Healthc Inform Res.  2015 Oct;21(4):213-222. 10.4258/hir.2015.21.4.213.

Recent Directions in Telemedicine: Review of Trends in Research and Practice

• Wilson LS
• Maeder AJ

• KMID: 2166869
• DOI: http://doi.org/10.4258/hir.2015.21.4.213

Abstract

OBJECTIVES
Healthcare is now routinely delivered by telecommunications-based services in all developed countries and an increasing number of developing countries. Telemedicine is used in many clinical specialities and across numerous healthcare settings, which range from mobile patient-centric applications to complex interactions amongst clinicians in tertiary referral hospital settings. This paper discusses some recent areas of significant development and progress in the field with the purpose of identifying strong trends in both research and practice activities.
METHODS
To establish the breadth of new ideas and directions in the field, a review of literature was made by searching PubMed for recent publications including terms (telemedicine OR telehealth) AND (challenge OR direction OR innovation OR new OR novel OR trend), for all searchable categories. 3,433 publications were identified that have appeared since January 1, 2005 (2,172 of these since January 1, 2010), based on a search conducted on June 1, 2015.
RESULTS
The current interest areas in these papers span both synchronous telemedicine, including intensive care, emergency medicine, and mental health, and asynchronous telemedicine, including wound and burns care, dermatology and ophthalmology.
CONCLUSIONS
It is concluded that two major drivers of contemporary tele medicine development are a high volume demand for a particular clinical service, and/or a high criticality of need for clinical exper tise to deliver the service. These areas offer promise for further study and enhancement of applicable telemedicine methods and have the potential for large-scale deployments internationally, which would contribute significantly to the advancement of healthcare.

Keyword

Telemedicine; Remote Consultation; Telecommunications; Delivery of Health Care

MeSH Terms

Burns
Critical Care
Delivery of Health Care
Dermatology
Developed Countries
Developing Countries
Emergency Medicine
Mental Health
Ophthalmology
Remote Consultation
Telecommunications
Telemedicine*
Tertiary Care Centers
Wounds and Injuries

Reference

1. World Health Organisation. Telemedicine: opportunities and developments in member states. Geneva, Switzerland: World Health Organisation;2010.

2. Tulu B, Chatterjee S, Maheshwari M. Telemedicine taxonomy: a classification tool. Telemed J E Health. 2007; 13(3):349–358.

3. Bashshur R, Shannon G, Krupinski E, Grigsby J. The taxonomy of telemedicine. Telemed J E Health. 2011; 17(6):484–494.

4. Li J, Wilson LS. Telehealth trends and the challenge for infrastructure. Telemed J E Health. 2013; 19(10):772–779.

5. Caswell W. Global telehealth market to expand 10x by 2018 [Internet]. [place unknown]: Modern Health Talk;2014. cited at 2015 Mar 20. Available from: http://www.mhealthtalk.com/global-telehealth-market-to-expand-10x-by-2018/#more-7937.

6. Marschollek M, Gietzelt M, Schulze M, Kohlmann M, Song B, Wolf KH. Wearable sensors in healthcare and sensor-enhanced health information systems: all our tomorrows? Healthc Inform Res. 2012; 18(2):97–104.

7. Fatehi F, Armfield NR, Dimitrijevic M, Gray LC. Technical aspects of clinical videoconferencing: a large scale review of the literature. J Telemed Telecare. 2015; 21(3):160–166.

8. Wade VA, Karnon J, Elshaug AG, Hiller JE. A systematic review of economic analyses of telehealth services using real time video communication. BMC Health Serv Res. 2010; 10:233.

9. Ahn Y, Jasmer RM, Shaughnessy T. Perspectives on the electronic ICU. ICU Dir. 2012; 3(2):64–69.

10. Hansen SK, Wilson LS, Roberson T. Applying an integrated approach to the design, implementation and evaluation of a telemedicine system. J Int Soc Telemed eHealth. 2013; 1(1):19–29.

11. Kumar S, Merchant S, Reynolds R. Tele-ICU: efficacy and cost-effectiveness of remotely managing critical care. Perspect Health Inf Manag. 2013; 10:1f.

12. Li J, Wilson LS, Qiao RY, Percival T, Krumm-Heller A, Stapleton S, et al. Development of a broadband telehealth system for critical care: process and lessons learned. Telemed J E Health. 2006; 12(5):552–560.

13. Wilson LS, Stevenson DR, Cregan P. Telehealth on advanced networks. Telemed J E Health. 2010; 16(1):69–79.

14. Westbrook JI, Coiera EW, Brear M, Stapleton S, Rob MI, Murphy M, et al. Impact of an ultrabroadband emergency department telemedicine system on the care of acutely ill patients and clinicians' work. Med J Aust. 2008; 188(12):704–708.

15. Latifi R, Hadeed GJ, Rhee P, O'Keeffe T, Friese RS, Wynne JL, et al. Initial experiences and outcomes of telepresence in the management of trauma and emergency surgical patients. Am J Surg. 2009; 198(6):905–910.

16. Kim YK, Kim KY, Lee KH, Kim SC, Kim H, Hwang SO, et al. Clinical outcomes on real-time telemetry system in developing emergency medical service system. Telemed J E Health. 2011; 17(4):247–253.

17. Muller-Barna P, Hubert GJ, Boy S, Bogdahn U, Wiedmann S, Heuschmann PU, et al. TeleStroke units serving as a model of care in rural areas: 10-year experience of the TeleMedical project for integrative stroke care. Stroke. 2014; 45(9):2739–2744.

18. World Health Organization. Prevention of mental disorders: effective interventions and policy options [Internet]. Geneva, Switzerland: World Health Organization;2004. cited at 2015 Apr 3. Available from: http://www.who.int/mental_health/evidence/en/prevention_of_mental_disorders_sr.pdf.

19. Yellowlees P, Odor A, Patrice K, Parish MB, Nafiz N, Iosif AM, et al. Disruptive innovation: the future of healthcare? Telemed J E Health. 2011; 17(3):231–234.

20. Mohr DC. Telemental health: reflections on how to move the field forward. Clin Psychol Sci Pract. 2009; 16(3):343–347.

21. Pruitt LD, Luxton DD, Shore P. Additional clinical benefits of home-based telemental health treatments. Prof Psychol Res Pr. 2014; 45(5):340–346.

22. Price M, Yuen EK, Goetter EM, Herbert JD, Forman EM, Acierno R, et al. mHealth: a mechanism to deliver more accessible, more effective mental health care. Clin Psychol Psychother. 2014; 21(5):427–436.

23. Gray LC, Armfield NR, Smith AC. Telemedicine for wound care: current practice and future potential. Wound Pract Res. 2010; 18(4):158–163.

24. Chanussot-Deprez C, Contreras-Ruiz J. Telemedicine in wound care: a review. Adv Skin Wound Care. 2013; 26(2):78–82.

25. Hasselberg M, Beer N, Blom L, Wallis LA, Laflamme L. Image-based medical expert teleconsultation in acute care of injuries: a systematic review of effects on information accuracy, diagnostic validity, clinical outcome, and user satisfaction. PLoS One. 2014; 9(6):e98539.

26. Santamaria N, Kapp S. TeleWound care: providing remote wound assessment and treatment in the home care setting: current status and future directions. Smart Homecare Technol TeleHealth. 2013; 1:35–41.

27. Canadian Agency for Drugs and Technologies in Health. Personal wireless device use for wound care consultation: a review of safety, clinical benefits and guidelines. Ottawa, Canada: Canadian Agency for Drugs and Technologies in Health;2014.

28. Chen CH, Young TH, Huang CH, Chang HH, Chen CL, Chien HF, et al. Patient-centered wound teleconsultation for cutaneous wounds: a feasibility study. Ann Plast Surg. 2014; 72(2):220–224.

29. Vowden K, Vowden P. A pilot study on the potential of remote support to enhance wound care for nursinghome patients. J Wound Care. 2013; 22(9):481–488.

30. Stern A, Mitsakakis N, Paulden M, Alibhai S, Wong J, Tomlinson G, et al. Pressure ulcer multidisciplinary teams via telemedicine: a pragmatic cluster randomized stepped wedge trial in long term care. BMC Health Serv Res. 2014; 14:83.

31. Saffle JR, Edelman L, Theurer L, Morris SE, Cochran A. Telemedicine evaluation of acute burns is accurate and cost-effective. J Trauma. 2009; 67(2):358–365.

32. Wallace DL, Hussain A, Khan N, Wilson YT. A systematic review of the evidence for telemedicine in burn care: with a UK perspective. Burns. 2012; 38(4):465–480.

33. Holt B, Faraklas I, Theurer L, Cochran A, Saffle JR. Telemedicine use among burn centers in the United States: a survey. J Burn Care Res. 2012; 33(1):157–162.

34. Armstrong AW, Wu J, Kovarik CL, Goldyne ME, Oh DH, McKoy KC, et al. State of teledermatology programs in the United States. J Am Acad Dermatol. 2012; 67(5):939–944.

35. Muir J. Telehealth: the specialist perspective. Aust Fam Physician. 2014; 43(12):828–830.

36. Massone C, Wurm EM, Hofmann-Wellenhof R, Soyer HP. Teledermatology: an update. Semin Cutan Med Surg. 2008; 27(1):101–105.

37. Whited JD. Teledermatology research review. Int J Dermatol. 2006; 45(3):220–229.

38. Levin YS, Warshaw EM. Teledermatology: a review of reliability and accuracy of diagnosis and management. Dermatol Clin. 2009; 27(2):163–176.

39. Vrucinic Z, Jankovic A, Miladinovic M, Gocev D, Bojanic P, Kacarevic R. Evaluation of clinical diagnosis with "store and forward" teledermatology. Acta Med Median. 2010; 49(4):23–30.

40. Warshaw EM, Gravely AA, Nelson DB. Accuracy of teledermatology/teledermoscopy and clinic-based dermatology for specific categories of skin neoplasms. J Am Acad Dermatol. 2010; 63(2):348–352.

41. Muir J, Lucas L. Tele-dermatology in Australia. Stud Health Technol Inform. 2008; 131:245–253.

42. Thomas J, Kumar P. The scope of teledermatology in India. Indian Dermatol Online J. 2013; 4(2):82–89.

43. Warshaw EM, Hillman YJ, Greer NL, Hagel EM, Mac-Donald R, Rutks IR, et al. Teledermatology for diagnosis and management of skin conditions: a systematic review. J Am Acad Dermatol. 2011; 64(4):759–772.

44. Mahendran R, Goodfield MJ, Sheehan-Dare RA. An evaluation of the role of a store-and-forward teledermatology system in skin cancer diagnosis and management. Clin Exp Dermatol. 2005; 30(3):209–214.

45. Moreno-Ramirez D, Ferrandiz L, Bernal AP, Duran RC, Martin JJ, Camacho F. Teledermatology as a filtering system in pigmented lesion clinics. J Telemed Telecare. 2005; 11(6):298–303.

46. Bowns IR, Collins K, Walters SJ, McDonagh AJ. Telemedicine in dermatology: a randomised controlled trial. Health Technol Assess. 2006; 10(43):iii–iv. ix–xi. 1–39.

47. Warshaw EM, Lederle FA, Grill JP, Gravely AA, Bangerter AK, Fortier LA, et al. Accuracy of teledermatology for pigmented neoplasms. J Am Acad Dermatol. 2009; 61(5):753–765.

48. Massone C, Brunasso AM, Campbell TM, Soyer HP. Mobile teledermoscopy: melanoma diagnosis by one click? Semin Cutan Med Surg. 2009; 28(3):203–205.

49. Kroemer S, Fruhauf J, Campbell TM, Massone C, Schwantzer G, Soyer HP, et al. Mobile teledermatology for skin tumour screening: diagnostic accuracy of clinical and dermoscopic image tele-evaluation using cellular phones. Br J Dermatol. 2011; 164(5):973–979.

50. Lamel SA, Haldeman KM, Ely H, Kovarik CL, Pak H, Armstrong AW. Application of mobile teledermatology for skin cancer screening. J Am Acad Dermatol. 2012; 67(4):576–581.

51. Wolf JA, Moreau JF, Akilov O, Patton T, English JC 3rd, Ho J, et al. Diagnostic inaccuracy of smartphone applications for melanoma detection. JAMA Dermatol. 2013; 149(4):422–426.

52. Whited JD. Accuracy and reliability of teleophthalmology for diagnosing diabetic retinopathy and macular edema: a review of the literature. Diabetes Technol Ther. 2006; 8(1):102–111.

53. Jones S, Edwards RT. Diabetic retinopathy screening: a systematic review of the economic evidence. Diabet Med. 2010; 27(3):249–256.

54. Chasan JE, Delaune B, Maa AY, Lynch MG. Effect of a teleretinal screening program on eye care use and resources. JAMA Ophthalmol. 2014; 132(9):1045–1051.

55. Cuadros J, Sim I. EyePACS: an open source clinical communication system for eye care. Stud Health Technol Inform. 2004; 107(Pt 1):207–211.

56. Cuadros J, Bresnick G. EyePACS: an adaptable telemedicine system for diabetic retinopathy screening. J Diabetes Sci Technol. 2009; 3(3):509–516.

57. Kumar S, Bulsara M, Yogesan K. Automated determination of distance visual acuity: towards teleophthalmology services. Clin Exp Optom. 2008; 91(6):545–550.

58. Srinivasan K, Ramesh SV, Babu N, Sanker N, Ray A, Karuna SM. Efficacy of a remote based computerised visual acuity measurement. Br J Ophthalmol. 2012; 96(7):987–990.

59. Tan JC, Poh EW, Srinivasan S, Lim TH. A pilot trial of tele-ophthalmology for diagnosis of chronic blurred vision. J Telemed Telecare. 2013; 19(2):65–69.

60. Maa AY, Evans C, DeLaune WR, Patel PS, Lynch MG. A novel tele-eye protocol for ocular disease detection and access to eye care services. Telemed J E Health. 2014; 20(4):318–323.

61. Zvornicanin E, Zvornicanin J, Hadziefendic B. The use of smart phones in ophthalmology. Acta Inform Med. 2014; 22(3):206–209.

62. Jang-Jaccard J, Nepal S, Alem L, Li J. Barriers for delivering telehealth in rural australia: a review based on Australian trials and studies. Telemed J E Health. 2014; 20(5):496–504.