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Tele-Medicine
In a time when medical services are under strain, what are the implications for people who need quality healthcare? Well, if new technology comes into play, medical experts can explain .... which means that they can be there without actually 'being there'! It's called Tele-medicine.
In every century there are people who insist that their field of science has reached its apex and cannot possibly be improved . Take Dr Berkely Moynihan, a surgeon born in 1865. After pioneering the aseptic rituals of surgery and the use of rubber gloves, and thanks to the development of anaesthesia and microscopy, Moynihan wrote in 1930, "We can surely never hope to see the craft of surgery made much more perfect than it is today¼...we are at the end of a chapter." He couldn't have been more wrong. In 1952 the first open heart surgery was performed, thanks to the heart-lung machine, and in 1967 the South African, Dr. Chris Barnard, performed the first heart transplant.
And since the seventies, other breakthroughs have been made that Moynihan would never have believed possible. Innovations such as Computerised Axial Tomography, otherwise known as CAT scans, and Magnetic Resonance Imaging, or MRI scans, were major milestones in the non-invasive diagnosis of disease.
The first step in tele-medicine is the use of video-conferencing. X-ray, MRI, CAT and sonar scans are all digital images that can be viewed from remote locations in real time. So is the image viewed by an endoscopic camera inside the body. All of which make it possible for doctors to diagnose and even treat ailments without being physically next to the patient.
Prof S. Prinsloo of the Pretoria Academic Hospital concurs: "We can link up virtually the whole of the rural clinic network, all the primary health care centres, all the smaller towns. X-rays can be taken and even other images - for instance skin lesions - can be taken by small cameras and sent electronically to the tertiary hospitals for interpretation. A report is then sent back to the referring doctor in the remote location."
"Telemedicine and ISDN - the communications technology behind Tele-medicine - allows the various players in the market to provide first world services to those remote areas," says Marius Coetzee of Telkom. "Many of the major institutions are investigating the possibility of setting up these Tele-medicine sites throughout the country and Telkom is the communications service provider for these Tele-medicine pilots." With video conferencing technology, a patient's data could even be transmitted, in real time, to the hospital while he was en route in the ambulance. But it is not only beneficial in the treatment of patients - Tele-medicine is already proving extremely effective in the training of doctors in new medical procedures.
The final test for telemedicine, of course, is to what degree it benefits the patient. And, unlike Dr Moynihan, we should realise that new breakthroughs will constantly redefine old preconceptions. To dismiss the benefits of telemedicine, would be to deny our society life-saving technology that is ripe with possibility.
CONTACTS
Prof S. F. Prinsloo
Marius Coetzee, Senior Manager: Multimedia Services |
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Created and maintained by Intekom works Copyright © 1998 Intekom |
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Contents and images © 1998 All rights reserved |
In the same decade, flexible endoscopes, which use fibre optic technology, were developed. This apparatus enabled surgeons to see the inside of hollow organs and today they are the preferred option for full blown surgical procedures. Lasers began to function as precise, microscopic 'knives' for performing eye and internal surgeries. Endoscopic video cameras have enabled the surgeon to make keyhole sized incisions in the abdomen, and operate on diseased organs without resorting to full 'open surgery'.
What these innovations all have in common, is their link to the information age. Many components of cyber-surgery are already in place, and it is clear that surgery - and medicine in general - is headed for yet another revolution - not in blood and guts, but in bits and bytes.
Dr James (Butch) Rosser, Assistant Professor of Surgery at Yale University, USA, is the founder of the unique 'Project Rain Forest' initiative, where a mobile operating theatre, in a specially equipped truck, was successfully deployed in remote South American jungle areas, utilising tele-medicine technologies. "One programme that tested the durability of this equipment was a recent Mount Everest expedition where we actually did tele-medical missions from the summit of Mount Everest. We tested all this technology, and the ability to video conference in this remote of remote areas, and it was an outstanding success. So we have laid the groundwork and achieved a great foundation that now can be used to launch this kind of technology throughout the world, including Africa."
Outlying clinics and medical facilities, manned only by General Practitioners and nursing staff, offer only limited benefit to that region. Until now. Through video-conferencing, specialists such as cardiologists could connect to remote rural clinics, and view - in real time - a sonar scan of a patient's heart. In another window on the screen, the cardiologist could simultaneously view and talk with the patient. This means that doctors are once again able to make house calls, without leaving their offices. Imagine the implications. Without leaving his desk, he could consult with dozens of patients in the comfort of their own homes. The house-call would be replaced by the far more cost effective, virtual house-call.
And in Johannesburg, robotic endoscopes like the AESOP system are already making life easier for surgeons by taking over the function of holding and positioning the endoscopic camera to view the organs during laparoscopic surgery. Surgeons in other cities can then assist in the operation by viewing these images simultaneously and conferring with the operating surgeon.