How to Choose a Proper Telemedicine System


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  Telemedicine Project “Beslan-Moscow”

  How to Choose a Proper Telemedicine System

  Remote Training in Medicine 

  Implementation of DiViSy Video Net"main"s in Clinical Practice

  Third generation of telemedicine system DiViSy TM21


How to Choose a Proper Telemedicine System

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. Ó 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.

Functions of telemedicine system

Areas of application


Possible connecting to any medical equipment both through analog and digital interface

Medical equipment with analog or digital interface


Parallel processing and transmitting of at least two video and one audio flows of information

Intersurgical histology and cytology, ultrasound, surgical operations, etc.


Interactive work with images on the "working table" and possibility to indicate the location to be studied and to draw over the image

Local or interactive work with medical images


Recording of medical static and dynamic images in the database

Keeping records of medical images, preparing information for transmission in off-line mode


Remote control over medical units having the functions of digital control

Remote microscope or other medical units control during consultation in on-line mode


Single interface for various types of diagnostics and treatment simultaneously from several experts

Video consulting in on-line mode


Use of any communication channels in on-line and off-line modes

Consulting through both slow analog and quick digital communication channels


Function of protocoling the main parameters of the consultation, like the time, the duration, the participants, etc.

Making protocols of the results of telemedicine consultation


Monitoring, remote diagnostics and parameters adjustment of telemedicine systems, during telemedicine consulting inclusive

Testing system's operation during telemedicine consultation


Opportunity to work in point-to-point, star-one-to-many (remote training), many-to-many (video consultation) without use of any additional equipment

Telemedicine consultation in on-line mode as well as educational sessions and video consultation


Protection and authorization devices, means of digital signature

Protection of information and signature to protocols of telemedicine consultation


Non-linear editing for preparing materials for lectures or various reports

Making diagnostic reports for medical histories or presentations


Combined transmission of medical imaging and data from life-support monitoring systems

Remote watch over patients and simultaneous review of medical telemetric data


Displaying text or presentation of the files executed in various editors in the window of the working-table

Remote training


Possible connection of previously made software and various processing algorithms of medical data

Use of previously accumulated materials and remote editing of medical images


Possible adaptation of telemedicine consultation in accordance with newly-developed methods of diagnostics and treatment

Working out independent methods of telemedicine consultation while developing new methods of diagnostics and treatment


Open interface for information exchange with other telemedicine and information systems

Creating gateways of medical information to exchange with other telemedicine systems


Russian language interface and user's manual in Russian

For comfortable work of physicians

Telemedicine systems providing these opportunities enable both telemedicine consultation in various fields of diagnostics and treatment and remote medical training.

Producers of telemedicine systems must provide maintenance support and operative adaptation of the system operation to various types of diagnostics and treatment. Thus preference must be given to those producers of telemedicine systems who in close cooperation with leading medical experts can promote them taking into account the feedback about the results of practical consultations.

There comes a time when telemedicine is used in practice for diagnosing and treating real patients at real hospitals. As for now, the DiViSy company has developed all hardware and software required for providing such consultations. Please refer to the news section at our site for the practical results of telemedicine sessions performed in on-line and off-line modes that have proved true efficiency of such consultations.




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