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Veterinary Forum August 2009 (Vol 26, No 8)

Business Skills —Telemedicine — expert opinions just a click away

by Paul E. Fisher,

    Telemedicine — an application of clinical medicine in which medical information is transferred over a network for the purpose of consulting on remote medical procedures or examinations.

    The origin of telemedicine dates back to the early 1900s, when telephones came into use. Physicians were quick to adopt the new technology for difficult case discussions with far-away specialists. In the 1950s, television moved telemedicine forward again, and by the late 1990s, the application was used heavily in human medicine as a result of high-speed Internet connections.

    Telemedicine uses two forms of communication: synchronous or asynchronous. Synchronous communication takes place in real time, such as video chat or over the telephone. Asynchronous communication involves pieces of information stored in an intermediate location, such as a computer server, until another person or group of people retrieves it. Veterinary telemedicine is almost invariably asynchronous.

    Veterinary medicine was quick to identify the need for telemedicine and the opportunity to connect with remote specialists in the late 1980s. Relatively inexpensive film and document scanners, digital radiography (DR) and computed radiography (CR) systems, the Digital Imaging and Communications in Medicine (DICOM) standard and reliable high-speed Internet connections have allowed telemedicine to mature as a valid practice option over the past few years. It is now a valuable service used by thousands of clinics worldwide.

    The most difficult part of telemedicine can be transmitting images or data from the primary clinic to the specialist. Because few regulations exist, it is important to look for vendors that provide DICOM-compliant equipment and user-friendly applications.

    There are cost-effective ways to encode and transmit images. Inexpensive film and document scanners can be used to digitize film and documents for direct transfer. Film can be digitized using such equipment as a digital camera and light box, inexpensive film scanners or high-end volume film scanners.

    Choosing the right equipment for your practice depends on the volume of images you want to digitize and how many cases you are planning to send to your telemedicine provider. Your telemedicine provider can assist you in determining what is right for your practice.

    If your clinic has DICOM-compliant DR or CR imaging systems, you are already in a position to quickly and easily send your images to a telemedicine provider.

    When choosing a telemedicine provider, you should consider your overall needs. Do you want telemedicine only, or do you want digital storage and access to additional services? Most telemedicine companies offer only teleradiology and telesonography services, but some companies offer multiple disciplines in addition to a secure full-featured online picture archiving and communication system (PACS) solution that allows access to images from any computer at any time.

    Many clinics opt to send all their imaging studies to specialists. In this competitive market, these practitioners find that having all their images read by a board-certified specialist sets them apart from other practices. It also can increase revenue because many of the reports recommend additional tests or studies for diagnosis and treatment. The service is simple and cost-effective and can allow clinics to practice a higher quality of medicine. In essence, telemedicine allows your clinic to hire groups of specialists to practice at your clinic.

    When shopping for a telemedicine provider, it is important to look for one that approaches business as a partnership with general practitioners and can provide your clinic with the services you need or want.

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