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introduction:telemedicine

This page is the 4th chapter of the 4S story:
4S is an ecosystem for providers and users of open source modules for telemedicine / telehealth systems based on national (Danish) and international standards.

...for telemedicine / telehealth systems...

The term “telemedicine” is one of the classic “catch-all” buzz-words. The WHO definition of this term is:

“The delivery of health care services, where distance is a critical factor, by all health care professionals using information and communication technologies for the exchange of valid information for diagnosis, treatment and prevention of disease and injuries, research and evaluation, and for the continuing education of health care providers, all in the interests of advancing the health of individuals and their communities.”

This definition more or less encompasses all situations where a clinician uses a telephone or some IT equipment in the treatment of a patient or group of patients, who are not present. It could be as trivial as a phone call between two clinicians discussing the general treatment of diabetes.

The general consensus about “telehealth” is even broader, as it also encompasses preventative / prophylactic actions. At the extreme, a “stop smoking” TV commercial could be considered a telehealth activity. In relation to 4S, however, telehealth is becoming increasingly relevant these years due to the emergence of many smartphone / smartwatch applications and wearable gadgets logging all kinds of personal activity data. This is also known as the Quantified Self movement. Here, interesting opportunities will emerge when these privately collected data can be used for prevention or early discovery of diseases – or perhaps reveal events leading up to the beginning of a chronic condition.

The purpose of 4S is to provide libraries of software modules which may be used by application developers to build concrete applications (e.g. fitness gadgets or smartphone apps). The keyword is interoperability, as it is hard for small software development companies to deal with the integration between their small application and the many complex and huge systems used in the healthcare sector (take for instance federated login solutions, or the delivery of data in appropriate electronic health record formats). In an ideal world, the small application development company should not have to worry about the integration with complex healthcare systems, instead, they should be able to grab a general-purpose toolbox with the tools they need for an easy integration. The ambition of 4S is to be this toolbox (the tools in the toolbox may come from many different sources, though).

The primary scope of 4S (at least to begin with) is remote patient monitoring, which is currently undergoing fast adoption in relation to many different (chronic) conditions. This theme is particularly interesting for a number of reasons:

  • “Traditional” clinical measurements of e.g. blood pressure, where a patient visits the doctor to have the measurement performed, suffer from the so-called “white-coat syndrome”, which means that the “uncomfortable” situation affects the patient's physiology (stress), causing a bad measurement.
  • In many situations, many unreliable measurements are better than a few reliable (or pseudo-reliable – see the white-coat syndrome above) measurements. For instance a bathroom scale may be 3 kg off, but a sequence of measurements on the same scale will still reveal trends in the body-weight which may indicate dehydration or the development of oedema.
  • The Quantified Self movement mentioned above and the collection of large amounts of data that could potentially be used to either prevent a disease or condition, or to treat it.
  • Technology in general becomes cheaper and smaller. This also applies to equipment which used to be available only at a hospital or microbiology lab due to size and price-tag. Today, an ECG monitor or a blood analyser is affordable for anyone – and in a few years they will probably both be built into a smartphone.

Collecting these vast amounts of data is one thing, but it is worthless if the data are not used for anything! Since the clinicians do not have the resources to manually process all these new data (the whole point was that they should save time), at some point automatic algorithms must be used to evaluate and interpret the data. This places huge demands on the quality of the software. Therefore, it is important for 4S to ensure high quality of the code!

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See also the following pages:

The following pages explain the fundamental idea of 4S:

introduction/telemedicine.txt · Last modified: 2018/12/12 13:27 (external edit)