Telehealth
After reading this chapter you should know the answers to these questions: What are the key informatics requirements for successful implementation of telehealth systems? What are some key benefits from and barriers to implementation of telehealth systems?
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Telehealth Justin B. Starren, Thomas S. Nesbitt, and Michael F. Chiang
After reading this chapter you should know the answers to these questions: • What are the key informatics requirements for successful implementation of telehealth systems? • What are some key benefits from and barriers to implementation of telehealth systems? • What are the most promising application domains for telehealth?
18.1
Introduction
Complexity and collaboration characterize health care in the early twenty-first century. Complexity arises from increasing sophistication in the understanding of health and disease, wherein etiological models must take into account both J.B. Starren, MD, PhD (*) Division of Health and Biomedical Informatics, Department of Preventive Medicine and Medical Social Sciences, Northwestern University Feinberg School of Medicine, 750 N. Lake Shore Dr., Chicago, IL 60611, USA e-mail: [email protected] T.S. Nesbitt, MD, MPH Department of Family and Community Medicine, School of Medicine, UC Davis Health System, 4610 X Street, Suite 3101m, Sacramento, CA 95817, USA e-mail: [email protected] M.F. Chiang, MD, MA Department of Ophthalmology & Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, 3375 SW Terwilliger Boulevard, Portland, OR 97239, USA e-mail: [email protected]
molecular processes and physical environments. Collaboration reflects not only inter-professional collaboration, but also a realization that successful attainment of optimal well-being and effective management of disease processes necessitate active engagement of clinicians, lay persons, concerned family members, and society as a whole. This chapter introduces the concepts of telemedicine and telehealth, and illustrates how maturing computer networks like the Internet make possible the collaborations necessary to achieve the full benefits of our growing understanding of health promotion, disease management and disability prevention. Consider the following situation: Samuel is a 76 year-old man with coronary artery disease, poorly-controlled Type II diabetes, and high blood pressure. In the past, he has been unable to keep medical appointments consistently because of difficulty arranging transportation. He had a recent acute hyperglycemic episode that required hospitalization. After 4 days he is medically stable and ready for discharge. He is able to measure his blood glucose and can safely administer the appropriate dose of insulin. The nurse notes that Samuel sometimes has trouble calibrating his insulin dose to the blood glucose reading.
This chapter is adapted from an earlier version in the third edition authored by Patricia Flatley Brennan and Justin B. Starren.
E.H. Shortliffe, J.J. Cimino (eds.), Biomedical Informatics, DOI 10.1007/978-1-4471-4474-8_18, © Springer-Verlag London 2014
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18.1.1
Telemedicine and Telehealth to Reduce the Distance Between the Consumer and the Health care System
Historically, health care has usually involved travel. Either t
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