<s>
Telehealth	O
is	O
the	O
distribution	O
of	O
health-related	O
services	O
and	O
information	O
via	O
electronic	B-Application
information	O
and	O
telecommunication	O
technologies	O
.	O
</s>
<s>
Telemedicine	B-Application
is	O
sometimes	O
used	O
as	O
a	O
synonym	O
,	O
or	O
is	O
used	O
in	O
a	O
more	O
limited	O
sense	O
to	O
describe	O
remote	O
clinical	O
services	O
,	O
such	O
as	O
diagnosis	O
and	O
monitoring	O
.	O
</s>
<s>
as	O
well	O
as	O
provide	O
distance-learning	O
;	O
meetings	O
,	O
supervision	O
,	O
and	O
presentations	O
between	O
practitioners	O
;	O
online	O
information	O
and	O
health	B-General_Concept
data	I-General_Concept
management	O
and	O
healthcare	O
system	O
integration	O
.	O
</s>
<s>
Telehealth	O
could	O
include	O
two	O
clinicians	O
discussing	O
a	O
case	O
over	O
video	B-Application
conference	I-Application
;	O
a	O
robotic	O
surgery	O
occurring	O
through	O
remote	O
access	O
;	O
physical	O
therapy	O
done	O
via	O
digital	O
monitoring	O
instruments	O
,	O
live	O
feed	O
and	O
application	O
combinations	O
;	O
tests	O
being	O
forwarded	O
between	O
facilities	O
for	O
interpretation	O
by	O
a	O
higher	O
specialist	O
;	O
home	O
monitoring	O
through	O
continuous	O
sending	O
of	O
patient	O
health	B-General_Concept
data	I-General_Concept
;	O
client	O
to	O
practitioner	O
online	O
conference	O
;	O
or	O
even	O
videophone	B-Application
interpretation	O
during	O
a	O
consult	O
.	O
</s>
<s>
Telehealth	O
is	O
sometimes	O
discussed	O
interchangeably	O
with	O
telemedicine	B-Application
,	O
the	O
latter	O
being	O
more	O
common	O
than	O
the	O
former	O
.	O
</s>
<s>
The	O
Health	O
Resources	O
and	O
Services	O
Administration	O
distinguishes	O
telehealth	O
from	O
telemedicine	B-Application
in	O
its	O
scope	O
,	O
defining	O
telemedicine	B-Application
only	O
as	O
describing	O
remote	O
clinical	O
services	O
,	O
such	O
as	O
diagnosis	O
and	O
monitoring	O
,	O
while	O
telehealth	O
includes	O
preventative	O
,	O
promotive	O
,	O
and	O
curative	O
care	O
delivery	O
.	O
</s>
<s>
The	O
United	O
States	O
Department	O
of	O
Health	O
and	O
Human	O
Services	O
states	O
that	O
the	O
term	O
telehealth	O
includes	O
"	O
non-clinical	O
services	O
,	O
such	O
as	O
provider	O
training	O
,	O
administrative	O
meetings	O
,	O
and	O
continuing	O
medical	O
education	O
"	O
,	O
and	O
that	O
the	O
term	O
telemedicine	B-Application
means	O
"	O
remote	O
clinical	O
services	O
"	O
.	O
</s>
<s>
The	O
World	O
Health	O
Organization	O
uses	O
telemedicine	B-Application
to	O
describe	O
all	O
aspects	O
of	O
health	O
care	O
including	O
preventive	O
care	O
.	O
</s>
<s>
The	O
American	O
Telemedicine	B-Application
Association	O
uses	O
the	O
terms	O
telemedicine	B-Application
and	O
telehealth	O
interchangeably	O
,	O
although	O
it	O
acknowledges	O
that	O
telehealth	O
is	O
sometimes	O
used	O
more	O
broadly	O
for	O
remote	O
health	O
not	O
involving	O
active	O
clinical	O
treatments	O
.	O
</s>
<s>
eHealth	B-Application
is	O
another	O
related	O
term	O
,	O
used	O
particularly	O
in	O
the	O
U.K.	O
and	O
Europe	O
,	O
as	O
an	O
umbrella	O
term	O
that	O
includes	O
telehealth	O
,	O
electronic	B-Application
medical	I-Application
records	I-Application
,	O
and	O
other	O
components	O
of	O
health	O
information	B-General_Concept
technology	I-General_Concept
.	O
</s>
<s>
Telehealth	O
requires	O
good	O
Internet	O
access	O
by	O
participants	O
,	O
usually	O
in	O
the	O
form	O
of	O
a	O
strong	O
,	O
reliable	O
broadband	B-General_Concept
connection	O
,	O
and	O
broadband	B-General_Concept
mobile	O
communication	B-General_Concept
technology	I-General_Concept
of	O
at	O
least	O
the	O
fourth	O
generation	O
(	O
4G	O
)	O
or	O
long-term	O
evolution	O
(	O
LTE	O
)	O
standard	O
to	O
overcome	O
issues	O
with	O
video	O
stability	O
and	O
bandwidth	O
restrictions	O
.	O
</s>
<s>
As	O
broadband	B-General_Concept
infrastructure	O
has	O
improved	O
,	O
telehealth	O
usage	O
has	O
become	O
more	O
widely	O
feasible	O
.	O
</s>
<s>
Delivery	O
can	O
come	O
within	O
four	O
distinct	O
domains	O
:	O
live	O
video	O
(	O
synchronous	O
)	O
,	O
store-and-forward	B-Protocol
(	O
asynchronous	O
)	O
,	O
remote	B-Application
patient	I-Application
monitoring	I-Application
,	O
and	O
mobile	B-Device
health	I-Device
.	O
</s>
<s>
Store-and-forward	B-Protocol
telemedicine	B-Application
involves	O
acquiring	O
medical	O
data	O
(	O
like	O
medical	B-Application
images	I-Application
,	O
biosignals	B-Algorithm
etc	O
.	O
)	O
</s>
<s>
Dermatology	O
(	O
cf	O
:	O
teledermatology	B-Application
)	O
,	O
radiology	O
,	O
and	O
pathology	O
are	O
common	O
specialties	O
that	O
are	O
conducive	O
to	O
asynchronous	O
telemedicine	B-Application
.	O
</s>
<s>
A	O
properly	O
structured	O
medical	O
record	O
preferably	O
in	O
electronic	B-Application
form	O
should	O
be	O
a	O
component	O
of	O
this	O
transfer	O
.	O
</s>
<s>
The	O
'	O
store-and-forward	B-Protocol
'	O
process	O
requires	O
the	O
clinician	O
to	O
rely	O
on	O
a	O
history	O
report	O
and	O
audio/video	O
information	O
in	O
lieu	O
of	O
a	O
physical	O
examination	O
.	O
</s>
<s>
Electronic	B-Application
consultations	I-Application
are	O
possible	O
through	O
interactive	O
telemedicine	B-Application
services	O
which	O
provide	O
real-time	O
interactions	O
between	O
patient	O
and	O
provider	O
.	O
</s>
<s>
Videoconferencing	B-Application
has	O
been	O
used	O
in	O
a	O
wide	O
range	O
of	O
clinical	O
disciplines	O
and	O
settings	O
for	O
various	O
purposes	O
including	O
management	O
,	O
diagnosis	O
,	O
counseling	O
and	O
monitoring	O
of	O
patients	O
.	O
</s>
<s>
Videotelephony	B-Application
comprises	O
the	O
technologies	O
for	O
the	O
reception	O
and	O
transmission	O
of	O
audio-video	O
signals	O
by	O
users	O
at	O
different	O
locations	O
,	O
for	O
communication	O
between	O
people	O
in	O
real-time	O
.	O
</s>
<s>
At	O
the	O
dawn	O
of	O
the	O
technology	O
,	O
videotelephony	B-Application
also	O
included	O
image	O
phones	O
which	O
would	O
exchange	O
still	O
images	O
between	O
units	O
every	O
few	O
seconds	O
over	O
conventional	O
POTS-type	O
telephone	O
lines	O
,	O
essentially	O
the	O
same	O
as	O
slow	O
scan	O
TV	O
systems	O
.	O
</s>
<s>
Currently	O
,	O
videotelephony	B-Application
is	O
particularly	O
useful	O
to	O
the	O
deaf	O
and	O
speech-impaired	O
who	O
can	O
use	O
them	O
with	O
sign	O
language	O
and	O
also	O
with	O
a	O
video	O
relay	O
service	O
,	O
and	O
well	O
as	O
to	O
those	O
with	O
mobility	O
issues	O
or	O
those	O
who	O
are	O
located	O
in	O
distant	O
places	O
and	O
are	O
in	O
need	O
of	O
telemedical	B-Application
or	O
tele-educational	O
services	O
.	O
</s>
<s>
Common	O
daily	O
emergency	O
telemedicine	B-Application
is	O
performed	O
by	O
SAMU	O
Regulator	O
Physicians	O
in	O
France	O
,	O
Spain	O
,	O
Chile	O
and	O
Brazil	O
.	O
</s>
<s>
A	O
recent	O
study	O
identified	O
three	O
major	O
barriers	O
to	O
adoption	O
of	O
telemedicine	B-Application
in	O
emergency	O
and	O
critical	O
care	O
units	O
.	O
</s>
<s>
Cultural	O
barriers	O
:	O
occurring	O
from	O
the	O
lack	O
of	O
desire	O
,	O
or	O
unwillingness	O
,	O
of	O
some	O
physicians	O
to	O
adapt	O
clinical	O
paradigms	O
for	O
telemedicine	B-Application
applications	O
.	O
</s>
<s>
An	O
example	O
of	O
telehealth	O
in	O
the	O
field	O
is	O
when	O
EMS	O
arrives	O
on	O
scene	O
of	O
an	O
incident	O
and	O
is	O
able	O
to	O
take	O
an	O
EKG	B-Application
that	O
is	O
then	O
sent	O
directly	O
to	O
a	O
physician	O
at	O
the	O
hospital	O
to	O
be	O
read	O
.	O
</s>
<s>
Telenursing	O
refers	O
to	O
the	O
use	O
of	O
telecommunications	O
and	O
information	B-General_Concept
technology	I-General_Concept
in	O
order	O
to	O
provide	O
nursing	O
services	O
in	O
health	O
care	O
whenever	O
a	O
large	O
physical	O
distance	O
exists	O
between	O
patient	O
and	O
nurse	O
,	O
or	O
between	O
any	O
number	O
of	O
nurses	O
.	O
</s>
<s>
In	O
Australia	O
,	O
during	O
January	O
2014	O
,	O
Melbourne	O
tech	O
startup	O
Small	O
World	O
Social	O
collaborated	O
with	O
the	O
Australian	O
Breastfeeding	O
Association	O
to	O
create	O
the	O
first	O
hands-free	O
breastfeeding	O
Google	B-Application
Glass	I-Application
application	O
for	O
new	O
mothers	O
.	O
</s>
<s>
The	O
application	O
,	O
named	O
Google	B-Application
Glass	I-Application
Breastfeeding	O
app	O
trial	O
,	O
allows	O
mothers	O
to	O
nurse	O
their	O
baby	O
while	O
viewing	O
instructions	O
about	O
common	O
breastfeeding	O
issues	O
(	O
latching	O
on	O
,	O
posture	O
etc	O
.	O
)	O
</s>
<s>
or	O
call	O
a	O
lactation	O
consultant	O
via	O
a	O
secure	O
Google	O
Hangout	O
,	O
who	O
can	O
view	O
the	O
issue	O
through	O
the	O
mother	O
's	O
Google	B-Application
Glass	I-Application
camera	O
.	O
</s>
<s>
It	O
is	O
an	O
instance	O
of	O
the	O
wider	O
phenomenon	O
of	O
telemedicine	B-Application
,	O
as	O
implemented	O
in	O
the	O
field	O
of	O
pharmacy	O
.	O
</s>
<s>
Telepharmacy	O
services	O
include	O
drug	O
therapy	O
monitoring	O
,	O
patient	O
counseling	O
,	O
prior	O
authorization	O
and	O
refill	O
authorization	O
for	O
prescription	O
drugs	O
,	O
and	O
monitoring	O
of	O
formulary	O
compliance	O
with	O
the	O
aid	O
of	O
teleconferencing	O
or	O
videoconferencing	B-Application
.	O
</s>
<s>
The	O
term	O
can	O
also	O
refer	O
to	O
the	O
use	O
of	O
videoconferencing	B-Application
in	O
pharmacy	O
for	O
other	O
purposes	O
,	O
such	O
as	O
providing	O
education	O
,	O
training	O
,	O
and	O
management	O
services	O
to	O
pharmacists	O
and	O
pharmacy	O
staff	O
remotely	O
.	O
</s>
<s>
Teledentistry	O
is	O
the	O
use	O
of	O
information	B-General_Concept
technology	I-General_Concept
and	O
telecommunications	O
for	O
dental	O
care	O
,	O
consultation	O
,	O
education	O
,	O
and	O
public	O
awareness	O
in	O
the	O
same	O
manner	O
as	O
telehealth	O
and	O
telemedicine	B-Application
.	O
</s>
<s>
Tele-audiology	B-Application
is	O
the	O
utilization	O
of	O
telehealth	O
to	O
provide	O
audiological	O
services	O
and	O
may	O
include	O
the	O
full	O
scope	O
of	O
audiological	O
practice	O
.	O
</s>
<s>
Telemedicine	B-Application
in	O
neurosurgery	O
was	O
historically	O
primarily	O
used	O
for	O
follow-up	O
visits	O
by	O
patients	O
that	O
had	O
to	O
travel	O
far	O
to	O
undergo	O
surgery	O
.	O
</s>
<s>
In	O
the	O
last	O
decade	O
,	O
telemedicine	B-Application
was	O
also	O
used	O
for	O
remote	O
ICU	O
rounding	O
as	O
well	O
as	O
prompt	O
evaluation	O
for	O
acute	O
ischemic	O
stroke	O
and	O
administration	O
of	O
IV	O
alteplase	O
in	O
conjunction	O
with	O
Neurology	O
.	O
</s>
<s>
From	O
the	O
onset	O
of	O
the	O
COVID-19	O
pandemic	O
,	O
there	O
was	O
a	O
rapid	O
surge	O
in	O
the	O
use	O
of	O
telemedicine	B-Application
across	O
all	O
divisions	O
of	O
neurosurgery	O
:	O
vascular	O
,	O
oncology	O
,	O
spine	O
,	O
and	O
functional	O
neurosurgery	O
.	O
</s>
<s>
Telemedicine	B-Application
is	O
not	O
limited	O
to	O
direct	O
patient	O
care	O
only	O
;	O
there	O
are	O
a	O
number	O
of	O
new	O
research	O
groups	O
and	O
companies	O
focused	O
on	O
using	O
telemedicine	B-Application
for	O
clinical	O
trials	O
involving	O
patients	O
with	O
neurosurgical	O
diagnoses	O
.	O
</s>
<s>
Teleneuropsychology	O
is	O
the	O
use	O
of	O
telehealth/videoconference	O
technology	O
for	O
the	O
remote	O
administration	O
of	O
neuropsychological	O
tests	O
.	O
</s>
<s>
Through	O
a	O
series	O
of	O
studies	O
,	O
there	O
is	O
growing	O
support	O
in	O
the	O
literature	O
showing	O
that	O
remote	O
videoconference-based	O
administration	O
of	O
many	O
standard	O
neuropsychological	O
tests	O
results	O
in	O
test	O
findings	O
that	O
are	O
similar	O
to	O
traditional	O
in-person	O
evaluations	O
,	O
thereby	O
establishing	O
the	O
basis	O
for	O
the	O
reliability	O
and	O
validity	O
of	O
teleneuropsychological	O
assessment	O
.	O
</s>
<s>
Telerehabilitation	B-Application
(	O
or	O
e-rehabilitation	B-Application
)	O
is	O
the	O
delivery	O
of	O
rehabilitation	O
services	O
over	O
telecommunication	O
networks	O
and	O
the	O
Internet	O
.	O
</s>
<s>
Some	O
fields	O
of	O
rehabilitation	O
practice	O
that	O
have	O
explored	O
telerehabilitation	B-Application
are	O
:	O
neuropsychology	O
,	O
speech	O
–	O
language	O
pathology	O
,	O
audiology	O
,	O
occupational	O
therapy	O
,	O
and	O
physical	O
therapy	O
.	O
</s>
<s>
Telerehabilitation	B-Application
can	O
deliver	O
therapy	O
to	O
people	O
who	O
cannot	O
travel	O
to	O
a	O
clinic	O
because	O
the	O
patient	O
has	O
a	O
disability	O
or	O
because	O
of	O
travel	O
time	O
.	O
</s>
<s>
Telerehabilitation	B-Application
also	O
allows	O
experts	O
in	O
rehabilitation	O
to	O
engage	O
in	O
a	O
clinical	O
consultation	O
at	O
a	O
distance	O
.	O
</s>
<s>
Most	O
telerehabilitation	B-Application
is	O
highly	O
visual	O
.	O
</s>
<s>
As	O
of	O
2014	O
,	O
the	O
most	O
commonly	O
used	O
mediums	O
are	O
webcams	B-Protocol
,	O
videoconferencing	B-Application
,	O
phone	O
lines	O
,	O
videophones	B-Application
and	O
webpages	O
containing	O
rich	B-Application
web	I-Application
applications	I-Application
.	O
</s>
<s>
The	O
visual	O
nature	O
of	O
telerehabilitation	B-Application
technology	O
limits	O
the	O
types	O
of	O
rehabilitation	O
services	O
that	O
can	O
be	O
provided	O
.	O
</s>
<s>
Rich	B-Application
web	I-Application
applications	I-Application
for	O
neuropsychological	O
rehabilitation	O
(	O
aka	O
cognitive	O
rehabilitation	O
)	O
of	O
cognitive	O
impairment	O
(	O
from	O
many	O
etiologies	O
)	O
were	O
first	O
introduced	O
in	O
2001	O
.	O
</s>
<s>
Tele-audiology	B-Application
(	O
hearing	O
assessments	O
)	O
is	O
a	O
growing	O
application	O
.	O
</s>
<s>
Currently	O
,	O
telerehabilitation	B-Application
in	O
the	O
practice	O
of	O
occupational	O
therapy	O
and	O
physical	O
therapy	O
is	O
limited	O
,	O
perhaps	O
because	O
these	O
two	O
disciplines	O
are	O
more	O
"	O
hands	O
on	O
"	O
.	O
</s>
<s>
Two	O
important	O
areas	O
of	O
telerehabilitation	B-Application
research	O
are	O
(	O
1	O
)	O
demonstrating	O
equivalence	O
of	O
assessment	O
and	O
therapy	O
to	O
in-person	O
assessment	O
and	O
therapy	O
,	O
and	O
(	O
2	O
)	O
building	O
new	O
data	O
collection	O
systems	O
to	O
digitize	O
information	O
that	O
a	O
therapist	O
can	O
use	O
in	O
practice	O
.	O
</s>
<s>
Ground-breaking	O
research	O
in	O
telehaptics	B-General_Concept
(	O
the	O
sense	O
of	O
touch	O
)	O
and	O
virtual	O
reality	O
may	O
broaden	O
the	O
scope	O
of	O
telerehabilitation	B-Application
practice	O
,	O
in	O
the	O
future	O
.	O
</s>
<s>
In	O
the	O
United	O
States	O
,	O
the	O
National	O
Institute	O
on	O
Disability	O
and	O
Rehabilitation	O
Research	O
's	O
(	O
NIDRR	O
)	O
supports	O
research	O
and	O
the	O
development	O
of	O
telerehabilitation	B-Application
.	O
</s>
<s>
Only	O
a	O
few	O
health	O
insurers	O
in	O
the	O
United	O
States	O
,	O
and	O
about	O
half	O
of	O
Medicaid	O
programs	O
,	O
reimburse	O
for	O
telerehabilitation	B-Application
services	O
.	O
</s>
<s>
If	O
the	O
research	O
shows	O
that	O
teleassessments	O
and	O
teletherapy	O
are	O
equivalent	O
to	O
clinical	O
encounters	O
,	O
it	O
is	O
more	O
likely	O
that	O
insurers	O
and	O
Medicare	O
will	O
cover	O
telerehabilitation	B-Application
services	O
.	O
</s>
<s>
In	O
India	O
,	O
the	O
Indian	O
Association	O
of	O
Chartered	O
Physiotherapists	O
(	O
IACP	O
)	O
provides	O
telerehabilitation	B-Application
facilities	O
.	O
</s>
<s>
With	O
the	O
support	O
and	O
collaboration	O
of	O
local	O
clinics	O
and	O
private	O
practitioners	O
and	O
the	O
Members	O
IACP	O
,	O
IACP	O
runs	O
the	O
facility	O
,	O
named	O
Telemedicine	B-Application
.	O
</s>
<s>
Telemedicine	B-Application
can	O
be	O
utilized	O
to	O
improve	O
the	O
efficiency	O
and	O
effectiveness	O
of	O
the	O
delivery	O
of	O
care	O
in	O
a	O
trauma	O
environment	O
.	O
</s>
<s>
Telemedicine	B-Application
for	O
trauma	O
triage	O
:	O
using	O
telemedicine	B-Application
,	O
trauma	O
specialists	O
can	O
interact	O
with	O
personnel	O
on	O
the	O
scene	O
of	O
a	O
mass	O
casualty	O
or	O
disaster	O
situation	O
,	O
via	O
the	O
internet	O
using	O
mobile	B-Application
devices	I-Application
,	O
to	O
determine	O
the	O
severity	O
of	O
injuries	O
.	O
</s>
<s>
Telemedicine	B-Application
for	O
intensive	O
care	O
unit	O
(	O
ICU	O
)	O
rounds	O
:	O
Telemedicine	B-Application
is	O
also	O
being	O
used	O
in	O
some	O
trauma	O
ICUs	O
to	O
reduce	O
the	O
spread	O
of	O
infections	O
.	O
</s>
<s>
A	O
new	O
approach	O
features	O
the	O
team	O
conducting	O
rounds	O
from	O
a	O
conference	O
room	O
using	O
a	O
video-conferencing	B-Application
system	O
.	O
</s>
<s>
Video-conferencing	B-Application
allows	O
the	O
remote	O
viewers	O
two-way	O
communication	O
with	O
clinicians	O
at	O
the	O
bedside	O
.	O
</s>
<s>
Telemedicine	B-Application
for	O
trauma	O
education	O
:	O
some	O
trauma	O
centers	O
are	O
delivering	O
trauma	O
education	O
lectures	O
to	O
hospitals	O
and	O
health	O
care	O
providers	O
worldwide	O
using	O
video	B-Application
conferencing	I-Application
technology	O
.	O
</s>
<s>
Telemedicine	B-Application
in	O
the	O
trauma	O
operating	O
room	O
:	O
trauma	O
surgeons	O
are	O
able	O
to	O
observe	O
and	O
consult	O
on	O
cases	O
from	O
a	O
remote	O
location	O
using	O
video	B-Application
conferencing	I-Application
.	O
</s>
<s>
ECGs	B-Application
,	O
or	O
electrocardiographs	B-Application
,	O
can	O
be	O
transmitted	O
using	O
telephone	O
and	O
wireless	O
.	O
</s>
<s>
Willem	O
Einthoven	O
,	O
the	O
inventor	O
of	O
the	O
ECG	B-Application
,	O
actually	O
did	O
tests	O
with	O
transmission	O
of	O
ECG	B-Application
via	O
telephone	O
lines	O
.	O
</s>
<s>
One	O
of	O
the	O
oldest	O
known	O
telecardiology	O
systems	O
for	O
teletransmissions	O
of	O
ECGs	B-Application
was	O
established	O
in	O
Gwalior	O
,	O
India	O
in	O
1975	O
at	O
GR	O
Medical	O
college	O
by	O
Ajai	O
Shanker	O
,	O
S	O
.	O
Makhija	O
,	O
P.K.	O
</s>
<s>
This	O
system	O
enabled	O
wireless	O
transmission	O
of	O
ECG	B-Application
from	O
the	O
moving	O
ICU	O
van	O
or	O
the	O
patients	O
home	O
to	O
the	O
central	O
station	O
in	O
ICU	O
of	O
the	O
department	O
of	O
Medicine	O
.	O
</s>
<s>
The	O
ECG	B-Application
output	O
was	O
connected	O
to	O
the	O
telephone	O
input	O
using	O
a	O
modulator	O
which	O
converted	O
ECG	B-Application
into	O
high	O
frequency	O
sound	O
.	O
</s>
<s>
At	O
the	O
other	O
end	O
a	O
demodulator	O
reconverted	O
the	O
sound	O
into	O
ECG	B-Application
with	O
a	O
good	O
gain	O
accuracy	O
.	O
</s>
<s>
The	O
ECG	B-Application
was	O
converted	O
to	O
sound	O
waves	O
with	O
a	O
frequency	O
varying	O
from	O
500Hz	O
to	O
2500Hz	O
with	O
1500Hz	O
at	O
baseline	O
.	O
</s>
<s>
In	O
addition	O
,	O
electronic	B-Application
stethoscopes	O
can	O
be	O
used	O
as	O
recording	O
devices	O
,	O
which	O
is	O
helpful	O
for	O
purposes	O
of	O
telecardiology	O
.	O
</s>
<s>
In	O
Pakistan	O
three	O
pilot	O
projects	O
in	O
telemedicine	B-Application
were	O
initiated	O
by	O
the	O
Ministry	O
of	O
IT	O
&	O
Telecom	O
,	O
Government	O
of	O
Pakistan	O
(	O
MoIT	O
)	O
through	O
the	O
Electronic	B-Application
Government	O
Directorate	O
in	O
collaboration	O
with	O
Oratier	O
Technologies	O
(	O
a	O
pioneer	O
company	O
within	O
Pakistan	O
dealing	O
with	O
healthcare	O
and	O
HMIS	O
)	O
and	O
PakDataCom	O
(	O
a	O
bandwidth	O
provider	O
)	O
.	O
</s>
<s>
Wireless	O
ambulatory	O
ECG	B-Application
technology	O
,	O
moving	O
beyond	O
previous	O
ambulatory	O
ECG	B-Application
technology	O
such	O
as	O
the	O
Holter	O
monitor	O
,	O
now	O
includes	O
smartphones	O
and	O
Apple	O
Watches	O
which	O
can	O
perform	O
at-home	O
cardiac	O
monitoring	O
and	O
send	O
the	O
data	O
to	O
a	O
physician	O
via	O
the	O
internet	O
.	O
</s>
<s>
Teleradiology	O
is	O
the	O
ability	O
to	O
send	O
radiographic	O
images	O
(	O
x-rays	B-Library
,	O
CT	O
,	O
MR	O
,	O
PET/CT	O
,	O
SPECT/CT	O
,	O
MG	O
,	O
US	O
...	O
)	O
from	O
one	O
location	O
to	O
another	O
.	O
</s>
<s>
Today	O
's	O
high-speed	O
broadband	B-General_Concept
based	O
Internet	O
enables	O
the	O
use	O
of	O
new	O
technologies	O
for	O
teleradiology	O
:	O
the	O
image	O
reviewer	O
can	O
now	O
have	O
access	O
to	O
distant	O
servers	O
in	O
order	O
to	O
view	O
an	O
exam	O
.	O
</s>
<s>
Therefore	O
,	O
they	O
do	O
not	O
need	O
particular	O
workstations	O
to	O
view	O
the	O
images	O
;	O
a	O
standard	O
personal	B-Device
computer	I-Device
(	O
PC	O
)	O
and	O
digital	O
subscriber	O
line	O
(	O
DSL	O
)	O
connection	O
is	O
enough	O
to	O
reach	O
Keosys	O
 '	O
central	O
server	O
.	O
</s>
<s>
Teleradiology	O
is	O
the	O
most	O
popular	O
use	O
for	O
telemedicine	B-Application
and	O
accounts	O
for	O
at	O
least	O
50%	O
of	O
all	O
telemedicine	B-Application
usage	O
.	O
</s>
<s>
Teledermatology	B-Application
allows	O
dermatology	O
consultations	O
over	O
a	O
distance	O
using	O
audio	O
,	O
visual	O
and	O
data	O
communication	O
,	O
and	O
has	O
been	O
found	O
to	O
improve	O
efficiency	O
,	O
access	O
to	O
specialty	O
care	O
,	O
and	O
patient	O
satisfaction	O
.	O
</s>
<s>
The	O
dermatologists	O
Perednia	O
and	O
Brown	O
were	O
the	O
first	O
to	O
coin	O
the	O
term	O
teledermatology	B-Application
in	O
1995	O
,	O
where	O
they	O
described	O
the	O
value	O
of	O
a	O
teledermatologic	O
service	O
in	O
a	O
rural	O
area	O
underserved	O
by	O
dermatologists	O
.	O
</s>
<s>
Teleophthalmology	O
is	O
a	O
branch	O
of	O
telemedicine	B-Application
that	O
delivers	O
eye	O
care	O
through	O
digital	O
medical	O
equipment	O
and	O
telecommunications	O
technology	O
.	O
</s>
<s>
Remote	B-Application
surgery	I-Application
(	O
also	O
known	O
as	O
telesurgery	B-Application
)	O
is	O
the	O
ability	O
for	O
a	O
doctor	O
to	O
perform	O
surgery	O
on	O
a	O
patient	O
even	O
though	O
they	O
are	O
not	O
physically	O
in	O
the	O
same	O
location	O
.	O
</s>
<s>
It	O
is	O
a	O
form	O
of	O
telepresence	B-Application
.	O
</s>
<s>
Remote	B-Application
surgery	I-Application
combines	O
elements	O
of	O
robotics	O
,	O
cutting-edge	O
telecommunications	O
such	O
as	O
high-speed	O
data	O
connections	O
,	O
telehaptics	B-General_Concept
and	O
elements	O
of	O
management	B-Application
information	I-Application
systems	I-Application
.	O
</s>
<s>
While	O
the	O
field	O
of	O
robotic	O
surgery	O
is	O
fairly	O
well	O
established	O
,	O
most	O
of	O
these	O
robots	B-Algorithm
are	O
controlled	O
by	O
surgeons	O
at	O
the	O
location	O
of	O
the	O
surgery	O
.	O
</s>
<s>
Remote	B-Application
surgery	I-Application
is	O
remote	O
work	O
for	O
surgeons	O
,	O
where	O
the	O
physical	O
distance	O
between	O
the	O
surgeon	O
and	O
the	O
patient	O
is	O
immaterial	O
.	O
</s>
<s>
Remote	B-Application
surgery	I-Application
or	O
telesurgery	B-Application
is	O
performance	O
of	O
surgical	O
procedures	O
where	O
the	O
surgeon	O
is	O
not	O
physically	O
in	O
the	O
same	O
location	O
as	O
the	O
patient	O
,	O
using	O
a	O
robotic	O
teleoperator	O
system	O
controlled	O
by	O
the	O
surgeon	O
.	O
</s>
<s>
Remote	B-Application
surgery	I-Application
combines	O
elements	O
of	O
robotics	O
and	O
high-speed	O
data	O
connections	O
.	O
</s>
<s>
Telemedicine	B-Application
has	O
been	O
used	O
globally	O
to	O
increase	O
access	O
to	O
abortion	O
care	O
,	O
specifically	O
medical	O
abortion	O
,	O
in	O
environments	O
where	O
few	O
abortion	O
care	O
providers	O
exist	O
or	O
abortion	O
is	O
legally	O
restricted	O
.	O
</s>
<s>
An	O
abortion	O
care	O
provider	O
communicates	O
with	O
the	O
person	O
located	O
at	O
another	O
site	O
using	O
clinic-to-clinic	O
videoconferencing	B-Application
to	O
provide	O
medical	O
abortion	O
after	O
screening	O
tests	O
and	O
consultation	O
with	O
clinic	O
staff	O
.	O
</s>
<s>
The	O
person	O
receives	O
counseling	O
and	O
instruction	O
from	O
an	O
abortion	O
care	O
provider	O
via	O
videoconference	B-Application
from	O
a	O
location	O
of	O
their	O
choice	O
.	O
</s>
<s>
A	O
systematic	O
review	O
of	O
telemedicine	B-Application
abortion	O
has	O
found	O
the	O
practice	O
to	O
be	O
safe	O
,	O
effective	O
,	O
efficient	O
,	O
and	O
satisfactory	O
.	O
</s>
<s>
In	O
the	O
United	O
States	O
,	O
eighteen	O
states	O
require	O
the	O
clinician	O
to	O
be	O
physically	O
present	O
during	O
the	O
administration	O
of	O
medications	O
for	O
abortion	O
which	O
effectively	O
bans	O
telehealth	O
of	O
medication	O
abortion	O
:	O
five	O
states	O
explicitly	O
ban	O
telemedicine	B-Application
for	O
medication	O
abortion	O
,	O
while	O
thirteen	O
states	O
require	O
the	O
prescriber	O
(	O
usually	O
required	O
to	O
be	O
a	O
physician	O
)	O
to	O
be	O
physically	O
present	O
with	O
the	O
patient	O
.	O
</s>
<s>
Telemedicine	B-Application
can	O
facilitate	O
specialty	O
care	O
delivered	O
by	O
primary	O
care	O
physicians	O
according	O
to	O
a	O
controlled	O
study	O
of	O
the	O
treatment	O
of	O
hepatitis	O
C	O
.	O
Various	O
specialties	O
are	O
contributing	O
to	O
telemedicine	B-Application
,	O
in	O
varying	O
degrees	O
.	O
</s>
<s>
Telemedicine	B-Application
has	O
also	O
been	O
beneficial	O
in	O
facilitating	O
medical	O
education	O
to	O
students	O
while	O
still	O
allowing	O
for	O
adequate	O
social	O
distancing	O
during	O
the	O
COVID-19	O
pandemic	O
.	O
</s>
<s>
Medication	O
assisted	O
treatment	O
(	O
MAT	O
)	O
is	O
the	O
treatment	O
of	O
opioid	O
use	O
disorder	O
(	O
OUD	O
)	O
with	O
medications	O
,	O
often	O
in	O
combination	O
with	O
behavioral	O
therapy	O
As	O
a	O
response	O
to	O
the	O
COVID-19	O
pandemic	O
the	O
use	O
of	O
telemedicine	B-Application
has	O
been	O
granted	O
by	O
the	O
Drug	O
Enforcement	O
Administration	O
to	O
start	O
or	O
maintain	O
people	O
OUD	O
on	O
buprenorphine	O
(	O
trade	O
name	O
Suboxone	O
)	O
via	O
telemedicine	B-Application
without	O
the	O
need	O
for	O
an	O
initial	O
in-person	O
examination	O
.	O
</s>
<s>
This	O
development	O
has	O
ensured	O
that	O
many	O
access	O
barriers	O
are	O
eliminated	O
,	O
as	O
medical	O
professionals	O
are	O
able	O
to	O
use	O
wireless	O
communication	B-General_Concept
technologies	I-General_Concept
to	O
deliver	O
health	O
care	O
.	O
</s>
<s>
Telehealth	O
eliminates	O
this	O
barrier	O
as	O
health	O
professionals	O
are	O
able	O
to	O
conduct	O
medical	O
consultations	O
through	O
the	O
use	O
of	O
wireless	O
communication	B-General_Concept
technologies	I-General_Concept
.	O
</s>
<s>
This	O
remote	B-Application
patient	I-Application
monitoring	I-Application
ability	O
enables	O
patients	O
to	O
stay	O
at	O
home	O
longer	O
and	O
helps	O
avoid	O
unnecessary	O
hospital	O
time	O
.	O
</s>
<s>
During	O
the	O
COVID-19	O
pandemic	O
,	O
there	O
were	O
large	O
increases	O
in	O
the	O
use	O
of	O
telemedicine	B-Application
for	O
primary	O
care	O
visits	O
within	O
the	O
United	O
States	O
,	O
increasing	O
from	O
an	O
average	O
of	O
1.4	O
million	O
visits	O
in	O
Q2	O
of	O
2018	O
and	O
2019	O
to	O
35	O
million	O
visits	O
in	O
Q2	O
2020	O
,	O
according	O
to	O
data	O
from	O
IQVIA	O
.	O
</s>
<s>
Use	O
of	O
telemedicine	B-Application
by	O
General	O
Practitioners	O
in	O
the	O
UK	O
rose	O
from	O
20	O
–	O
30%	O
pre-COVID	O
to	O
almost	O
80%	O
by	O
the	O
beginning	O
of	O
2021	O
.	O
</s>
<s>
A	O
2023	O
study	O
published	O
in	O
the	O
Journal	O
of	O
the	O
American	O
College	O
of	O
Surgeons	O
showed	O
telemedicine	B-Application
as	O
making	O
a	O
positive	O
impact	O
,	O
with	O
expectations	O
exceeded	O
for	O
those	O
physicians	O
and	O
patients	O
who	O
had	O
consulted	O
online	O
for	O
surgeries	O
.	O
</s>
<s>
Restrictive	O
licensure	O
laws	O
in	O
the	O
United	O
States	O
require	O
a	O
practitioner	O
to	O
obtain	O
a	O
full	O
license	O
to	O
deliver	O
telemedicine	B-Application
care	O
across	O
state	O
lines	O
.	O
</s>
<s>
In	O
2008	O
,	O
the	O
U.S.	O
passed	O
the	O
Ryan	O
Haight	O
Act	O
which	O
required	O
face-to-face	O
or	O
valid	O
telemedicine	B-Application
consultations	O
prior	O
to	O
receiving	O
a	O
prescription	O
.	O
</s>
<s>
State	O
medical	O
licensing	O
boards	O
have	O
sometimes	O
opposed	O
telemedicine	B-Application
;	O
for	O
example	O
,	O
in	O
2012	O
electronic	B-Application
consultations	I-Application
were	O
illegal	O
in	O
Idaho	O
,	O
and	O
an	O
Idaho-licensed	O
general	O
practitioner	O
was	O
punished	O
by	O
the	O
board	O
for	O
prescribing	O
an	O
antibiotic	O
,	O
triggering	O
reviews	O
of	O
her	O
licensure	O
and	O
board	O
certifications	O
across	O
the	O
country	O
.	O
</s>
<s>
Subsequently	O
,	O
in	O
2015	O
the	O
state	O
legislature	O
legalized	O
electronic	B-Application
consultations	I-Application
.	O
</s>
<s>
There	O
has	O
been	O
a	O
particular	O
push	O
toward	O
mHealth	B-Device
applications	O
as	O
many	O
areas	O
,	O
even	O
underdeveloped	O
ones	O
have	O
mobile	O
phone	O
and	O
smartphone	O
coverage	O
.	O
</s>
<s>
In	O
a	O
2015	O
article	O
reviewing	O
research	O
on	O
the	O
use	O
of	O
a	O
mobile	B-Device
health	I-Device
application	O
in	O
the	O
United	O
Kingdom	O
,	O
authors	O
describe	O
how	O
a	O
home-based	O
application	O
helped	O
patients	O
manage	O
and	O
monitor	O
their	O
health	O
and	O
symptoms	O
independently	O
.	O
</s>
<s>
The	O
mobile	B-Device
health	I-Device
application	O
allows	O
people	O
to	O
rapidly	O
self-report	O
their	O
symptoms	O
–	O
95%	O
of	O
patients	O
were	O
able	O
to	O
report	O
their	O
daily	O
symptoms	O
in	O
less	O
than	O
100	O
seconds	O
,	O
which	O
is	O
less	O
than	O
the	O
5	O
minutes	O
(	O
plus	O
commuting	O
)	O
taken	O
to	O
measure	O
vital	O
signs	O
by	O
nurses	O
in	O
hospitals	O
.	O
</s>
<s>
The	O
downside	O
of	O
using	O
mHealth	B-Device
applications	O
is	O
that	O
not	O
everyone	O
,	O
especially	O
in	O
developing	O
countries	O
,	O
has	O
daily	O
access	O
to	O
internet	O
or	O
electronic	B-Application
devices	O
.	O
</s>
<s>
The	O
Australian	O
hands-free	O
breastfeeding	O
Google	B-Application
Glass	I-Application
application	O
reported	O
promising	O
results	O
in	O
2014	O
.	O
</s>
<s>
A	O
scientific	O
review	O
indicates	O
that	O
,	O
in	O
general	O
,	O
outcomes	O
of	O
telemedicine	B-Application
are	O
or	O
can	O
be	O
as	O
good	O
as	O
in-person	O
care	O
with	O
health	O
care	O
use	O
staying	O
similar	O
.	O
</s>
<s>
Advantages	O
of	O
the	O
nonexclusive	O
adoption	O
of	O
already	O
existing	O
telemedicine	B-Application
technologies	O
such	O
as	O
smartphone	O
videotelephony	B-Application
may	O
include	O
reduced	O
infection	O
risks	O
,	O
increased	O
control	O
of	O
disease	O
during	O
epidemic	O
conditions	O
,	O
improved	O
access	O
to	O
care	O
,	O
reduced	O
stress	O
and	O
exposure	O
to	O
other	O
pathogens	O
during	O
illness	O
for	O
better	O
recovery	O
,	O
reduced	O
time	O
and	O
labor	O
costs	O
,	O
efficient	O
more	O
accessible	O
matching	O
of	O
patients	O
with	O
particular	O
symptoms	O
and	O
clinicians	O
who	O
are	O
experts	O
for	O
such	O
,	O
and	O
reduced	O
travel	O
while	O
disadvantages	O
may	O
include	O
privacy	O
breaches	O
(	O
e.g.	O
</s>
<s>
Telemedicine	B-Application
could	O
also	O
be	O
used	O
for	O
connected	O
networks	O
between	O
health	O
care	O
professionals	O
.	O
</s>
<s>
Telemedicine	B-Application
also	O
can	O
eliminate	O
the	O
possible	O
transmission	O
of	O
infectious	O
diseases	O
or	O
parasites	B-Device
between	O
patients	O
and	O
medical	O
staff	O
.	O
</s>
<s>
Many	O
patient	O
experience	O
studies	O
indicate	O
high	O
satisfaction	O
with	O
telemedicine	B-Application
.	O
</s>
<s>
It	O
also	O
found	O
that	O
the	O
COVID-19	O
pandemic	O
substantially	O
increased	O
,	O
voluntarily	O
,	O
the	O
adoption	O
of	O
telephone	O
or	O
video	O
consultation	O
and	O
suggests	O
that	O
telemedicine	B-Application
technology	O
"	O
is	O
a	O
key	O
factor	O
in	O
delivery	O
of	O
health	O
care	O
in	O
the	O
future	O
"	O
.	O
</s>
<s>
Digital	B-Application
interventions	I-Application
for	I-Application
mental	I-Application
health	I-Application
conditions	I-Application
seem	O
to	O
be	O
cost-effective	O
compared	O
to	O
no	O
intervention	O
or	O
non-therapeutic	O
responses	O
such	O
as	O
monitoring	O
.	O
</s>
<s>
Telemedicine	B-Application
can	O
be	O
beneficial	O
to	O
patients	O
in	O
isolated	O
communities	O
and	O
remote	O
regions	O
,	O
who	O
can	O
receive	O
care	O
from	O
doctors	O
or	O
specialists	O
far	O
away	O
without	O
the	O
patient	O
having	O
to	O
travel	O
to	O
visit	O
them	O
.	O
</s>
<s>
Recent	O
developments	O
in	O
mobile	B-Protocol
collaboration	I-Protocol
technology	O
can	O
allow	O
healthcare	O
professionals	O
in	O
multiple	O
locations	O
to	O
share	O
information	O
and	O
discuss	O
patient	O
issues	O
as	O
if	O
they	O
were	O
in	O
the	O
same	O
place	O
.	O
</s>
<s>
Remote	B-Application
patient	I-Application
monitoring	I-Application
through	O
mobile	O
technology	O
can	O
reduce	O
the	O
need	O
for	O
outpatient	O
visits	O
and	O
enable	O
remote	O
prescription	O
verification	O
and	O
drug	O
administration	O
oversight	O
,	O
potentially	O
significantly	O
reducing	O
the	O
overall	O
cost	O
of	O
medical	O
care	O
.	O
</s>
<s>
Telemedicine	B-Application
can	O
also	O
facilitate	O
medical	O
education	O
by	O
allowing	O
workers	O
to	O
observe	O
experts	O
in	O
their	O
fields	O
and	O
share	O
best	O
practices	O
more	O
easily	O
.	O
</s>
<s>
Remote	B-Application
surgery	I-Application
and	O
types	O
of	O
videoconferencing	B-Application
for	O
sharing	O
expertise	O
(	O
e.g.	O
</s>
<s>
Medicare	O
will	O
only	O
reimburse	O
live	O
video	O
(	O
synchronous	O
)	O
type	O
services	O
,	O
not	O
store-and-forward	B-Protocol
,	O
mhealth	B-Device
or	O
remote	B-Application
patient	I-Application
monitoring	I-Application
(	O
if	O
it	O
does	O
not	O
involve	O
live-video	O
)	O
.	O
</s>
<s>
The	O
downsides	O
of	O
telemedicine	B-Application
include	O
the	O
cost	O
of	O
telecommunication	O
and	O
data	O
management	O
equipment	O
and	O
of	O
technical	O
training	O
for	O
medical	O
personnel	O
who	O
will	O
employ	O
it	O
.	O
</s>
<s>
Virtual	O
medical	O
treatment	O
also	O
entails	O
potentially	O
decreased	O
human	O
interaction	O
between	O
medical	O
professionals	O
and	O
patients	O
,	O
an	O
increased	O
risk	O
of	O
error	O
when	O
medical	O
services	O
are	O
delivered	O
in	O
the	O
absence	O
of	O
a	O
registered	O
professional	O
,	O
and	O
an	O
increased	O
risk	O
that	O
protected	O
health	O
information	O
may	O
be	O
compromised	O
through	O
electronic	B-Application
storage	O
and	O
transmission	O
.	O
</s>
<s>
There	O
is	O
also	O
a	O
concern	O
that	O
telemedicine	B-Application
may	O
actually	O
decrease	O
time	O
efficiency	O
due	O
to	O
the	O
difficulties	O
of	O
assessing	O
and	O
treating	O
patients	O
through	O
virtual	O
interactions	O
;	O
for	O
example	O
,	O
it	O
has	O
been	O
estimated	O
that	O
a	O
teledermatology	B-Application
consultation	O
can	O
take	O
up	O
to	O
thirty	O
minutes	O
,	O
whereas	O
fifteen	O
minutes	O
is	O
typical	O
for	O
a	O
traditional	O
consultation	O
.	O
</s>
<s>
Other	O
obstacles	O
to	O
the	O
implementation	O
of	O
telemedicine	B-Application
include	O
unclear	O
legal	O
regulation	O
for	O
some	O
telemedical	B-Application
practices	O
and	O
difficulty	O
claiming	O
reimbursement	O
from	O
insurers	O
or	O
government	O
programs	O
in	O
some	O
fields	O
.	O
</s>
<s>
Some	O
medical	O
organizations	O
have	O
delivered	O
position	O
statement	O
on	O
the	O
correct	O
use	O
of	O
telemedicine	B-Application
in	O
their	O
field	O
.	O
</s>
<s>
Another	O
disadvantage	O
of	O
telemedicine	B-Application
is	O
the	O
inability	O
to	O
start	O
treatment	O
immediately	O
.	O
</s>
<s>
In	O
the	O
United	O
States	O
,	O
telemedicine	B-Application
companies	O
are	O
collaborating	O
with	O
health	O
insurers	O
and	O
other	O
telemedicine	B-Application
providers	O
to	O
expand	O
marketshare	O
and	O
patient	O
access	O
to	O
telemedicine	B-Application
consultations	O
.	O
</s>
<s>
From	O
1999	O
to	O
2018	O
,	O
the	O
University	O
Hospital	O
of	O
Zurich	O
(	O
USZ	O
)	O
offered	O
clinical	O
telemedicine	B-Application
and	O
online	O
medical	O
advice	O
on	O
the	O
Internet	O
.	O
</s>
<s>
The	O
team	O
consisted	O
of	O
up	O
to	O
six	O
physicians	O
who	O
are	O
specialists	O
in	O
clinical	O
telemedicine	B-Application
at	O
the	O
USZ	O
and	O
have	O
many	O
years	O
of	O
experience	O
,	O
particularly	O
in	O
internal	O
and	O
general	O
medicine	O
.	O
</s>
<s>
By	O
providing	O
an	O
anonymous	O
space	O
where	O
users	O
can	O
talk	O
about	O
(	O
shameful	O
)	O
diseases	O
,	O
online	O
telemedical	B-Application
services	O
empower	O
patients	O
and	O
their	O
health	O
literacy	O
is	O
enhanced	O
by	O
providing	O
individualized	O
health	O
information	O
.	O
</s>
<s>
The	O
Clinical	O
Telemedicine	B-Application
and	O
Online	O
Counselling	O
service	O
of	O
the	O
University	O
Hospital	O
of	O
Zurich	O
is	O
currently	O
being	O
revised	O
and	O
will	O
be	O
offered	O
in	O
a	O
new	O
form	O
in	O
the	O
future	O
.	O
</s>
<s>
For	O
developing	O
countries	O
,	O
telemedicine	B-Application
and	O
eHealth	B-Application
can	O
be	O
the	O
only	O
means	O
of	O
healthcare	O
provision	O
in	O
remote	O
areas	O
.	O
</s>
<s>
For	O
example	O
,	O
the	O
difficult	O
financial	O
situation	O
in	O
many	O
African	O
states	O
and	O
lack	O
of	O
trained	O
health	O
professionals	O
has	O
meant	O
that	O
the	O
majority	O
of	O
the	O
people	O
in	O
sub-Saharan	O
Africa	O
are	O
badly	O
disadvantaged	O
in	O
medical	O
care	O
,	O
and	O
in	O
remote	O
areas	O
with	O
low	O
population	O
density	O
,	O
direct	O
healthcare	O
provision	O
is	O
often	O
very	O
poor	O
However	O
,	O
provision	O
of	O
telemedicine	B-Application
and	O
eHealth	B-Application
from	O
urban	O
centers	O
or	O
from	O
other	O
countries	O
is	O
hampered	O
by	O
the	O
lack	O
of	O
communications	O
infrastructure	O
,	O
with	O
no	O
landline	O
phone	O
or	O
broadband	B-General_Concept
internet	O
connection	O
,	O
little	O
or	O
no	O
mobile	O
connectivity	O
,	O
and	O
often	O
not	O
even	O
a	O
reliable	O
electricity	O
supply	O
.	O
</s>
<s>
India	O
has	O
broad	O
rural-urban	O
population	O
and	O
rural	O
India	O
is	O
bereaved	O
from	O
medical	O
facilities	O
,	O
giving	O
telemedicine	B-Application
a	O
space	O
for	O
growth	O
in	O
India	O
.	O
</s>
<s>
Since	O
2018	O
,	O
telemedicine	B-Application
has	O
expanded	O
in	O
India	O
.	O
</s>
<s>
On	O
25	O
March	O
2020	O
,	O
in	O
the	O
wake	O
of	O
COVID-19	O
pandemic	O
,	O
the	O
Ministry	O
of	O
Health	O
and	O
Family	O
Welfare	O
issued	O
India	O
's	O
Telemedicine	B-Application
Practice	O
Guidelines	O
.	O
</s>
<s>
The	O
Board	O
of	O
Governors	O
entasked	O
by	O
the	O
Health	O
Ministry	O
published	O
an	O
amendment	O
to	O
the	O
Indian	O
Medical	O
Council	O
(	O
Professional	O
Conduct	O
,	O
Etiquette	O
and	O
Ethics	O
)	O
Regulations	O
,	O
2002	O
that	O
gave	O
much-needed	O
statutory	O
support	O
for	O
the	O
practice	O
of	O
telemedicine	B-Application
in	O
India	O
.	O
</s>
<s>
In	O
April	O
2020	O
,	O
the	O
union	O
health	O
ministry	O
launched	O
the	O
eSanjeevani	O
telemedicine	B-Application
service	O
that	O
operates	O
at	O
two	O
levels	O
:	O
the	O
doctor-to-doctor	O
telemedicine	B-Application
platform	O
,	O
and	O
the	O
doctor-to-patient	O
platform	O
.	O
</s>
<s>
This	O
service	O
crossed	O
five	O
million	O
tele-consultations	O
within	O
a	O
year	O
of	O
its	O
launch	O
indicating	O
conducive	O
environment	O
for	O
acceptability	O
and	O
growth	O
of	O
telemedicine	B-Application
in	O
India	O
.	O
</s>
<s>
The	O
Satellite	O
African	O
eHEalth	B-Application
vaLidation	O
(	O
SAHEL	O
)	O
demonstration	O
project	O
has	O
shown	O
how	O
satellite	O
broadband	B-General_Concept
technology	O
can	O
be	O
used	O
to	O
establish	O
telemedicine	B-Application
in	O
such	O
areas	O
.	O
</s>
<s>
In	O
2014	O
,	O
the	O
government	O
of	O
Luxembourg	O
,	O
along	O
with	O
satellite	O
operator	O
,	O
SES	O
and	O
NGOs	O
,	O
Archemed	O
,	O
Fondation	O
Follereau	O
,	O
Friendship	O
Luxembourg	O
,	O
German	O
Doctors	O
and	O
Médecins	O
Sans	O
Frontières	O
,	O
established	O
SATMED	B-Application
,	O
a	O
multilayer	O
eHealth	B-Application
platform	O
to	O
improve	O
public	O
health	O
in	O
remote	O
areas	O
of	O
emerging	O
and	O
developing	O
countries	O
,	O
using	O
the	O
Emergency.lu	O
disaster	O
relief	O
satellite	O
platform	O
and	O
the	O
Astra	O
2G	O
TV	O
satellite	O
.	O
</s>
<s>
SATMED	B-Application
was	O
first	O
deployed	O
in	O
response	O
to	O
a	O
report	O
in	O
2014	O
by	O
German	O
Doctors	O
of	O
poor	O
communications	O
in	O
Sierra	O
Leone	O
hampering	O
the	O
fight	O
against	O
Ebola	O
,	O
and	O
SATMED	B-Application
equipment	O
arrived	O
in	O
the	O
Serabu	O
clinic	O
in	O
Sierra	O
Leone	O
in	O
December	O
2014	O
.	O
</s>
<s>
In	O
June	O
2015	O
SATMED	B-Application
was	O
deployed	O
at	O
Maternité	O
Hospital	O
in	O
Ahozonnoude	O
,	O
Benin	O
to	O
provide	O
remote	O
consultation	O
and	O
monitoring	O
,	O
and	O
is	O
the	O
only	O
effective	O
communication	O
link	O
between	O
Ahozonnoude	O
,	O
the	O
capital	O
and	O
a	O
third	O
hospital	O
in	O
Allada	O
,	O
since	O
land	O
routes	O
are	O
often	O
inaccessible	O
due	O
to	O
flooding	O
during	O
the	O
rainy	O
season	O
.	O
</s>
<s>
The	O
development	O
and	O
history	O
of	O
telehealth	O
or	O
telemedicine	B-Application
(	O
terms	O
used	O
interchangeably	O
in	O
literature	O
)	O
is	O
deeply	O
rooted	O
in	O
the	O
history	O
and	O
development	O
in	O
not	O
only	O
technology	O
but	O
also	O
society	O
itself	O
.	O
</s>
<s>
Humans	O
have	O
long	O
sought	O
to	O
relay	O
important	O
messages	O
through	O
torches	B-Application
,	O
optical	O
telegraphy	O
,	O
electroscopes	O
,	O
and	O
wireless	O
transmission	O
.	O
</s>
<s>
Early	O
forms	O
of	O
telemedicine	B-Application
achieved	O
with	O
telephone	O
and	O
radio	O
have	O
been	O
supplemented	O
with	O
videotelephony	B-Application
,	O
advanced	O
diagnostic	O
methods	O
supported	O
by	O
distributed	B-Operating_System
client/server	I-Operating_System
applications	I-Operating_System
,	O
and	O
additionally	O
with	O
telemedical	B-Application
devices	O
to	O
support	O
in-home	O
care	O
.	O
</s>
<s>
In	O
the	O
21st	O
century	O
,	O
with	O
the	O
advent	O
of	O
the	O
internet	O
,	O
portable	B-Application
devices	I-Application
and	O
other	O
such	O
digital	O
devices	O
are	O
taking	O
a	O
transformative	O
role	O
in	O
healthcare	O
and	O
its	O
delivery	O
.	O
</s>
<s>
Another	O
instance	O
of	O
early	O
telehealth	O
,	O
specifically	O
telemedicine	B-Application
was	O
reported	O
in	O
The	O
Lancet	O
in	O
1879	O
.	O
</s>
<s>
When	O
the	O
American	O
National	O
Aeronautics	O
and	O
Space	O
Administration	O
(	O
NASA	O
)	O
began	O
plans	O
to	O
send	O
astronauts	O
into	O
space	O
,	O
the	O
need	O
for	O
telemedicine	B-Application
became	O
clear	O
.	O
</s>
<s>
In	O
order	O
to	O
monitor	O
their	O
astronauts	O
in	O
space	O
,	O
telemedicine	B-Application
capabilities	O
were	O
built	O
into	O
the	O
spacecraft	O
as	O
well	O
as	O
the	O
first	O
spacesuits	O
.	O
</s>
<s>
Additionally	O
,	O
during	O
this	O
period	O
,	O
telehealth	O
and	O
telemedicine	B-Application
were	O
promoted	O
in	O
different	O
countries	O
especially	O
the	O
United	O
States	O
and	O
Canada	O
.	O
</s>
<s>
Massachusetts	O
General	O
Hospital	O
and	O
Boston	O
's	O
Logan	O
International	O
Airport	O
had	O
a	O
role	O
in	O
the	O
early	O
use	O
of	O
telemedicine	B-Application
,	O
which	O
more	O
or	O
less	O
coincided	O
with	O
NASA	O
's	O
foray	O
into	O
telemedicine	B-Application
through	O
the	O
use	O
of	O
physiologic	O
monitors	O
for	O
astronauts	O
.	O
</s>
<s>
This	O
was	O
expanded	O
upon	O
in	O
1967	O
,	O
when	O
Kenneth	O
Bird	O
at	O
Massachusetts	O
General	O
founded	O
one	O
of	O
the	O
first	O
telemedicine	B-Application
clinics	O
.	O
</s>
<s>
Consultations	O
were	O
achieved	O
through	O
microwave	O
audio	O
as	O
well	O
as	O
video	B-Application
links	I-Application
.	O
</s>
<s>
The	O
airport	O
began	O
seeing	O
over	O
a	O
hundred	O
patients	O
a	O
day	O
at	O
its	O
nurse-run	O
clinic	O
that	O
cared	O
for	O
victims	O
of	O
plane	O
crashes	O
and	O
other	O
accidents	O
,	O
taking	O
vital	O
signs	O
,	O
electrocardiograms	B-Application
,	O
and	O
video	O
images	O
that	O
were	O
sent	O
to	O
Massachusetts	O
General	O
.	O
</s>
<s>
In	O
1972	O
the	O
Department	O
of	O
Health	O
,	O
Education	O
and	O
Welfare	O
in	O
the	O
United	O
States	O
approved	O
funding	O
for	O
seven	O
telemedicine	B-Application
projects	O
across	O
different	O
states	O
.	O
</s>
<s>
The	O
first	O
interactive	O
telemedicine	B-Application
system	O
,	O
operating	O
over	O
standard	O
telephone	O
lines	O
,	O
designed	O
to	O
remotely	O
diagnose	O
and	O
treat	O
patients	O
requiring	O
cardiac	O
resuscitation	O
(	O
defibrillation	O
)	O
was	O
developed	O
and	O
launched	O
by	O
an	O
American	O
company	O
,	O
MedPhone	O
Corporation	O
,	O
in	O
1989	O
.	O
</s>
<s>
The	O
advent	O
of	O
high-speed	O
Internet	O
,	O
and	O
the	O
increasing	O
adoption	O
of	O
ICT	B-General_Concept
in	O
traditional	O
methods	O
of	O
care	O
,	O
spurred	O
advances	O
in	O
telehealth	O
delivery	O
.	O
</s>
<s>
Increased	O
access	O
to	O
portable	B-Application
devices	I-Application
,	O
like	O
laptops	O
and	O
mobile	O
phones	O
,	O
made	O
telehealth	O
more	O
plausible	O
;	O
the	O
industry	O
then	O
expanded	O
into	O
health	O
promotion	O
,	O
prevention	O
and	O
education	O
.	O
</s>
<s>
In	O
2002	O
,	O
Dr.	O
G	O
.	O
Byron	O
Brooks	O
,	O
a	O
former	O
NASA	O
surgeon	O
and	O
engineer	O
who	O
had	O
also	O
helped	O
manage	O
the	O
UTMB	O
Telemedicine	B-Application
program	O
,	O
co-founded	O
Teladoc	O
in	O
Dallas	O
,	O
Texas	O
,	O
which	O
was	O
then	O
launched	O
in	O
2005	O
as	O
the	O
first	O
national	O
telehealth	O
provider	O
.	O
</s>
<s>
In	O
the	O
2010s	O
,	O
integration	O
of	O
smart	O
home	O
telehealth	O
technologies	O
,	O
such	O
as	O
health	O
and	O
wellness	O
devices	O
,	O
software	O
,	O
and	O
integrated	O
IoT	B-Operating_System
,	O
has	O
accelerated	O
the	O
industry	O
.	O
</s>
<s>
In	O
2015	O
,	O
Mercy	O
Health	O
system	O
opened	O
Mercy	O
Virtual	O
,	O
in	O
Chesterfield	O
,	O
Missouri	O
,	O
the	O
world	O
's	O
first	O
medical	O
facility	O
dedicated	O
solely	O
to	O
telemedicine	B-Application
.	O
</s>
<s>
Telehealth	O
allows	O
for	O
Zoom	O
calls	O
and	O
video	B-Application
chats	I-Application
from	O
across	O
the	O
world	O
checking	O
in	O
on	O
patients	O
and	O
speaking	O
to	O
physicians	O
.	O
</s>
