Telemedicine Annotated Bibliography by runout


									                  Telemedicine Annotated Bibliography

                               By Michael Pancewicz

This annotated bibliography covers 30 of the main journal, online and newspaper articles
associated with the subject of telemedicine. I feel that the topic of telemedicine is important in
this contemporary era of information and communication technologies. Three of the eight UN
Millennium Development Goals are concerned with some aspect of improving issues to do
with health. Telemedicine has its pitfalls in that it can be too expensive for the countries and
regions which need it most, but if these problems could be overcome then telemedicine could
have an important role in helping those in need of medical attention.

There are three sections within this bibliography and they are journal, online and newspaper
articles. Being an innovation that has developed most rapidly over the past decade the
majority of the information on telemedicine is contained either in Journals or on the
worldwide web. This may be a benefit however as these two sources are perhaps the easiest to
reach (both can be obtained via an internet connection) for those without access to an
extensive library. The articles that have been reviewed cover all aspects of telemedicine and
include examples from both the developed and developing countries. I felt this was important
as the MDGs are not purely for those in developing countries.

         1. Adewale, O.S. (2004) „An internet-based telemedicine system in Nigeria‟,
         International Journal of Information Management, 24(3), p.221

         This journal article discusses how Nigeria‟s population of 120 million have limited
         access to basic health care. Geographic isolation, the scarcity of physicians and
         hospitals, and difficulties of travel to larger cities where such care is available are
         among the factors limiting this access. In an attempt to offer a solution to this problem
         the author suggests an internet-bases telemedicine system that could support
         consultations among remotely placed patients, rural health workers and specialists in
         the urban cities and provide a secure access to remote patient records. The paper
         further discusses some of the challenges and implementation issues of telemedicine in

         2. Adeyinka, M.B. (1997) „Fundamentals of modern telemedicine in Africa‟, Methods
         Inf Med, 36(2), 95-98

         Outlined in this article is how FOMTA (Fundamentals of modern telemedicine in
         Africa) has an initiative which aims to increase the awareness and stimulate the
         participation of Developing Countries in the telemedicine and health care telematics
         projects through demonstrations, pilot projects, workshops, and training and exchange
         activities. Adeyinka believes that it is feasible for telemedicine to be used in the
         developing countries.

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         3. Boulanger, B. et al (2001) „Telemedicine: a solution to the follow-up of rural
         trauma patients?‟, Journal of the American College of Surgeons, 192(4), 447-452

         The hypothesis of this paper is that telemedicine-based follow-up of trauma patients
         discharged to remote areas is feasible and is associated with high patient and physician
         satisfaction. Both the study design and results are commented upon and the conclusion
         states that early results are encouraging with high levels of satisfaction. Thus
         Boulanger et al believe that telemedicine-based follow-up should be expanded to other
         regions of Kentucky which have not benefited from this initiative.

         4. Brown, N. (1998) „The telemedicine information exchange: an online resource‟,
         Computers in Biology and Medicine, 28(5), 509-519

         This paper mentions how telemedicine has grown from mostly government-subsidized
         research initiatives into a fledgling industry. The Telemedicine Research Centre in
         Portland, USA, is identified as both a product and a vehicle for the rapid growth this
         industry has seen. Finally this article describes the TIE's development, advantages and
         disadvantages of a web-based online library, and it's co-development with a rapidly
         expanding industry.

         5. Epstein, D. and Vernaci, R.L. (1998) ‚Telemedicine meets the global village‟,
         Perspectives in Health, 3(2)

         An evaluation of the way telemedicine has moved forward since the idea was first
         pioneered by the space programs of the former Soviet Union and the United States to
         allow medical teams on the ground to monitor the physical conditions of astronauts in
         orbit or journeying to the moon. Particular attention is paid to the way information
         access closes distances and the way the individual tools can be put to work to produce
         success stories in telemedicine. To conclude Epstein and Vernaci provide a glossary of
         useful terminologies in the field of telemedicine.

         6. Gustke, S.S., Balch, D.C., West, V.L., and Rogers, L.O. (2000) „Patient satisfaction
         with telemedicine‟, Telemedicine Journal, 6(1), 5-13

         This paper evaluates patient satisfaction with regards to telemedicine and clinical
         consultations. A satisfaction rate of 98.3% was recorded amongst those questioned.
         The result was consistent with other findings within this topic. Main areas of
         dissatisfaction highlighted are appointment scheduling, patient travel times and patient
         involvement in the physical examination. In conclusion this paper says that additional
         research needs to be done using different constructs to patient satisfaction.

         7. Kokdemir, P., and Gorkey, S. (2002) „Are telemedicine/telehealth services ethical?‟,
         Sendrom, 14(1), 86-92

         A review of the benefits and drawbacks of Telemedicine and Telehealth services and
         an assessment of the two statements World Medical Association has made on the
         subject. Benefits listed include how the internet has permitted physicians, other health
         care professionals, patients, and other consumers to quickly access medical
         information in unprecedented volume. Information is given on how many
         consultations were done in the United States by interactive video conference system.

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         On the negative side the privacy of patient information is considered as there are
         doubts to how well information will be protected.

         8. Marsh, A. (1998) „The Creation of a global telemedical information society‟,
         International Journal of Medical Informatics, 49(2), 173-194

         Although slightly dated this paper highlights the main issues and possibilities with
         regards to telemedicine. A figure that is given states that the expected revenue by the
         year 2000 is US$21 billion and this provides a useful comparison to journal articles of
         more recent times. A significant emphasis is placed on the vital role of the worldwide
         web in the widespread implementation of telemedicine projects. The Euromed Project
         is the specified case study and it has identified 20 building blocks resulting in 39 steps
         requiring multi-disciplinary collaborations in order to prevent the information society
         being developed in an ad-hoc fashion.

         9. Martínez, A. (2004) „Rural Telemedicine for Primary Healthcare in Developing
         Countries‟, IEEE Technology and Society Magazine, 23(2), p.13

         While admitting that there are indeed benefits of using telemedicine for primary
         healthcare in developing countries the author states that there are difficulties in
         achieving these benefits. This is because of the fact that in the rural areas of many
         developing countries telephone networks and computers are extremely scarce. This is
         the fundamental difference between developed and developing countries and
         worryingly this inequality is becoming seen in urban and rural areas within developing

         10. Mbarika, V.W.A. (2004) „Is Telemedicine the Panacea for Sub-Saharan Africa's
         Medical Nightmare?‟, Communications of the ACM, 47(7), p.21

         A review of the efforts made by governmental, non-governmental and international
         development organisations in a bid to implement telemedicine in the sub-Saharan
         African countries. Although considered a solution to the growing medical problems
         seen in the area, telemedicine struggles to be widely used due to the shortage of
         medical personnel. The region averages fewer than 10 doctors per 100,000 people, and
         14 countries within the region do not have a single radiologist. The specialists and
         services available are concentrated in cities.

         11. Miller, T.E., Derse, A.R. (2002) „Between Strangers: the practice of medicine
         online‟, Health Affairs, 21(4), 168-179

         A review of the use of the internet to allow on-line communication between patients
         and physicians. The use of on-line communication has been said to improve the
         quality, timeliness, and efficiency of medical care. With the increased usage of this
         method, calls have come for a review of regulations with regards to accountability and
         the establishment of acceptable parameters for online medical practice.

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         12. Rasid, M.F.A., Woodward, B. (2005) „Bluetooth telemedicine processor for
         multichannel biomedical signal transmission via mobile cellular networks‟, IEEE
         Transactions on Information Technologies in Biomedicine, 9(1), 35-43

         Rasid and Woodward discuss the emerging issues in m-Health such as how best to
         exploit the mobile communications technologies that are now almost globally
         available. With the design of a processor that samples signals from sensors on a
         patient, it is hoped that a system can be produced where a patient's biomedical signals
         can be directly transmitted to a hospital for monitoring or diagnosis. The added
         objective of being „future proofed‟ is discussed with the hope that the system can
         continually be modified simply by updating the software.

         13. Stanberry, B. (2000) „Telemedicine: barriers and opportunities in the 21st century‟,
         Journal of Internal Medicine, 247(6), 615-628

         This paper aims to examine how health telematics will develop in the first 10 years of
         the new millennium and, in particular, to assess what operational, ethical and legal
         barriers may lie in the way of this development. Included is a description of the key
         principles and concepts involved in telemedicine and a short historical overview of
         telemedicine's evolution over the past century. Four evolving health telematics
         applications are examined in detail: electronic health records; the transmission of
         visual media in disciplines such as teleradiology, teledermatology, telepathology and
         teleophthalmology; telesurgery and robotics and the use of call centres and decision-
         support software.

         14. Stanberry, B. (2001) „Legal ethical and risk issues in telemedicine‟, Computer
         Methods and Programs in Biomedicine, 64(3), 225

         Stanberry summarizes the main topics of discussion at a workshop hosted by the
         Centre for Law Ethics and Risk in Telemedicine at the 2nd International Conference
         on Advances in the Delivery of Care. The paper outlines that there was a broad
         consensus that many of the legal and ethical issues raised by those who dislike the
         idea of treating distant patients were not specific to telemedicine but to medicine and
         healthcare in general.

                                           Online Articles

         15. Brown, N. (1996) „Telemedicine Coming of Age‟,
         xml Updated on January 13, 2005 (visited 2/02/05)

         This paper discusses how telemedicine can vary from a simple phone call between two
         health professionals to something as sophisticated as using satellite technology to
         broadcast a consultation between two countries. This article continues by outlining the
         two different kinds of technology that make up for most of the telemedicine
         applications in use today: „store and forward‟ and „two-way interactive television‟.
         Advantages to telemedicine are shown yet the barriers to the practice are shown in
         greater detail. In conclusion the article offers the possibility of a „Personal Diagnosis

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         System‟ in the future which would monitor our daily health status and notify a
         physician if we became ill.

         16. Einterz, E.M.(2001) „Telemedicine in Africa: potential, problems, priorities‟,
         (visited 28/02/05)

         Einterz speaks about how having an up-and-running and paid for telemedicine system
         would be wonderful yet realistically attention needs to be paid to the more urgent
         areas of medicine in Africa. His practice struggles to overcome the lowest of low-
         technology failures such as the lack of portable water, unreliable sources of electricity
         and underdeveloped systems of transportation and communication. He states that the
         means to prevent Malaria and childhood malnutrition are known yet money is being
         spent on telemedicine which won‟t be able to cure these diseases. Einterz suggests that
         the solutions to these problems are known and should not be avoided.

         17. Ganapathy, K. (n.d) „Telemedicine in India-the Apollo experience‟
         (visited 19/03/05)

         This article briefly reviews some aspects of Telemedicine, particularly its relevance in
         a developing country like India and the experience of the Apollo Hospitals in setting
         up telemedicine centres. A simple and easy to understand section called „What is
         telemedicine?‟ allows the reader to gain a good awareness of general issues before
         more detailed aspects are discussed. These aspects include points which need to be
         addressed in implementing telemedicine projects in India and the aims of a pilot study
         which is to be carried out.

         18. Geneva University Hospitals (n.d) „Telemedicine at the World Summit on the
         (visited 16/03/05)

         In 2003 the Geneva University Hospitals presented several telemedicine projects to
         the World Summit on the Information Society. This excerpt is general information that
         will be given on the ability of telemedicine to provide medical expertise without the
         need to move the patient or physician. Particular attention is given to telemedicine‟s
         potential to open up all points of possible relations on the planet such as increased co-
         operation between the North and South.

         19. Haywood, A., updated July 2002 „Telemedicine and the Community Service
         (visited 14/03/05)

         Two definitions for telemedicine are provided and so is a list of the various disciplines
         involved. South Africa is the case study and a very thorough examination is

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         undertaken exploring the details of telemedicine in this country. South Africa is in
         Phase II of its nationwide telemedicine program and the mission of the South African
         Telemedicine System is to facilitate the provision of high quality, cost-effective health
         care to all the citizens of South Africa, particularly to women and children in the rural

         20. Hilman, D. (2004) „Health for All Through Telehealth‟,
         (visited 15/03/05)

         This article mentions that telehealth can be the key to achieving Health for All in
         Africa. Uganda is the case study as there has been criticism of the use of a „high-tech‟
         approach in a country with so many basic needs. In response Hilman states that with
         the aid of a „battery pack‟ the project had the capacity to have a 24-hour
         teleconferencing which helped educate medical and nursing students.

         21. Jambusaria, A., updated January 1999, „The Advantages of Telemedicine‟,
         (visited 16/03/05)

         This website has five detailed sections which are: the advantages of telemedicine, the
         disadvantages of telemedicine, types of telemedicine, viewing a telemedicine unit and
         links to other telemedicine sites. The four types of telemedicine are telepathology,
         teledermatology, teleradiology and primary care. A definition of the topic is also
         provided. An example is given to illustrate the advantages of the use of telemedicine
         but some of the disadvantages include infrastructural and funding problems.

         22. Jiva Health (n.d) „TeleDoc: Sustainable Healthcare for Rural India‟
         (visited 18/03/05)

         An introduction to the work of Jiva‟s „Teledoc‟ which provides effective healthcare,
         and brings high-quality medical attention directly to rural India. Information is given
         on the way Teledoc seeks to bridge this critical gap between rural populations and
         quality health services by using Java-enabled mobile telephones to provide village-
         based healthcare workers with real-time ability to record and transmit diagnostic
         information. To conclude this article outlines six points the program hopes to deliver

         23. Koomson, G (n.d) „Telemedicine in rural Uganda‟,
         (visited 18/03/05)

         On this page George Koomson says that he believes radio can play a big part in
         improving basic health and reducing the number of maternal deaths. Opinions are also
         drawn from people who studied a pilot health project in Eastern Uganda‟s Iganga
         district. The overall judgment is that the project was successful as it raised awareness
         of critical issues and also provided some training. Because of this success the project
         has been adapted to be carried out in three other districts and there are plans for
         adaptation to 30 other places.

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         24. Leitch, R. (n.d) „Trout Fishing in Africa‟,
         (visited 14/03/05)

         This column is a response to Einterz‟s „Telemedicine in Africa: potential, problems,
         priorities‟ article. Leitch takes the view that her model for telemedicine is designed for
         use in Western countries and that technologies in Africa do allow for telemedicine to
         take place. Most technologies have minimum power run ability and have the ability to
         harness sunlight. Leitch is also convinced that investing in telemedicine and enhancing
         health care resources in the Horn of Africa need be neither a linear progression nor
         mutually exclusive.

         25. Markle Foundation (n.d) „Markle Telemedicine Clinic in Cambodia‟
         (visited 18/03/05)

         The Markle Foundation Telemedicine clinic in Ratanakiri Province, Cambodia,
         provides a model for the way in which information and communication technologies
         can be harnessed to improve the quality of health and life in the developing world. It
         brings the specialized skills of doctors at Harvard Medical School-affiliated teaching
         hospitals to one of the most isolated and medically-underserved areas of Cambodia
         and the region.

         26. Medical Research Council of South Africa (n.d) „Telemedicine Research Centres‟,
         (visited 18/03/05)

         This website discusses the challenges to South Africa‟s healthcare delivery system. To
         achieve the goal of providing basic health care to all South African citizens the
         government has identified Telemedicine as the tool for facilitating this aim. The
         objectives of the National Telemedicine Research Centre are listed as well as the
         activities the centre will participate in. Lastly the terms of reference of the
         Telemedicine Research centre are shown.

         27. Onyejekwe, E., updated 9th September 1998, Can telemedicine/telehealth help
         (visited 17/03/05)

         There are two parts to this online article and in the first part the author lays out some
         of the problems women face in gaining access to telemedicine technology. In the
         second part the author shows how telemedicine and telehealth can be effectively
         applied to remove some of these problems. In conclusion, Onyejekwe states that
         government policies with regards to health, education and total well being are crucial
         if success is to be achieved.

         28. Versweyveld, L. (n.d) „"Telehealth in Africa" promotes telemedicine in
         developing countries‟,

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         (visited 16/03/05)

         The content of this webpage is regarding the project “Telehealth in Africa”. The first
         concern of the project's participants is to provide facilities for diagnosis, prevention,
         training and education by means of satellite telecommunication systems, radio-bridges,
         fibre optic cables, computer networks for the transfer of case sheets, X-rays, and
         diagnostic analysis. A list of renowned institutions and industries in the fields of
         telecommunications and health, like the International Telecommunication Union
         (ITU), the Politecnico di Milano, and the French Ministry of Health are also

                                        Newspaper Articles

         29. Highfield, R. (2001) „Surgeons perform operation across the Atlantic‟, The Daily
         Telegraph, filed 27th September

         This newspaper article highlights the first transatlantic operation, using remote-
         controlled robots to remove the gall bladder of a woman in France. Previously thought
         of as limited to a few hundred miles because of the time lag of existing
         communications, telemedicine now has the potential of ignoring space and distance
         barriers and allows a surgeon to perform an operation on a patient anywhere in the

         30. Stokes, P. (2004) „X-rays sent off to Spain‟, The Daily Telegraph, filed 11th

         In his article for The Daily Telegraph, Stokes reports on how a hospital is sending its
         X-rays and scans abroad for examination because of a national shortage of specialist
         staff. This shortage of specialist staff has led to some patients complaining over the
         length of time they have to wait for their results. The answer for Barnsley district
         general hospital was for x-rays to be sent to the Telemedicine Clinic, in Barcelona,
         which guarantees analysis within three days - two hours for urgent cases.

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