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TELEMEDICINE SYSTEM, CHOISE


Telemedicine is conceptually a process of remote communication of two or more physicians to provide medical services of higher quality to their patients.

In the last decade of the twenty's century the development of telemedicine was primarily characterized by numerous experiments attempting to apply different computer and telecommunication technologies to solve various medical problems. The onset coincides with the advent of modems enabling to transmit various medical information through telephone lines. First were transmitted data of electrocardiographs and other similar medical, so-called telemetric, units, it was gradually followed by transmission of images. Replacing of low speed telephone channels with the high speed ones resulted in attempting to use business videoconferencing in medicine and also made for the progress of various digitalization systems of medical information. Electronic mail and Internet started to be used.

The ways all these experiments were performed had very much in common. At first a telecommunication technology was developed and then it was attempted to be applied to one or other communication technologies to use for medical matters. This phase is getting over now, when a certain experience in telemedical consultation has been gained and it has become evident that only those systems that are specially designed for particular medical requirements, including all types of diagnostics and treatment, and basing on these requirements use adequate modern computer and communication technologies can have a true practical impact on its realization.

Because of this, while forming a telemedicine system it is required to base on the medical requirements, rather than the reverse. Telemedicine systems must become an organic part of diagnostics and treatment and in doing so they must be in no conflict with any requirements of ergonomics, or human engineering.

Currently there are no and there cannot be any standards for telemedicine systems. The assertion that a telemedicine system must meet the ITU requirements of a H.320/323 type and other similar requirements are based on the out-dated approach and attempts to apply pure engineering standards to the telemedicine systems as the basic ones. The work on the standards is just starting and because of this the telemedicine systems must have open interface enabling to change the available data formats depending on particular requirements and thus to adapt the systems to the protocols of medical data exchange and storage being newly developed. In addition, the telemedicine systems must be easily connectable to the medical equipment being newly developed and because of this they must have open interface to enable such connections.

How the general approaches are being developed may be illustrated by systems for telepathology, the field of telemedicine having the largest practical experience. One of the pioneers of the telepathology, German professor K.Kayser, writes in his book on telepathology (Telepathology. Telecommunication, Electronic Education and Publishing in Pathology. Springer-Verlag Berlin Heidelberg) published this year that "by now, no imaging standards required for telepathology have been defined yet". Mr.Kayser mentions only imaging standards, for the other aspects of telemedicine, its organizational, financial, documentation, law and other issues no platform on which the standards might be developed has ever been worked on. This is also true in regard to other types of medical diagnostics and treatment.

Relying on the practical experience in providing telemedicine consultation we have worked out the basic criteria the telemedicine systems must meet at this point of telemedicine development.

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