Telemedicine history

As a surprise to many that the concept of telemedicine is not that new and started actually when telecommunications got the significant part in our life. The core concept of sending data and information through over a distance has repeated itself again and again in form of written telegraphs, voice telephone calls and Radio waves. For the same reason explains why telemedicine related theoretical with telecommunication channels and related technologies. Since Alexander Graham invented and got patented the telephone 1876 and Heinrich Rudolf Hertz did their first radio wave emission the race of wired and wireless communication went to the peak. At beginning was hard and difficult to apply the same telecommunication technologies by the same devices in medical field but along decades the trials did not stop to get and involve part of wireless technologies in healthcare industry. Pennsylvania 1950’s medical staff of two medical centers they started to transmitted radiologic images data and description through telephone. Afterward some radiologists in Montreal did the same with modification to Tele-radiology system of image transmissions and exchange between hospitals. Couple of years later 1959, University of Nebraska medical staff had succeeded to transmit neurological examination to students via two way interactive television network. By 1964, they built a telemedicine platform link allowed health services provision at Norfolk State Hospital, 112 miles far from the campus. The point of explosion to work and evolve over Tele-medical communication channels moved strongly when the medical workers found that when they used data delivery channels among them and within medical work. The results got better and effort became much less than usual at the time, everything changed once they involve the remote communication channels.

After decades till now; the matter of data nature got more complicated and rich in quantities and qualities with no doubts that Tele-medicine will be new vehicle of data transmission between providers and value receivers. Many projects designed to affect and confirm the goal and practically applied with sporadic remote communities in order to do fit positioning of technology utilizations of different sorts from wired and wireless communication platform between physicians and nurses in one side and patients and care takers from other side. It was not strange that people accepted the idea quickly than had been imagined and moreover took it as new tool for survival of their family lives. They found in Tele-medicine time to talk to the GPs regularly and say what was hard instead of take days of travelling to tell them so. Medical care and consultations arrived over there with nothing to pay from your effort, money and time even if there is no full facilities medical care but at least to find a channel to ask and know what you going to do with your case.

Now the matter of sending personal medical data to Family doctor is normal and regular action repeated whenever you want to do. After occupying the web our life and work tasks which enable physicians and medical staffs to be ready and get your medical data and check with you everything throughout hours of the day. The care and communication got easier with patients especially children while the patients feel more satisfied with new technologies and started by themselves to exaggerate the role of Tele-medicine and Tele-communication in healthcare to prove somewhat that Telemedicine changed their life for better and healthier. Full health J

Telemedicine concepts and work fundamentals

Since researchers and e-health system designers found urgent need to use modern communication channels in order to serve and satisfy remote area masses particularly when central hospital for basic services not available. They found matter of reach people physically everywhere over their demands impossible to occur while their demands and regular care still on spot of interest most of the time. Some of e-health designer thought that may be make medical campaign available for while then replace it afterward by some sort of communication channels. Even this hypothesis could not meet a lot of acceptance because if we could set up a channel of communication after medical teams existence physically why not exceed the point to provide the same existence also through the same communication channel. While other researchers thought about telephone and mobile communication in cases of regular diagnostic procedures and follow up after, from many point of view it was the nearest part of work and reachable point to most of patients in remote areas and also that could determines regular needs to be physically existed in case of urgency and surgery. Before talking about the telemedicine in touch of details would like firstly to explain the concept of telemedicine and m-health:

Digital Clinic: it is the basic constituents of telemedicine communication unite and considered the main part of work patch. By digital clinic become easy to set patient movable database for farther processing and regular analytical judgments, integration of different devices and interoperability and eventually control cost effectiveness and final outcomes.

Digital patient: I guess this the difficult part and hard one to consume most of our effort with patients and masses that was briefly described by patient self measurements, patient generated data, behaviour modification and digital retention and engagement. Actually in order to create good simple steps cascades among patients that will serve most of them and teach them innovative modern channel of communications by which would be easier to contact follow up and even to monitoring the cases.

Digital device: It forms the infrastructures for the devices and communication channels thus digital simplicity, wireless and wearable devices, sensors and handheld imaging. Digital infrastructure for telemedicine and m-health look like media of data existence which serve the aim of flowing data between medical workers and patients over different levels of medical services and demands.

It was not imaginable ever that solution has gave patients remote monitoring and diagnosis through mobile and later through web over PC screens by cloud data service provision directly with medical staffs.  Moreover all of these services when patient still there in living place with unmentionable effort of own side. The work does not get and run that fast but took decades throughout process of evolving and progress to the form we have known at our present. There are still opportunities for development and additional modification for existed tools could be better if they change for better and may be the best in near future. Full health J

Medical services in remote areas

Among cascade of medical care currents and introduced services there are category of people naturally according to their geographical distribution. They can’t get the same equal medical care and services even with full existence of technologies and service infrastructures. The point here is not how advanced the technologies involved to work and serve those patients but what kind and how fast delivery channels going to be ready to give them proper attention and feasible level of care acceptance. For those who born and lived somewhile part of their life in remote rural areas, they know what I mean by delivery channels of service while difficulties surrounded the area to be reached. People and patients in remote rural areas used to struggle to get the minimum of medical services and with unpunctual schedules of delivery. As mentioned before people never care about technical issues and work problems they want to achieve health welfare and see their families sound through good medical value provision. For instance; people who live on the islands found it difficult to move getting attach back of any central hospitals while medical staffs and nurses found the same problem when they have to move there for some medical campaigns and medicines provision issues. Almost the same problem if the village surrounded by highlands or mountains and in case of absence of any medical center or hospital the same consequences would be about services.

Researchers began long ago to find a solution for remote rural areas and even for isolated islands to give appropriate level of medical services. In old times that was hard to find lowest level of medical care and most of separate campaigns dependent to serve them for short period of time and then leave the population in such areas without any medical services after. Later; modern life played significant role to safe them some sort of services at least for children and women with much less for chronic cases and zero for emergency and urgent situations. After e-health services and digital medicine facilities started to invade most of countries and government work routines. The problem owns different opportunities for better solutions might be the best and make most of parties satisfied. Medical diagnosis sessions and talking to medical workers was handling easily through many of communication channels whether innovative or conventional but still physical move of medical nurses and physicians in case of emergency and acute cases not available till now.

Numerous needs of remote public aggregates got more and more with different and modern life pattern of living; mothers need more care and children become more sensitive to environment and weather changes up or less the situation became different than their patience with no medical care got fragile to tolerate or stay ahead the same. Reasonable percent of village and remote population left the villages and have got to emigrate the farms to get modern lifestyle they prefer to live while elderly citizens prefer to stay in nature and far away from city rush and crowd life. The next post is going to discuss how e-health solve most of this problems in details and what transformation carried out on theirs to find the medical values they were looking for and as long as they was dreaming to get them in easy way. Full health J

Clinical Document Architecture (CDA)

CDA is documentary system formed to use certain standards of documents delivery and exchange texts between different e-health departments. Among most of data transfer and delivery protocols CDA is one of the most popular because its comprehensive nature including wide range of accessibility and readability figures. It formed mainly from XML-mark up based standards for exchange of different kind clinical information. The nature of medical work has different forms of texts and informed data moreover, in most situations, there are clinical or specific information related to group of patients. Delivery process and transferred files were a burden at beginning of health technologies era due to the difference in delivery protocols among stakeholders and their work systems with authorized receivers. After trials to get the optimum documentary standards and then CDA solve the problem and polarized the whole procedure to get linear pathways toward aimed target of maximize the benefits of documentary transfers.

CDA documentary system is formed from three main layers to reach optimum texts readability and processing; first layer is considered the header architecture which derived from RIM in order to build up rest of the documentary operating layers. The second layer of CDA architecture is the body of the formatted texts that play the core database of e-health texts and associated informed documents which would be delivered daily between different working platforms of other stakeholders. The body layer enables data transferring without further processing or additional transformation. The significance of body importance lies in being architecture of data bank and final processed formed delivered information which serve and play the awaited role of delivery, storage and then retrieval of documentary texts on demands. Some questions rose up to ask what is difference than other former explained protocols of medical data delivery?!.

Actually there is no difference of the work purposes and final targets but the only meaning difference in the procedure of data architecture and delivery among other e-health platforms. Where there is not opportunity for other systems to serve and process documentary texts, CDA is the fit one for this mission and do the role of architecture and delivery effectively with no interoperability in-between steps. 

The last layer is observational layer that serves role of structured observational data layers to perform in better way and exaggerate the rightness of operation among receivers and their platforms. Some researchers define the last one as indicator for operational efficiency and performance measurement. Although somehow they seem right in their definition about it but from own viewpoint there is analytical integrated role wrap the functionality of head and body under one data current serve different purposes and goals without interruption to minor operations of each on separate basis. This analytical role work as  indicator to match and figure the operational correctness. Full health J

Why it is so simple?

I would like in this post to explain something different than what used to do; being good writer or editor never related to how hard your readers struggle to get your idea and reach your purpose. As much as your idea  had been understood properly first and then got introduced in understandable way that will make reader enable to catch the idea and get the full impact of their reading time. Markets packed and full of books by deeply hard effort to get what the writer exactly wanted to give and how such convoluted procedures in order to show that author is out of pack with touch of uniqueness. Actually the opposite always true that when narrative way is simple and less complicated which mean that anyone even out of work field or career could clearly understand it. Being with or against are not going to change the matter of fact because understandable writing texts are the main object of mine while being hard or difficult that not to show anyone that am good writer. Most of people who used to read in regular basis know that very well and to give them a book with no purpose than sophisticated packed pages that means they waste their life time particularly if they are from people category who seriously want to learn something new everyday.  Being simple it does not mean you are beginner ever and being understandable never mean also that you have not meaning and words pool to express more. Just wanted it clear simple message get to reach to those who academically involved or even not.

Albert  Einstein said once…‘Any intelligent fool can make things bigger and more complex….It takes a touch of genius – and a lot of courage to move in the opposite direction’….

‘If you can’t explain it simple, you don’t understand it well enough’….Also said.

If Albert Einstein failed to persuade you that such simplicity is everything in science I guess there is no one on this earth can actually do for you. That for sure does not mean people do not go for better and more self improvement but should be steadily and regularly over writing topics and according to level of difficulty of the written text. Whatever your belief and your preferable school in text narration whether complexity or simplicity might be right from your point of view but also and on the level of rightness others still feel right to express themselves in the way they prefer to do and with whom they like to be with. Packed posts and convoluted data layers are not our blogger main object and will never be; simplicity is my first target and how to deliver hard tough information in simple understandable short posts that enable everyone even school children to get and understand the idea and with that purpose I get what I have wanted from this blogger.

As philosophy behind simplicity depends mainly on our lifestyle that differed for long decades along; people got more rush in life and less patient to digest hard tough information without simplification. Intense feeling of demands and daily requirements make most of people hard to figure out what behind reality and appearance. Because life got rush and competition everywhere they own full of excuses in such behaviour which make them scattered and distracted to pay excessive attention about academic avenues in short time particularly in details. When they get them in simple way you give them what they are looking for but appropriately matching their fast lifestyle whether that covers most of public knowledge or not but still simplicity owns touch of difference toward people who really care about knowledge and improvement. Full health J