The objectives to be realized by telemedicine technology mainly include: telemedicine diagnostic system for the purpose of checking and diagnosing, telemedicine consultation system for the purpose of consulting and consulting, telemedicine education system for the purpose of teaching and training, and telemedicine bed monitoring system for the purpose of home bed.
Application of different purposes and needs, in the telemedicine system configuration of the equipment and the use of communication network environment is also different. Telemedicine diagnostic system is mainly configured with a variety of digital medical instruments and the corresponding communication interface, and mainly run on the hospital's internal local area network. End-user equipment includes electronic scanners, digital cameras, and microphones and speakers. A telemedicine education system is similar to a medical consultation system, and operates primarily on a broadband network using videoconferencing. Regardless of the type of telemedicine system, computers and multimedia equipment are essential.
Telemedicine has a wide range of applications and is typically used for a variety of cases including radiology, casework, dermatology, cardiology, endoscopy, and neurology. Telemedicine technology has a wide range of applications, thus determining that this technology has a huge scope for development. The application of multimedia technology in telemedicine depends on the support of a wide range of multimedia digital devices. Multimedia technology in telemedicine is mainly used in the following aspects:
(1) Media capture. High-resolution images can be captured by digital cameras (heads).
(2) Media storage. Audio, video, and medical images need to be stored temporarily or permanently in a computer, which can be accomplished with magnetic or optomagnetic devices (e.g., hard drives, floppy disks, CD-ROMs, etc.).
(3) Compression/decompression. Now the popular JPEG image compression standard can do 10:1 to 20:1, and diagnostic results show that it is not damaging to the image.
(4) Image processing. Its basic functions should include angular rotation, horizontal and vertical telescoping, correction of acquisition errors, and in the clinic conditions can be observed with the naked eye to a clear image.
(5) User interface. Graphical interfaces are most prevalent in medicine because they reflect more medical information (visualization information), so monitors, keyboards, mice, and window management software are the most basic telemedicine user interfaces. In addition, multimedia devices are also required. (1) Network interface. Different telemedicine needs and communication environments have a variety of choices for communication networks, so there are high and low network interface rates.
(2) Network protocol. ATM (Asynchronous Transfer Mode) interconnection protocol is widely used in telemedicine systems. In the telephone network transmission of medical images can be used H.324 videoconferencing protocol. TCP / IP protocol can be used for LAN and WAN interfaces, with which to access medical images and remote medical information sources.
(3) Video transmission. According to different telemedicine needs, the video transmission rate is different, and can be roughly divided into two categories: low rate and high rate transmission, the former is used for videoconferencing, and the latter is used for the transmission of diagnostic videos.
(4) Audio transmission. In addition to video within the telemedicine system, there is audio transmission, which can also be divided into two categories of low-rate and high-rate transmission, the former for consultation sessions, the latter is used to diagnose the condition.
(5) Static image (film) transmission. Usually static image (slice) transmission is a unidirectional communication, the transmission rate is calculated in a single frame, and the traffic is bursty.
(6) Medical record file. It is also unidirectional, and mainly text information, so the transmission bandwidth requirements are not high.
(7) Backbone network. As a backbone network for telemedicine there are a variety of options, but with the expansion of the network, it is necessary to interconnect the various LANs into a wide area network through bridges or routers. In the late 1950s, American scholar Wittson first used a two-way television system for medical treatment; in the same year, Jutra et al. created teleradiology. Since then, the United States continue to use communications and electronic technology for medical activities, and the emergence of the word Telemedicine, now domestic experts unified translation for "telemedicine (or telemedicine)".
First-generation telemedicine
The telemedicine activities from the early 1960s to the mid-1980s are considered the first generation of telemedicine. The development of telemedicine at this stage was slow. Analyzed objectively, the information technology at that time was not developed enough, the information superhighway was in its nascent stage, the amount of information transmission was extremely limited, and telemedicine was constrained by communication conditions.
The second generation of telemedicine
Since the late 1980s, with the continuous improvement of the level of modern communication technology, a large number of valuable projects have been launched one after another, and their momentum and impact far exceeded that of the first-generation technology, which can be regarded as the second generation of telemedicine. Judging from the amount of literature included in Medline, the amount of literature on telemedicine increased geometrically during the 10-year period from 1988 to 1997. In the implementation of telemedicine system, the United States and Western European countries have the fastest development speed, and the contact information is mostly through satellite and integrated service data network (ISDN), which has made great progress in remote consultation, remote consultation, long-distance transmission of medical images, teleconferencing, and military medicine.In 1988, the United States put forward the concept that the telemedicine system should be treated as an open and distributed system, i.e., from a broad perspective, telemedicine should include modern telemedicine, telemedicine, telemedicine, telemedicine, and telemedicine. In a broad sense, telemedicine should include modern information technology, especially two-way audio-visual communication technology, computers and remote sensing technology to transmit medical services to distant patients or information exchange between doctors. At the same time, American scholars have also defined the concept of telemedicine system as follows: telemedicine system refers to a whole, which provides medical services to a specific group of people through communication and computer technology. This system includes a variety of functions such as remote diagnosis, information service, remote education, etc. It is based on computer and network communication, and is aimed at the multimedia technology of medical information, and carries out long-distance video and audio information transmission, storage, query and display. The Georgia State Educational Medical System (CSAMS) is currently the world's largest and most extensive coverage of distance education and telemedicine network for wired, wireless and satellite communication activities, telemedicine network is a part of it.
Europe and the European Union organized a large-scale telemedicine system promotion experiment involving 3 biomedical engineering laboratories, 10 large companies, 20 pathology laboratories and 120 end-users to promote the popularization of telemedicine. Australia, South Africa, Japan, Hong Kong and other countries and regions have also carried out various forms of telemedicine activities. 1988 December, the former Soviet Union, Armenia *** and the country of a strong earthquake, in the United States and the Soviet Union under the auspices of the Joint Working Group on Space Physiology, the United States National Aeronautics and Space Administration for the first time carried out the international telemedicine, so that a hospital in Armenia and the United States of America, four hospitals linked to the consultation. This demonstrated the ability of telemedicine to cross international political, cultural, social, and economic boundaries.
Telemedicine in the U.S. had an early start, but its judicial system once prevented the full development of telemedicine. The so-called remote is limited to a state, because the U.S. requires the practice of medicine to obtain a license to practice medicine in the state where it is located, and the practice of medicine across state lines involves legal issues. According to statistics, in 1993, about 2,250 patients in the United States and Canada were seen through the telemedicine system, of which 1,000 were renal dialysis consultations of only three to five minutes by a sentinel physician in Texas; the average consultation time for the remaining conditions was about 35 minutes.
Telemedicine works in the U.S. have earmarked funds, partly provided by states and federal funding boards.In fiscal year 1994, at least 13 different federal grant programs allocated $85 million for telemedicine, with Georgia alone allocating $8 million to set up telemedicine networks in six regions. Third-generation telemedicine
In 2010, telemedicine began to gradually show into the community, towards the family, more for the individual, to provide directional, personalized service development characteristics. According to qidi.com smart home industry report telemedicine and smart phone development closely synchronized with the development of the internet of things technology and the popularity of smart phones, telemedicine also began to combine with cloud computing, cloud services, many intelligent health care products gradually came out, remote blood pressure meter, remote electrocardiograph, and even the emergence of the remote fetal cardiology instrument, to the majority of the ordinary users to provide a more convenient, more intimate daily health care, medical monitoring services. Prevention and medical monitoring services. Telemedicine has also developed from disease treatment to disease prevention.
Google began testing remote medical services
October 13 foreign media Recode reported that Google (537.94, 4.73, 0.89%) is now quietly entering the increasingly popular field of remote medical care. Google's official microblogging confirmed that it has begun testing telemedicine services, patients can be consulted by video . China is a vast country, the level of medical care has obvious regional differences, especially in the vast rural and remote areas, so telemedicine in China is more necessary for the development. China began to explore telemedicine only in the 1980s. 1988, the People's Liberation Army General Hospital conducted a neurosurgery remote case discussion with a hospital in Germany via satellite. 1995, Shanghai Education and Research Network, the Shanghai Medical University teleconsultation program was launched, and set up a telemedicine consultation research laboratory. At present, dozens of hospital websites in more than 20 provinces and cities in China, including Peking Union Medical College Hospital of the Chinese Academy of Medical Sciences and Fu Wai Cardiovascular Disease Hospital of the Chinese Academy of Medical Sciences, which have been qualified by acceptance and formally put into operation, have carried out remote, off-site, real-time, and dynamic live TV consultation for hundreds of patients with difficult, acute and serious illnesses around the country, and have successfully carried out the full broadcast of a large-scale international conference, and organized domestic and international lectures on special topics, Academic exchanges and surgical observation dozens of times, greatly promoting the development of China's telemedicine cause.
According to the overall planning of national health informatization, the Department of Health of the General Logistics Department of the People's Liberation Army has put forward the "three major projects" for the construction of military health system informatization, which are respectively listed as the national "Golden Health Project", the military word 1, 2, and 3, of which the military word "2" is for the construction of the whole army, which is for the construction of the whole army. No. 2 project is the construction of the military medical and health information network and telemedicine consultation system.
Although China's telemedicine has achieved initial results, but from the level of developed countries there is still a big gap in technology, policy, regulations, practical applications need to be constantly improved; at the same time, the general public's understanding of telemedicine has to be further improved.
The development of telemedicine technology is inextricably linked to the progress of communication and information technology. China's vast territory, especially in rural and remote areas of the lower level of medical care, telemedicine is more necessary for the development, but is still subject to technical, legal and cognitive constraints.
In order to realize the monitoring of critical patients, most hospitals in the early days took the means of television monitoring, which is the prototype of telemedicine. The development of computer technology and communication technology, especially the development of the Internet, for remote diagnosis, remote treatment and remote surgery provides a technical platform. Thus, the modern sense of telemedicine as a new application of technology mentioned, and soon received widespread attention.