications and systems. In addition, telemedicine solutions should allow for billing and connection to insurance systems. Under the RSBY healthcare scheme, the government has mandated that every person who is availing of the RSBY facility be issued a smart card that would track his/her vital...
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