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Telemedicine is a new direction in medicine. 

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Telemedicine is a new direction in medicine. 

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Telemedicine refers to the provision of remote clinical services, via real-time two-way communication between the patient and the healthcare provider, using electronic audio and visual means.

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Record #1 of 1
ID: CN-00758176
AU: Ryuzaki M
AU: Nakamoto H
AU: Nishida E
AU: Sone M
AU: Nakajima S
AU: Suzuki Y
TI: The Blood Pressure Control Crossover Study with Amlodipine vs. Nifedipine CR Monitoring Precise Home Blood Pressure via New Telemedicine System Using Cellular Phone
SO: Hypertension
YR: 2005
VL: 46
NO: 5
CC: Hypertension
PG: 866â867
PT: Journal article
AB: Introduction: We already developed a telemedicine system using a cellular phone and internet web site to monitor changes in blood pressure and pulse rate in patients at home (Nakamoto et al., Hypertension 42: 442Ã¢â¬"3, 2003). Using this system, we have conducted the blood pressure control crossover study with amlodipine vs. nifedipine CR. Methods: Patients who were not taking an antiâhypertensive caâantagonist other than amlodipine (A) or nifedipine CR (N) were eligible to enter this study. The patients in the first group (n 11) started A 2.5 mg/day. Doses of A were increased to achieve home blood pressure less than 135 / 85 mmHg to the extent of 7.5 mg/day. If necessary, atenolol was added. After achieving the target blood pressure, home blood pressure was monitored for more than 6 weeks and then A was changed to N. Home blood pressure monitoring was continued for more than 6 weeks after changing medication. The patients in second group (n 9) took N firstly, and then changed to A. The alternative doses were as follows; A 2.5 mg/day N 20 mg/day, A 5.0 mg/day N 40mg/day, A 7.5 mg/day N 60 mg/day. Blood pressure was checked at least twice a day, in the morning within 1 hour after wakeâup and in the evening before going to bed. Data of blood pressure and pulse rate were measured by automatic sphygmomanometer and were directly collected by iâconverter. All data including the time of measurement were directly sent and accumulated in the main server constructed in NTT DoCoMo data center through cellular phone operated by iâconverter. We could download data to CSV file like Excel and analyze them easily. Results: The mean of morning blood pressure in each period of medicine was significantly decreased in N period ( 133.0 1.1 / 78.1 1.1 mmHg (A) vs. 130.0 0.9 / 77.9 1.0 mmHg (N), p 0.05 ). The mean of morning pulse rate significantly increased in N period ( 68.4 1.2 beats / min (A) vs. 70.5 1.3 beats / min (N), p 0.05 ).Conclusion: The blood pressure reduction effect of nifedipine CR is stronger than that of amlodipine. Also, nifedipine CR increases pulse rate at our alternative dose setting. In this study, we have collected more data of home blood pressure in the quality and quantity than the previous studies through our telemedicine system. We also reduced the effort of data analysis with this system. (59th Annual Fall Conference and Scientific Sessions of the Council for High Blood Pressure Research)
US: https://www.cochranelibrary.com/central/doi/10.1002/central/CN-00758176/full



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The development of telemedicine in the world

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The development of telemedicine in the world

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Though telemedicine has been around for decades, advancements in the field have been slow due to various financial, regulatory, and technological challenges.

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ID: ED000105
AU: Rada G
TI: Telemedicine: are we advancing the science?
SO: Cochrane Database of Systematic Reviews
YR: 2015
NO: 9
PB: John Wiley & Sons, Ltd
SN: 1465-1858
KY: Effective practice/health systems
DOI: 10.1002/14651858.ED000105
US: https://doi.org//10.1002/14651858.ED000105

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ID: CD011942
AU: Odendaal WA
AU: Anstey Watkins J
AU: Leon N
AU: Goudge J
AU: Griffiths F
AU: Tomlinson M
AU: Daniels K
TI: Health workersâ perceptions and experiences of using mHealth technologies to deliver primary healthcare services: a qualitative evidence synthesis
SO: Cochrane Database of Systematic Reviews
YR: 2020
NO: 3
PB: John Wiley & Sons, Ltd
SN: 1465-1858
KY: Cell Phone; Delivery of Health Care [*methods]; Developing Countries; Health Personnel; Health Services; Humans; Perception; Primary Health Care [*methods]; Qualitative Research; Rural Health Services; Telemedicine [*methods]; Text Messaging
CC: [Effective Practice and Organisation of Care]
DOI: 10.1002/14651858.CD011942.pub2
AB: Abstract - Background Mobile health (mHealth), refers to healthcare practices supported by mobile devices, such as mobile phones and tablets. Within primary care, health workers often use mobile devices to register clients, track their health, and make decisions about care, as well as to communicate with clients and other health workers. An understanding of how health workers relate to, and experience mHealth, can help in its implementation. Objectives To synthesise qualitative research evidence on health workers' perceptions and experiences of using mHealth technologies to deliver primary healthcare services, and to develop hypotheses about why some technologies are more effective than others. Search methods We searched MEDLINE, Embase, CINAHL, Science Citation Index and Social Sciences Citation Index in January 2018. We searched Global Health in December 2015. We screened the reference lists of included studies and key references and searched seven sources for grey literature (16 February to 5 March 2018). We reâran the search strategies in February 2020. We screened these records and any studies that we identified as potentially relevant are awaiting classification. Selection criteria We included studies that used qualitative data collection and analysis methods. We included studies of mHealth programmes that were part of primary healthcare services. These services could be implemented in public or private primary healthcare facilities, community and workplace, or the homes of clients. We included all categories of health workers, as well as those persons who supported the delivery and management of the mHealth programmes. We excluded participants identified as technical staff who developed and maintained the mHealth technology, without otherwise being involved in the programme delivery. We included studies conducted in any country. Data collection and analysis We assessed abstracts, titles and fullâtext papers according to the inclusion criteria. We found 53 studies that met the inclusion criteria and sampled 43 of these for our analysis. For the 43 sampled studies, we extracted information, such as country, health worker category, and the mHealth technology. We used a thematic analysis process. We used GRADEâCERQual to assess our confidence in the findings. Main results Most of the 43 included sample studies were from lowâ or middleâincome countries. In many of the studies, the mobile devices had decision support software loaded onto them, which showed the steps the health workers had to follow when they provided health care. Other uses included inâperson and/or text message communication, and recording clients' health information. Almost half of the studies looked at health workers' use of mobile devices for mother, child, and newborn health. We have moderate or high confidence in the following findings. mHealth changed how health workers worked with each other : health workers appreciated being more connected to colleagues, and thought that this improved coâordination and quality of care. However, some described problems when senior colleagues did not respond or responded in anger. Some preferred faceâtoâface connection with colleagues. Some believed that mHealth improved their reporting, while others compared it to "big brother watching". mHealth changed how health workers delivered care : health workers appreciated how mHealth let them take on new tasks, work flexibly, and reach clients in difficultâtoâreach areas. They appreciated mHealth when it improved feedback, speed and workflow, but not when it was slow or time consuming. Some health workers found decision support software useful; others thought it threatened their clinical skills. Most health workers saw mHealth as better than paper, but some preferred paper. Some health workers saw mHealth as creating more work. mHealth led to new forms of engagement and relationships with clients and communities : health workers felt that communicating with clients by mobile phone improved care and their relationships with clients, but felt that some clients needed faceâtoâface contact. Health workers were aware of the importance of protecting confidential client information when using mobile devices. Some health workers did not mind being contacted by clients outside working hours, while others wanted boundaries. Health workers described how some community members trusted health workers that used mHealth while others were sceptical. Health workers pointed to problems when clients needed to own their own phones. Health workers' use and perceptions of mHealth could be influenced by factors tied to costs, the health worker, the technology, the health system and society, poor network access, and poor access to electricity : some health workers did not mind covering extra costs. Others complained that phone credit was not delivered on time. Health workers who were accustomed to using mobile phones were sometimes more positive towards mHealth. Others with less experience, were sometimes embarrassed about making mistakes in front of clients or worried about job security. Health workers wanted training, technical support, userâfriendly devices, and systems that were integrated into existing electronic health systems. The main challenges health workers experienced were poor network connections, access to electricity, and the cost of recharging phones. Other problems included damaged phones. Factors outside the health system also influenced how health workers experienced mHealth, including language, gender, and poverty issues. Health workers felt that their commitment to clients helped them cope with these challenges. Authors' conclusions Our findings propose a nuanced view about mHealth programmes. The complexities of healthcare delivery and human interactions defy simplistic conclusions on how health workers will perceive and experience their use of mHealth. Perceptions reflect the interplay between the technology, contexts, and human attributes. Detailed descriptions of the programme, implementation processes and contexts, alongside effectiveness studies, will help to unravel this interplay to formulate hypotheses regarding the effectiveness of mHealth. Plain language summary Health workers' perceptions and experiences of using mHealth technologies to deliver primary healthcare services: a qualitative evidence synthesis What is the aim of this review? The aim of this Cochrane Review of qualitative research was to explore how health workers view and experience the use of mobile phones and tablets when delivering primary healthcare services. To answer this, we analysed 43 studies about health workers' views and experiences of mobile health (mHealth) programmes. Key messages Health workers welcomed the benefits of mHealth, and described how they used mobile phones to improve their work and relationships with each other and with clients. However, they also experienced challenges, including poor network coverage and access to electricity. People implementing mHealth programmes should try to address these challenges and build on health workers' positive experiences. What was studied in this review? Health workers often use mobile phones and tablets to provide services. It is important to understand what health workers think about these devices, as this can affect the quality of services. We looked for studies that explored health workers' views and experiences of using mobile devices in primary care. What are the main findings of this review? We sampled 43 of the 53 included studies in this review. Most were from lowâ or middleâincome countries, and included both lay health workers and health professionals. Many used mobile phones or tablets when delivering health care to mothers, children or newborns. Many of the mobile devices had software that helped health workers follow the correct steps when providing services. Health workers also used mobile phones to communicate with clients, and to record clients' health information. We have moderate or high confidence in the following findings. mHealth changed how health workers worked with each other : health workers appreciated being more connected to colleagues, and thought that this improved coâordination and quality of care. However, some described problems when senior colleagues did not respond or responded in anger. Some preferred faceâtoâface connection with colleagues. Some believed that mHealth improved their reporting, while others compared it to "big brother watching". mHealth changed how health workers delivered care : health workers appreciated how mHealth let them take on new tasks, work flexibly, and reach clients in difficultâtoâreach areas. They appreciated mHealth when it improved feedback, speed and workflow, but not when it was slow or time consuming. Some health workers found decision support software useful; others thought it threatened their clinical skills. Most health workers saw mHealth as better than paper, but others saw mHealth as creating more work. mHealth led to new forms of engagement and relationships with clients and communities : health workers felt that communicating with clients by mobile phone improved care and their relationships with clients, but felt that some clients needed faceâtoâface contact. Health workers were aware of the importance of protecting confidential client information when using mobile devices. Some health workers did not mind being contacted by clients outside working hours, while others wanted boundaries. Health workers described how some community members trusted health workers that used mHealth while others were sceptical. Health workers pointed to problems when clients needed to own their own phones. Health workers' use and perceptions of mHealth could be influenced by factors tied to costs, the health worker, the technology, the health system and society, poor network access, and poor access to electricity : some health workers did not mind covering extra costs. Others complained that phone credit was not delivered on time. Health workers who were accustomed to using mobile phones were sometimes more positive towards mHealth. Others with less experience, were sometimes embarrassed about making mistakes in front of clients or worried about job security. Health workers wanted training, technical support, userâfriendly devices, and systems that were integrated into existing electronic health systems. The main challenges health workers experienced were poor network connections, access to electricity, and the cost of recharging phones. Other problems included damaged phones. Factors outside the health system also influenced how health workers experienced mHealth, including language, gender, and poverty issues. Health workers felt that their commitment to clients helped them cope with these challenges. How upâtoâdate is this review? We searched for studies published up to January 2018.
US: https://doi.org//10.1002/14651858.CD011942.pub2

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Tele-education has been used for many years to deliver continuing education programmes to rural health-care professionals. The main modes are audio, video and computer. Tele-education technologies have an important role to play in addressing the professional isolation which is experienced by rural and remote health-care professionals.

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The purpose of conducting and participating in the teleconference.

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The purpose of conducting and participating in the teleconference.

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Teleconferencing is a cost-effective way to communicate with people in different locations. This is because it eliminates the need for people to travel to different locations in order to participate in a meeting when doing project planning or goal setting. This can save companies money on travel costs.

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ID: CN-02183591
AU: Plow M
AU: Packer T
AU: Mathiowetz VG
AU: Preissner K
AU: Ghahari S
AU: Sattar A
AU: Bethoux F
AU: Finlayson M
TI: REFRESH protocol: a non-inferiority randomised clinical trial comparing internet and teleconference to in-person 'Managing Fatigue' interventions on the impact of fatigue among persons with multiple sclerosis
SO: BMJ open
YR: 2020
VL: 10
NO: 8
PG: e035470
PM: PUBMED 32801193
XR: EMBASE 632604236
PT: Journal article
KY: *Internet; *fatigue /therapy; *multiple sclerosis; *teleconference; Adult; Article; Controlled study; Fatigue [etiology, therapy]; Female; Health care delivery; Human; Humans; Internet; Major clinical study; Male; Mental function; Multiple Sclerosis [complications]; New England; Perception; Physical performance; Quality of Life; Quality of life; Randomized Controlled Trials as Topic; Self care; Self concept; Social status; Telecommunications; Young Adult
DOI: 10.1136/bmjopen-2019-035470
AB: Introduction Multiple sclerosis (MS) is an immuneâmediated disease of the central nervous system. It is considered a major cause of nonâtraumatic disability in young adults. One of the most common and disabling symptoms of MS is fatigue. MS fatigue can impact all aspects of quality of life, including physical, mental and social function. Fortunately, fatigue selfâmanagement interventions, such as 'Managing Fatigue: A 6 week energy conservation course', can decrease the impact of fatigue and improve healthârelated quality of life. The purpose of this study is to compare three modes of delivering the Managing Fatigue intervention âtwo remote delivery formats (teleconference and internet) and one inâperson format âon perceptions of fatigue and its impact on physical, mental and social function. Methods and analysis A nonâinferiority randomised clinical trial is being conducted to compare the three delivery formats (1:1:1 allocation ratio) among 582 participants with MS living in the Midwestern and Northeastern United States. The hypothesis is that teleconference and internet versions of the intervention are nonâinferior to the traditional mode of clinical service delivery (ie, one to one, in person) in terms of the primary outcome of selfâreported fatigue impact (ie, Fatigue Impact Scale) and the secondary outcome of healthârelated quality of life (ie, Multiple Sclerosis Impact Scale). Outcomes are being measured at baseline, 2 months, 3 months and 6 months. The primary analysis tool will be linear mixed effects model. The prespecified inferiority margin for the primary outcome is 10 points. We will also examine whether baseline characteristics (eg, sociodemographic) moderate outcomes of the Managing Fatigue intervention and whether changes in selfâefficacy and fatigue selfâmanagement behaviours mediate changes in outcomes. Ethics and dissemination The protocol is approved centrally by the institutional review board at Case Western Reserve University. Eligible participants give consent before being enrolled and randomised into the study. The study results will be disseminated through relevant advocacy organisations, newsletters to participants, publication in peerâreviewed journals and presentations at scientific conferences. Trial registration number NCT03550170; Preâresults.
US: https://www.cochranelibrary.com/central/doi/10.1002/central/CN-02183591/full

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Types of teleconferences and server. Participation in online and offline teleconferences

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Types of teleconferences and server. Participation in online and offline teleconferences

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There are at least six types of teleconferencing: audio, audiographic, computer, video, business television (BTV), and distance education.

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The new systems have varying degrees of interactivity - the capability to talk back to the user. They are enabling and satellites, computers, teletext, viewdata, cassettes, cable, and videodiscs all fit the same emerging pattern. They provide ways for individuals to step out of the mass audiences and take an active role in the process by which information is transmitted. The new technologies are de-massified so that a special message can be exchanged with each individual in a large audience. They are the opposite o mass media and shift control to the user.

Many are asynchronous and can send or receive a message at a time convenient for individuals without being in communication at the same time. This overcomes time as a variable affecting communication. A video, data and voice delivery system reduces travel costs. When the material is retrieved and saved to a video tape or disc, the material can be used at anytime or anyplace.

As more interactive technologies emerge, the value of being an independent learner will increase. Research shows that learning from new technologies is as effective as traditional methods. Large groups are cost-effective and everyone gets the same information.

Types of Teleconferences

Distance learning can be conducted by audio conference. In fact, it is one of the most underutilized, yet cost effective methods available to education. Instructors should receive training on how to best utilize audio conferences to augment other forms of distance learning.

Audiographics can be used for meetings and distance learning.

Computer conferencing is an emerging area for distance education. Some institutions offer credit programs completely by computer. Students receive texts and workbooks via mail. Through common files assigned to a class which each student can assess, teachers upload syllabi, lectures, grades and remarks. Students download these files, compose their assignment and remarks off-line, then upload them to the common files.

Students and instructors are usually required to log on for a prescribed number of days during the week. Interaction is a large component of the students' grades.

Through computers, faculty, students and administrators have easy access to one another as well as access to database resources provided through libraries. The academic resources of libraries and special resources can be accessed such as OCLC, ERIC, and Internet.

Administrators can access student files, retrieve institutional information from central repositories such as district or system offices, government agencies, or communicate with one another. Other resources can be created such as updates on state or federal legislation.

Video conferencing is an effective way to use one teacher who teaches to a number of sites. It is very cost effective for classes which may have a small number of students enrolled at each site. In many cases, video conferencing enables the institution or a group of institutions to provide courses which would be canceled due to low enrollment or which could not be supported otherwise because of the cost of providing an instructor in an unusual subject area. Rural areas benefit particularly from classes provided through video conferencing when they work with a larger metropolitan institution that has full-time faculty.

Through teleconferencing, institutions are able to serve all students equitably.

Why Use a Teleconference?

Videoconferencing increases efficiency and results in a more profitable use of limited resources. It is a very personal medium for human issues where face-to-face communications are necessary. When you can see and hear the person you are talking to on a television monitor, they respond as though you were in the same room together. It is an effective alternative to travel which can easily add up to weeks of non-productive time each year. With videoconferencing, you never have to leave the office. Documents are available, and experts can be on hand. A crisis that might take on major proportions if you are out of town, can be handled because you're on the job. Videoconferencing maximizes efficiency because it provides a way to meet with several groups in different locations, at the same time.

As the limited resource of funding has decreased, limited resources now include instructors, parking spaces and buildings. Students now include time as a limited resources. Teleconferencing enables institutions to share facilities and instructors which will increase our ability to serve students.

Move Information - Not People

Electronic delivery is more efficient than physically moving people to a site, whether it is a faculty member or administrator.

Satellite Communications

Long distance telephone calls, national and international televised sporting events, and cable movie channels operate via satellites. Satellites have been used for years.

International Satellite

Alpha Lyracom Space Communications/Pan American Satellite is the world's first private international satellite system. PAS-1 carries many specialized communications services including full and part-time video, low and high speed data, broadcast data and radio and business television to over 70 countries on three continents. It can be seen (received) by a 2.4 meter antenna. It has 18 C-band and six Ku-band transponders with a shared capacity that increases traffic.

PanAmSat handles all phases of an international broadcast as compared to INTELSAT (International Telecommunications Satellite Organization) where the customer must book the domestic and foreign half circuits and pay for each downlink. INTELSAT was established primarily to handle the PTT telephone transmissions, while PanAmSat was established to be easily accessible by distance education institutions and private enterprise. The FCC licenses PanAmSat transportables for years, as compared to the FCC special temporary authority (STA) license for INTELSAT. PanAmSat transportables can uplink from any location without a special license.

PanAmSat writes yearly contracts with customers. It does not charge for multiple downlinks. Time on PAS-1 books from between $960 to $2,400 per hour depending on the volume discount based on yearly usage. To book time on PAS-1, call the day-of-air or future event number, with the origination site, uplink, downlink sites, and conference time. PanAmSat handles the rest. By booking time through satellite brokers (EDS, PSN, Satellite Management International) ad hoc users can reduce time costs. PanAmSat is negotiating for three more satellites to be in place in 1994-95.

Compressed Video

Digital compression means that the codec compresses the video signal or data to a fraction of its original size so that the data rate is appropriate to transmit over low-cost terrestrial telephone lines or on a fraction of a satellite transponder. Codecs (COder/DECorder) compress the video and audio signal allowing it to be transmitted in a smaller bandwidth which reduces the cost of the transmission.

Standard transmission rates for video teleconferencing are multiples of 64 Kbs up to the T1 rate of 1.54 Mbs. Some codecs allow speed selection to match the circuit used. The speed selected is based on the content. When close to full motion video is needed, higher rates are needed.

T1 circuits connect PBXs to the telephone company's central office and can carry up to 24 voice channels at a lower cost than 24 voice circuits. A 56 Kb or 64 KBS codec operates in the range of one voice channel. A standard video signal digitized at 90 Mbs is comprised of about 1400 voice channels.

Freeze Frame Video

Freeze frame video uses telephone channels to transmit video information. Because of the narrow bandwidth, the image takes a few moments to reach the receive site where it appears on the TV as a still picture. The advantages are lower costs and flexibility in linking multiple sites. Slow scan systems are similar to freeze frame and the terms are often used synonymously.

Freeze frame technologies include a range of features; analog, digital, monochrome or color pictures, resolutions, transmission speeds, and extra memory. Newer models provide multiple send times to select the resolution and transmission time through digital circuits and compression coding. Some units transmit video information in digital format over a data circuit which reduces the transmission time to about nine seconds to a 56 kilobit link. Because of the faster transmission rates, many new freeze frame applications use data circuits.

Compressed video (near motion) and full-motion video differ; compressed video uses compression techniques to reduce channel bandwidth; images may not look as natural and may blur or lose background resolution. The advantage is that the significant reduction in bandwidth reduces costs. Compressed video uses a telephone data circuit - currently a T1 carrier or 1.5 or 3 megabits - to transmit video, voice and data. It reduces video information (NTSC Standard-color video) with a compression technique to eliminate redundant information and reduce the 100 million bits signal to 1.5 or 3 million bits.

Digital video signals are broken down into thousands of elements called pixels. Between frames, many are the same. A codec takes advantage of this duplication by sending complete information on the first pixel and a brief code to repeat the values. This reduces the information sent and the bandwidth required. Interframe coding for conditional replenishment compares the changes between two frames and transmits changes. Motion compensation predicts changes between frames and transmits only the difference. Software holds the compression algorithm which can be upgraded. The CCITT Px64 international standard requires rates to operate in multiples of 64.

Full-Motion Video

Standard TV signals are broadcast using a significant amount of the bandwidth of wideband channels - 4 to 6 megahertz for color analog - to send video, voice and data. Because of the large channel capacity, it transmits a picture with the full motion and resolution of broadcast TV. The bandwidth used is the digital equivalent of 80 Mbps or more which corresponds to a full satellite transponder or 1820 voice phone lines. This translates into high costs for signal transmission.

Compression for One-Way Video

Consumer application for compressed video systems use higher rates than two-way compressed video to achieve near-broadcast quality video image. A digitally compressed video signal can be broadcast over 1/20 of a regular transponder channel reducing costs to under $200 per hour.

One use of the technology is SKY PIX, a pay per view movie service based on a Compression Labs, Inc. codec marketed by NW Star Scan which offers viewers a choice of up to 40 movies. The picture quality is better than VHS transmission quality. Scientific Atlanta offers PrimeStar, a competing entertainment service, which transmits at a data rate of 4 to 4.5 Mbs. Using the same technology, they will offer B-Mac users compatibility with compressed video users at a lower price because the transmission uses a fraction of a regular transponder channel.

Compression Labs, Inc. has recently introduced the SpectrumSaver System which can broadcast a digital signal to a fraction of a satellite transponder. Because up to 15 or 18 signals can be carried on a transponder (depending upon the system configuration), the cost of satellite time is significantly reduced. The National Technological University (NTU) is using the system, as well as ITESM in Mexico. Each institution reports a savings of $1 million in satellite time during the first year of operation. The system is entirely digital.

Scientific Atlanta is about to bring its new digital satellite system to the market. This system is an upgrade to an existing Scientific Atlanta analog satellite system. As such, users will be able to broadcast in either analog or digital format.

Fiber Optic Systems

The transmission of voice, video and data by light wave signals inside a thin, transparent glass fiber cable, is providing more choices for telecommunications users and is rapidly bringing digital communication to the home and office. One pair of fibers can carry up to 10,000 telephone calls simultaneously. Advantages: transmission clarity, speed, accuracy, security, and volume. Disadvantages: Construction, installation and maintenance costs, but they are declining.

from "The Distance Learning Technology Resource Guide," by Carla Lane

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The new systems have varying degrees of interactivity - the capability to talk back to the user. They are enabling and satellites, computers, teletext, viewdata, cassettes, cable, and videodiscs all fit the same emerging pattern. They provide ways for individuals to step out of the mass audiences and take an active role in the process by which information is transmitted.

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Use of telemedicine", "Role of ICT in medicine"

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Use of telemedicine", "Role of ICT in medicine"

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How Telemedicine Is Transforming Health Care

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The revolution is finally here—raising a host of questions for regulators, providers, insurers and patients.