Page 38 - Part 1 Introduction to Telemedicine

SVMIC Introduction to Telemedicine

to channels like email, texting, portals and social media that are not

necessarily contemplated in current definitions of telemedicine. (It
is actually a little artificial to separate them, because the

technologies are the same for most purposes.)

For any platform or modality, providers are responsible for

understanding, at least at a clinician level, how the technology

works and how to operate it effectively. This is basically the same
expectation as for any medical device, such as an EKG machine,

ultrasound or electrocautery. This doesn’t mean being able to
answer questions at a technician level, but it does imply for

applications like EHRs, email, text messaging, etc., that professional

users are demonstrably competent to run them.

On the patient side, there is also an obvious requirement that the

technology be understood well enough to be properly used. This
requirement can often be met by having a qualified assistant on

the patient end of the system. When success depends on data

entry by patients or third parties, human factors need to be taken
into account.

For clinicians, an important factor is the reliability and limitations of
the information being transmitted. For instance:

 How accurate is the blood pressure monitor? What is the

resolution of the cellphone image of a skin lesion? (Actually,
this could be better than direct, human vision.)

 How reliable is a home cardiac rhythm monitor?

 Does the webcam show a clear enough view of the patient to

detect a slight facial droop?

 What factors might cause alteration or degradation of the

transmitted data?

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