Telemedicine

The concept of proper telemedicine has been around for decades. It is an excellent use of computer-mediated communication that connects medical doctors and patients; slashing down unnecessary steps e.g. waiting in lines, long trips from remote areas etc. Third world countries such as Bangladesh with high population density and inaccessible or remote habitats can have quality and accessible healthcare using telemedicine services. The impacts of telemedicine on the forthcoming healthcare sector are inevitable and it will only get better.

Keywords: telemedicine, computer mediated communication, online healthcare, virtual doctor.

Cape Breton University

December 16, 2019

Living in a remote area could be a challenging job. It comes with social isolation and limited access to certain services. For the citizens of highly developed nations; living in remote locations could be peaceful, and it does not always have to come with restrictions on basic services as owning a vehicle might not be that big of a deal. However, it is not the same case for citizens of most of the third world nations. It is estimated that about 7.15 billion people i.e. 95% of the world population are concentrated in only 10% of the world land (United Nations, DESA, 2019). The remaining 376.5 million people live in areas classified as remote lands (European Commission, Joint Research Centre (JRC), 2008). Healthcare is a huge issue in the remote areas of most third world nations; as well as certain minorities in the first world (Buckley & Meihubers, 1997). Telemedicine is a system where doctors, medical professionals, and patients communicate each other through computers to receive personalized healthcare services. It is better than face-to-face consultations in many cases (Hyattsville, 1997). Telemedicine could be a savior in the worldwide healthcare crisis (Frankel, Harris, Cannon, & Schwanz, 1996).

Delivering crucial services through computer mediated communication is not a new concept. There have been several services available for decades that are delivered by means of computer mediated communication – for example, education, business consultations, international trades etc. (Wilton, 1990). Telemedicine is no different. The idea can be traced back to the mid-13^th century. Heliograph was used to transmit the information regarding bubonic plague across Europe in the same way news about war and famine were transmitted. It is also a well-known fact that the Americans used telegraph to transmit causality lists and order medical supplies. Although the start of proper telemedicine would be after the invention of the first telephone in 1876. By the 1900s physicians were the first adopters of the telephone and the role of telephone remains very important in this field. Physicians started delivering healthcare services in remote areas of Alaska and Australia through radio in the 1930s (Bashshur & Shannon, 2009). Early proper telemedicine usage includes, television, radio, telegraph etc. Telemedicine services nowadays are mainly delivered through the internet and mobile network.

Computer mediated communication today is mostly about the internet. It is amazing how CMC is capable of being so advanced since the internet took over. Telemedicine is just another creative solution developed through CMC. The whole idea of telemedicine revolves around making healthcare more accessible for all. Expansion of the digital market, affordability of the internet, and electronics has given healthcare providers more opportunities to reach and cater to the people who need it most. It has also grown into a big market; creating more jobs for the people. The telemedicine market in the US is expected to be around 35 billion US dollars by 2025 (Grand View Research, 2018).

Telemedicine services are growing rapidly in several developing countries in the Asian continent. Bangladesh is a prime example of how healthcare services can be more accessible to the people and flourish through CMC. Most of the developed nations have health insurance provided to all the citizens by the state, funded by their taxpayer’s contribution; United States of America being an exception (Rosenthal, 2017). However, the case is not same for the developing nations. There are a lot of limitations on what the governments of those nations can do for the citizens due to extreme poverty and huge non-taxpaying population (United Nations, DESA, 2019). There is a small nation in southeast Asia which has a promising solution that is already fully developed but known by a very few people. In April 2016, Telenor; a Norwegian multinational mobility company launched their telemedicine service in Bangladesh which provides affordable solutions for the poverty-stricken community. It solves two problems at once, being affordable and accessible (Telenor, 2016). Even though Bangladesh falls under the poverty line when it comes to the income per head, most of the population owns some sort of telecommunication device (Byuro, 2009). Telenor launched their telemedicine service named Tonic which not only provides online health consultations but also, generous health insurance coverage for anyone at an affordable rate. Tonic’s most expensive insurance subscription costs less than $40 a year, with the cheapest one being free for their phone users (prepaid or postpaid) and covers doctor consultations, hospital admission etc. (Telenor, 2016). It is impressive how a private foreign company could put such an infrastructure for modern healthcare that is accessible for all using CMC in that a market like Bangladesh. The growth data is yet to be available but from my personal experience during my visit in summer 2019, it was smooth and seemed promising.

There are very few differences between telemedicine and face-to-face consultations except for emergencies that require a person to be in the operation theatre. In order to consult a doctor face-to-face in a conventional clinic, a patient needs to take an appointment, take a trip to the clinic from their location and wait for their turn to come. Using CMC eliminates all these steps and connects a person to the doctor in matter of seconds; just from a click command through an electronic device. Most of the handheld devices these days are capable of basic tests such as checking heart beat, SpO2 level etc. It gets easier for the healthcare professionals/doctors to receive the information from a handheld device by instructing their patient via CMC than having them face-to-face and checking everything with older equipment. It is possible to perform complex operations using biomechanical robots which could help clinics in remote locations having lack of experienced doctors or having low budget to perform expert operations reducing the risk at many levels (Gu, Yamamoto, & Inagawa, 2012). If we observe the conditions of the hospitals in first world countries where most of the healthcare programs are state-funded, it is essential to acknowledge the lack of medical professionals; especially doctors (Rosen, Israeli, & Shortell, 2012). A globalized telemedicine system can help all the countries come out of the healthcare issues as it will give all the nations a universal pool of doctors from all the continents. This could however be a little implausible but not impossible. Briefly, in most of the cases telemedicine service via CMC is much better and efficient than face-to-face doctor consultations as it removes the necessity of transportation to the facility and the wait time.

Computer mediated communication has shaped the healthcare sector and made it accessible for all. It is amazing to see that the world of CMC is more than unnecessary texting and tweeting. Healthcare is getting simpler and more accessible for the people from any part of the world and beyond. Yes, it is possible to expand it outside planet earth as well and has been tested successfully a long time ago. Telemetry research and development was undertaken by the National Aeronautics and Space Administration (NASA) in its first manned space-flight program. “Demonstrating that physiological functions for astronauts in space could be monitored successfully by physicians on earth, NASA's scientists, engineers, and contractors developed sophisticated biomedical telemetry and telecommunications systems for biomedical applications” (Bashshur & Shannon, 2009). Applications of telemedicine will continue to grow, and it would be able to perform more complex tasks as television, telephone, and computer technologies advance (Bashshur & Shannon, 2009). It is evident that telemedicine via CMC has a promising future and it is reshaping the world of healthcare for everyone regardless their location.

Bashshur, R. L., & Shannon, G. W. (2009). History of Telemedicine: Evolution, Context, and Transformation. New Rochelle (NY): Mary Ann Liebert, Inc.

Buckley, P., & Meihubers, S. (1997). Indigenous peoples' health : Issues and care in rural and remote areas of the world :an annotated bibliography with international coverage. Melbourne, Australia: Moe, Vic.: Monash University, Australian Rural Health Research Institute.

Byuro, P. (2009). Updating poverty maps of Bangladesh : Key findings. Dacca: World Bank; Bangladesh Bureau of Statistics; World Food Programme.

European Commission, Joint Research Centre (JRC). (2008). Urbanization: 95% Of The World's Population Lives On 10% Of The Land. European Commission, Joint Research Centre (JRC).

Frankel, G., Harris, C., Cannon, D. H., & Schwanz, L. (1996). Healthcare Crisis. Postgraduate medicine, Vol.87, 87(6), .21-23.

Grand View Research. (2018). Total telemedicine market in the United States from 2014 to 2025 (in billion U.S. dollars). Statista estimates.

Gu, Z., Yamamoto, I., & Inagawa, N. (2012). Research and Development of Biomechanical Robot for Medical Operation. Advanced Materials Research, 452-453, 1121-1126.

Hyattsville. (1997). Telemedicine needs better evaluation. Public Health Reports, 112(1), 5-6.

Rosen, B., Israeli, A., & Shortell, S. (2012). Accountability and responsibility in health care. Singapore ; Hackensack: Issues in addressing an emerging global challenge (World Scientific series in global healthcare economics and public policy (v. 1).

Rosenthal, E. (2017). An American sickness : How healthcare became big business and how you can take it back. New York: Penguin Press.

Telenor. (2016, Apr). Telenor Health takes flight in Bangladesh. Retrieved Dec 15, 2019, from https://www.telenor.com/telenor-health-takes-flight-in-bangladesh/

United Nations, DESA. (2019). World Population Prospects: The 2019 Revision. United Nations.

Wilton, C. (1990). Online Services : Review, Trends & Forecast. Simba Information Inc.

Zundel, K. M. (1996). Telemedicine: history, applications, and impact on librarianship. Bull Med Libr Assoc, 71-79.