Mobile Telemedicine Vehicle

In this post I would like to introduce the application of Mobile Telemedicine Vehicle (MTV). MTV provides an effective alternative to provide medical care when accessing to hospitals is not convenient or unavailable. MTV is another area where business and ICT could come together to increase the quality of healthcare.

One example in of MTV in the use for emergency and natural disaster response is the one designed by Loma Linda University Medical Center (LLUMC) and the United States Army (the Army)¹. It is aimed to provide high quality medical care to civilians in the case where normal hospital services were not available due to situations such as terrorist attack or earthquake¹.  

The MTV from LLUMC was equipped with highly sophisticated care and telecommunication technologies and devices such as satellite system and telemedicine connectivity¹. In this way the MTV is able to provide real-time data transfer without the dependence on land-based communications¹. Also the vehicle has medical equipment, such as x-rays, vital statistics, and live video, by which doctors off-site could provide necessary care to patients whose data could be sent real-time from the MTV¹. In addition, the MTV from LLUMC also was designed to have off-road capabilities, built on the Mercedes-Benz chassis by UNICAT¹.

The following video provides more details about the MTV from LLUMC:

The second area of application of MTV is to provide easier access to high quality healthcare services. The MTV recently acquired by Kaiser Permanente (KP), a leading healthcare provider, is a good example in this field². The goal is to provide greater coverage of healthcare services to the Kaiser Permanent members on the home island of Hawaii, the Big Island².

With the installation of Kaiser Permanente HealthConnect, KP’s signature electronic health record system, the MTV is expected to serve about 12,000 Hawaii residents². It would allow KP the mobile team to access to member health care data on a real-time basis². Also, women on the Big Island would have access to the latest breast cancer detection technology, thanks to a digital mammography unit equipped on the MTV that would transfer real-time patient data to doctors in KP hospitals². In addition, residence on the Big Island could receive healthcare services such as urinalysis, gonorrhea and chlamydia testing, cholesterol, glucose and waive testing, and immunization services².

The following are the pictures of the MTV and the equipment installed on it:

These two examples imply that telemedicine could have multiple layers of technology. Traditionally telemedicine is only accessible from remote stationary health centers or from patient homes. Then one layer of telecommunication technologies, such as mobile phones and video conferences could link the patient site with doctors in distant hospitals where advanced healthcare treatment and consultation could be delivered to the patients. In the case of MTV, telemedicine was made possible by the layer of telecommunication technologies on top of mobility technologies. It even further increased the value of telemedicine in the sense that patients now do not have to travel to get quality healthcare. For example, in the case of an earthquake, patients with limited mobility could stay where they are to get quality treatment from MTVs. Also, another example would be in a flu pandemic case. Instead of going to hospitals with the potential to increase Hospital Associated Infections (HAI) cases or to risk the health of nurses and doctors, patients could stay in their homes or communities to be treated by mobile healthcare staff on MTVs. In this way, the pandemic could be better controlled because of the reduced mobility of infected patients.

The combination of telemedicine and transportation could be taken further to concepts such as “Mobile Telemedicine Helicopters”. It could be of special use in natural disasters where ground transportation is not possible.

In conclusion, the potential of telemedicine could be fully realized when creatively combined and enabled by other technologies.

References:
1. http://lomalindahealth.org/medical-center/for-health-professionals/center-for-prehospital-care/care/mobile-telemedicine-vehicle.page
2. http://xnet.kp.org/newscenter/pressreleases/nat/2009/061109hawaiimobilehealth.html

More on the Telemedicine Application in Patient Transportation

Here I would like to add a supplementary case to further illustrate the application of telemedicine in patient transportation. In this case, not only we see how telemedicine could improve patient care, but also the business implications, especially for telecommunication devices companies.

At Cincinnati Children's Hospital Medical Center (CCHMC), sophisticated telecommunication devices have been installed on the ambulances. This idea was originated by Dr. Hamilton Schwartz at CCHMC from the use of webcams to talk to his family¹.

In order to allow his critical care transport teams to provide quality care from the pick-up site to the hospital room, Dr. Schwartz chose GlobalMedia to design and develop an in-transit mobile telemedicine solution called Transport AV Telemedicine System². This system combined the TotalExam camera, a high-resolution handheld video camera, with a digital stethoscope, microphone and headset². It is then connected to the Internet via 3G, 4G, or 802.11 networks².

Using this system, the critical care team would be able to transmit real-time patient data through live video and freeze-frame images from the ambulances to the doctors at CCHMC².

What’s better was that the Transport AV system not only is used inside the ambulance, but also is able to travel with the patients by attaching to the gurney in the ambulance. It allows uninterrupted communication between care givers on-site with patients and doctors in CCHMC to give continuous monitoring and care delivery². In addition to prepare and set up necessary operation rooms, the Transport AV system also enable hospital administrators to register for the patients before their arrival, saving critical time for treatment².

This case is a great example how telecommunication providers and device manufacturers could work together to provide state-of-the-art health services to patients. Frequent conversations and interactions between patients, doctors, and care givers and telemedicine technology and service companies is an efficient way to design and develop customized telemedicine products and solutions.

The following is the picture of TotalExam from GlobalMedia

The following is the picture of the Transport AV Telemedicine System

References:

1.       http://www.informationweek.com/news/healthcare/mobile-wireless/showArticle.jhtml?articleID=220600778

2.       http://www.globalmedia.com/newsletter/Volume1-page5.html

Mobile Telemedicine: Transiting Patients

In this post I am going to talk about the importance of telecommunication technologies in ambulance during the process of patient transportation. This application of telemedicine have significant benefits to patients and care givers and present great opportunities for hospitals.

First let’s look at the application of telemedicine in emergency care. Patients who had to be transferred to hospitals by ambulance usually require instant care by care givers and doctors. However without doctors and specialists on the ambulance, emergency care givers could only provide basic life-sustaining cares. Many lives had been lost in the ambulance on the way to hospitals. To give the needed care at the earliest possible time, University of Maryland Medical Center and University of Maryland School of Medicine in Baltimore established the first ambulance equipped with video and computer technology to assess and treat stroke patients¹. This invention was partnered with TRW Inc. and partially funded by National Library of Medicine¹.

 Providing two-way audio and video communication between ambulance and a computer in a doctor’s office, the new system had successfully transported 12 stroke patients in test runs¹. There would be more sophisticated equipment installed in this system, allowing doctors to examine patients before they reach the hospital to determine which treatment would be required¹.

According to the American Heart Association, Stroke is the leading cause of disability for U.S. adults¹. Every year about 750,000 Americans suffer from a stroke¹. However, only a small percentage of them were able to get the drug they needed within a 3-hour window. By using this now telemedicine system on ambulance, more stroke patients would be benefited from real-time diagnosis and treatment from doctors even before they were transported to hospitals.

Stroke patients will more likely to choose hospitals with such services. Embracing telemedicine in ambulance would signficantly increase the quality of services provided by hospitals and thus increase the competitive advantages of hospitals with such technologies.

Reference:

1.       http://www.umm.edu/news/releases/telemedicine.htm

The First Sino-India JV for Advancement in Telemedicine

In this post I will talk about how India and China, two of the fastest growing economies in the world, are collectively working together in the field of telemedicine. The population of these two countries poses an attractive domestic market for telemedicine. At the same time, the advancement in technologies in both software and hardware positioned India and China to enter and compete internationally in the telemedicine industry.

In September 17, 2007 the first ever Sino-India Joint Venture (JV) in telemedicine research and services was formed in Kunming, Yunnan, China¹. The JV is called Sunpa Sobha Software (China) Ltd (3S) and is formed by Sobha Renaissance Information Technology (SRIT) from India and Yunnan Sunpa Image Tel Tech Co. Ltd (Sunpa) from China². With a registered capital of $1 million and more than 200 employees, 3S will be based in Kunming and have offices in four Chinese cities, Beijing, Shanghai, Guangzhou, and Shenzhen². 60% of the capital investment was from Sunpa and 40% from SRIT². However, SRIT is planning to invest $20 million in the Chinese telemedicine field in the years to come².

This JV will combine the SRIT's flagship Software Products, “Renaissance Care Magnum” and “Renaissance rChive” and Sunpa’s telemedicine peripherals and devices to benefit patients and hospitals in both India and China³. In the future, Chinese hospitals will gain access to SRIT’s expertise in Clinical, Radiological, Diagnostic and Medical Imaging software³. At the same time Sunpa’s signature tele-vital sign monitoring, tele-dermatology, tele-pathology devices will bring advancement in telemedicine to India³.

The two parties are both very optimistic about the future of 3S with projected revenue of $100 million by 2010². I believe this is a realistic goal given the population in both India and China. Also as internationally recognized software, SRIT, and hardware provider, Sunpa, in telemedicine, both companies already established extensive network both domestically in India and China and internationally in regions like South Africa and Southeast Asia⁴, this JV could also play an important role to explore international markets.

The following video provides more details about 3S and the two joinging parties.

Reference:
1. http://www.youtube.com/watch?v=L_0V5mZmXoc
2. http://www.chinadaily.com.cn/bizchina/2007-09/21/content_6125374.htm
3. http://www.renaissance-it.com/srit2/corporate/site/en/Sunpa_Sobha_Postevent_media.html

Implications from Rwanda - Mobile Technology and Telemedicine

In January 2011, I was fortunate enough to spend three weeks in Rwanda for the Innovation for Humanity project. As a Chinese native I thought I understand what emerging market means. However this trip proved me wrong not only I see more opportunities in Rwanda but also I identified areas from which China should learn.

The use of mobile technology to provide better healthcare is one of these areas. The benefits of mobile health comes in two layers - providing better quality healthcare and covering more patients in rural areas. From auditing the process of my client, a private clinic in Kigali, I learnt that all of its patients have cell phones. To better serve patients with chronic disease such as Malaria, doctors needed to keep track of the progress and conditions of these patients. One way, and the most common way, to do this is to require the patients to re-visit periodically. However every few patients do so because the time spent on traveling was too long and the cost of transportation was high. The doctors at this clinic envisioned using mobile phones as the mean to check the status of patients and deliver health care services. Upon finishing streamlining its operations, raising enough funds to cover the communication cost of using mobile technology might be a very attractive project for us next year.

Although private clinics were facing funding hurdles to realize telemedicine using mobile phones, the public healthcare system has already achieved this goal. A good example is the mHealth initiative, where communicate healthcare workers were provided with mobile phones. In Rwandan healthcare system, Community Healthcare Centers are the basic level that were supported by volunteers, called community healthcare workers. Their job is to visit rural area families to provide basic healthcare services and gather information. Enabled by these cell phones, community healthcare workers are now able to send text messages to Community Healthcare Centers or larger Referral Hospitals with the health conditions and healthcare needs of the patients. In this way needed health care services would be provided in an accurate and timely manner.

The case in Rwanda reminded us that telemedicine does not require sophisticated technology. Basic mobile technology could solve challenges faced by many developing countries.

Kicking off......with A Personal Experience

Even with limited knowledge and experiences in ICT, I did not consume too many neurons to figure out that Telemedicine, enabled by advancement in ICT, will eventually re-structure how health care services are delivered. According to American Telemedicine Association (ATA), Telemedicion is defined as the exchange of medical information from one site to another through information and communication technologies with the aim to improve the treatment of patients.

Although I have been hearing about various cases where patients' lives had been saved through the collective efforts of doctors, surgeons, and specailists via telemedicine, my first personal encounter to this method was in a cloudy day in 2007 when I went to Jinxiang Pharmacy, the largest chain in Beijing, but forgot my perscription from the doctor. Just as I was scratching my head, one of the pharmacist asked about my symptoms and told me that I could get a new perscription in the pharmacy. Noticed my confusion and hesitation, the pharmacist told me that vedioconferencing was available through which I could consult with licensed doctors. Unwilling to drive back to the hospital because of the traffic and waiting, I tried this new technology and after 20 minutes I was able to go home with the same perscribed drugs without any hassle.

Although only limited diagnose and care could be provided through this vedioconferencing technology in this pharmacy, it allowed many patients to avoid the crowdness and waiting in a regular public hospital. This service has been a good complementarity to Jinxiang's online order and free delivery services for OTC drugs.

Instead of going through all the hassle in terms of traffic and waiting as well as the risk of cross-infection at hospitals, now patients could get their medication at home or within walking distance because Jinxiang is everywhere. Using telemedicine together with other ICT technologies, Jinxiang becomes the real one-stop basic healthcare center for a large number patients in Beijing.