Telemedicine The Possibility and Realities

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Dr. Sunil Shroff

President
Medical Computer Society of India
A-113, Annanagar,
Chennai - 600102
[email protected]

Prof. and Head of the Department
Urology & Renal Transplantation
Sri Ramachandra Medical College
Chennai - 600116
[email protected]


Common Telemedicine Terminology


World Wide Web: A vast interconnected electronic publishing medium. It is a subset of computers on the Internet, enabling users to leap from one computer database to another at the click of a mouse, following any information linked through a technology known as hypertext.

Internet: One of today's most widely used buzzwords. It is not actually a network, but rather the interconnection of thousands of separate networks using a common lingo. The Net now connects universities, companies and millions of individuals who can use it to exchange messages and data.

E-Mail: The most common use of networks. It is the Net's answer to the traditional mail system ("snail-mail"), and such devices as answering machines, faxes and telephones.

ISDN: ISDN stands for "Integrated Service Digital network", a low-to-medium speed technology for digital telephony. ISDN facility provides a set of standards with which to create common services that will operate over any digital network in the world. Usually transmits at 64-128Kbps, although higher speeds are possible. ISDN is broken into 64 Kbps bearer channels (B-channels) and 16 Kbps data channels (D-channels) . Basic Rate Interface (BRI) generally provides a 128 Kbps data rate ("2B+D"), while Primary Rate Interface (PRI) can provide up to 1.54 Mbps (the equivalent of a T1 circuit). Fiber Optic Cable - consists of a hair-thin, flexible glass rod encased in a cable that uses light to transmit audio, video, and data signals. Fiber optic cable is capable of supporting up to 625 Mbps of data transmission. Very helpful in Rapid exchange of radiological imaging and other diagnostic data.

Bandwidth: The capacity of an electronic transmission medium to transmit data per unit of time. The higher the bandwidth, the more data can be transmitted. Typically measured in kilobits or megabits per second, (Mbps). Standard telephones are low bandwidth devices (maximum bandwidth = 33.6 Kbps). Cable television uses high bandwidth (up to 140 Mbps).

Bit - stands for binary digit. It is the smallest possible unit of information making up a character or a word in digital code, and is represented as either "on" or "off' by the numbers "0" or "1."

Byte: Each data character, such as the letter A, is composed of 8 bits, called a "byte" (abbreviated "B"). Units of storage are often referred to in terms of the number of bytes (e.g., a "100 MB hard drive").

Kbps: Kilobits (thousands of bits) per second. A typical compressed video clinical interaction is transmitted at 385 Kbps.

Mbps: Megabits (millions of bits) per second. A typical uncompressed video signal requires 45 Mbps (or more) to transmit.

Gb (Gigabit): - one billion bits of information - usually used to express a data transfer rate (e.g., 1 gigabit/second = lGbps). The bandwidth of optical fiber is often in the gigabit or billion-bits-per-second range. GHz (Gigahertz) - one billion cycles per second. It is a measurement of analog signal transmission.

Router: A device which routes data to the segment of the network it was meant to go to, rather than be broadcast to all segments. Modem - a modulator/demodulator. This device converts digital information into analog form for transmission over a telecommunications channel, and reconverts it to digital form at the point of reception.

Multiplexer: - equipment which transmits two or more lines of voice, data, or video information over a single channel. For example, a multiplexer enables a single T1 telephone line to be split into a number of different "channels" to allow for multiple applications to be carried along the same T1 line.

Codec: - a term used for a "code/decode" electrical device which converts an analog electrical signal into a digital form for transmission purposes. It is generally used to transform video signals into digital form for transmission over digital transmission systems. Generally speaking, this digital information must be reconverted into analog form at its point of reception.



REFERENCES & FURTHER READING

  1. Complete robot-assisted laparoscopic urologic surgery: a preliminary report. J Am Coll Surg 1995 Dec;181(6):552-7. Partin AW; Adams JB; Moore RG; Kavoussi LR Jambs Buchanan Urological Institute, Johns Hopkins Medical Institutions, Baltimore, MD, USA.
  2. A novel method of surgical instruction: international telementoring. World J Urol 1998;16(6):367-70. Lee BR; Bishoff JT; Janetschek G; Bunyaratevej P; Kamolpronwijit W; Cadeddu JA; Ratchanon S; O'Kelley S; Kavoussi LR
  3. A robotic system for percutaneous renal access. J Urol 1997 Oct;158(4):1589-93. Cadeddu JA;Bzoste A; Schreiner S; Barnes AC; Roberts WW; Anderson JH; Taylor RH; Kavoussi LR
  4. "Telerobotic Surgery - Techniques & Applications", Mathews, R., Cadeddu, J., Stoianovici, D., Docimo, S. (1998), Computer Techniques in Medical and Biotechnology Systems, G&B, New Jersey.

(The "Medical Computer Society of India" promotes the use of IT in healthcare including Telemedicine. The goal of the society is to get both computer technocrats and medical professionals on one platform and speak the same language of developments for the healthcare applications. Both doctors and non-doctors are eligible to become members. If you wish to become member of the society please visit the website www.mcsindia.org for details and print the membership form and send it by post. If you experience any problem please contact [email protected] or write to us at - Medindia.net, A-113 Annanagar, 3rd Avenue, Chennai- 600102.)
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