Care at a distance, or in-absentia care, was conducted via post. Thanks to telecommunication technologies, Telemedicine (maybe in a narrow sense) has extended healthcare to far-place patients and has been most beneficial for populations living in isolated communities and remote regions. To some extent, Tele-medical Healthcare has somewhat overcome the space limitation of Hospital Healthcare.
Some say Telemedicine in a broad sense refers to the use of communications and information technologies for the delivery of clinical and medical care. In other words, Telemedicine may postulate two healthcare providers or professionals called physicians or clinicians, discussing a case over the telephone, or videoconferencing equipment to conduct a real-time consultation between medical specialists in two different areas. And it means a clinical medicine where medical data is transferred through interactive audiovisual media for consulting and remote medical examinations.
Three main methodological procedures of Telemedicine in a wide sense are store-and-forward, remote monitoring and interactive telemedical healthcare.
Store-and-forward telemedicine involves acquiring clinical or medical data, such as medical images, vital signs etc. and then transmitting this data to a physician or medical specialist at a convenient time for asynchronous assessment. A difference between traditional in-person and telemedical healthcare is the presence of both parties at the same time. Dermatology, radiology, and pathology are conducive to asynchronous telemedicine.
Remote monitoring enables physicians or medical professionals to monitor a patient remotely, using various medical devices. This method is primarily used for managing chronic diseases or specific conditions, such as heart disease, diabetes mellitus, or asthma. These services can provide comparable healthcare outcomes to traditional in-person patient, supply greater satisfaction to patients, and may be cost-effective.
Interactive telemedicine services or telemedical healthcare provide real-time interactions between a patient and healthcare-providers, including phone conversations, online communication and home visits. Many-sided activities such as history review, vital signal examination, and psychiatric evaluations can be conducted to those in traditional face-to-face treatment. And so, "interactive" telemedicine services may be less costly than in-person clinical visits.
Strictly speaking, we'd better use telemedicine and telemedical healthcare differently, for healthcare is the service of providing medical or clinical care. The terms tele-health, tele-consultation or e-healthcare are at times wrongly interchanged with telemedicine or telemedical healthcare. Like the terms "medicine" and "healthcare", telemedicine often refers only to clinical and medical activities while the term tele-health can refer to clinical and non-clinical services such as medical education, administration, and research.
The term e-Health is often used as an umbrella term that includes tele-health, electronic medical records, and other components of health IT. E-Health is a large scale multi-disciplined area which corresponds to a broad field of applications spanning from clinical applications, (e.g. tele-consultation, clinical or medical decision support, vital signs monitoring, home tele-care, ambulatory healthcare, and e-Prescribing) to personalized health professional continuing education and e-Prevention through longitudinal healthcare event recording and lifetime health care records.
And then what is the key difference between e-Health and u-Health In the aspect of u-Health devices, u-Health needs several functions, that is, performing one or a few dedicated functions (embedded), using technology in moving (mobile), and using devices while the user's hands, voice, eyes or attention are actively engaged with the physical environment (wearable). In the aspect of u-Health Networking, it requires connecting devices, embedded in such a way that the connectivity is unobtrusive and always available (pervasive), linking changes in the environment with computer systems (context-aware), and perceiving its environment and reacting accordingly (sentient). As the result of the above-mentioned ubiquitous functions, u-Health system works in concert to support people, carrying out their everyday life activities, tasks and rituals in easy, natural way by using information and intelligence that is hidden in the network connecting these devices (ambient).
U-Health is not linking patients to the healthcare providers with some electrical devices and IT, but building up an ergonomic human-centered healthcare system. And so u-Health works anytime, anywhere and always on. In a seamless way, u-Health gathers and exchanges appropriate and accurate data from various sources, and responds just in real time to patients in need, and transmits medical information, knowledge, and relevant expertise to those who are in need of care.
Through patient-oriented medical interventions, the ambient and seamless U-Health encourages a focus on preventive measures, and greater emphasis on self-care. In addition, it can aid in realizing rapid changes in a nation's healthcare infrastructures, financing, administration, management, and healthcare delivery systems and procedures such as reduced administration costs and eliminating "inappropriate and unnecessary" emergency services. Moreover, reduced administrative and medical costs due to more efficient information flow and more effective workflows will further reduce the cost of products and services.
U-Healthcare can include not only individual purchasers such as patients, caregivers, or physicians, but also large group purchasers such as healthcare retailers, hospitals, or health maintenance organizations. Large group purchasers can also include communities such as senior groups, virtual communities, sociopolitical advocacy groups, or even multinational corporations. U-Healthcare providers perceive value arising out of reduced consumer search costs, product and service promotion costs, and business transaction costs. Similarly, patients perceive value arising out of reduced product and service search costs and transaction costs. In addition, customer-focused U-Healthcare also provides improved shopping experiences and user convenience.
On the basis of ambient and seamless u-Health technologies and U-healthcare, digitalized e-Hospitals establish u-Hospital. U-hospital is not the linking and gathering of several e-Hospitals but the systematizing, converging and integrating of healthcare: in-hospital and out-of-hospital healthcare, personal and public healthcare, physical and mental healthcare, and moreover health and social services.
Under u-Hospital, healthcare will be done to patients regardless of whether they are in or out of the hospital. In particular, on the same financial ground, including private and public insurances, out-of-hospital care will be no less generously covered than in-hospital care. Today our most important healthcare problems involve chronic diseases; deaths from suicide, homicide, and accidents; mental illness; drug abuse; and genetic disorders. To deal with these problems effectively we need to integrate personal and public healthcare with u-Health technologies and under u-Hospital. Most healthcare problems today have a significant emotional and behavioral component, and we need to integrate physical and mental healthcare through u-Health technologies. Healthcare is delivered to patients who are in need of more than healthcare. They include the elderly, the emotionally disturbed, the physically and mentally handicapped, alcoholics and other drug abusers, and so on. Because these patients need an integration of health and social services, we will have to integrate ambient u-Health technologies into u-Hospital.
Methodologically, it follows from u-Hospital that 'How far is one, a patient or not, able to live relatively undisturbed in his/her daily life, at the same time to be under observation, and to carry on his/her typical daily activities, while maintaining contact with his/her physician anywhere when needed'.
Kim Hak-dong (m57102637@korea.com) is the director of Mobicomm Inc. & KW U-Globe Corp. and director of Gana Animal Hospital.
