2023-05-15 20:10:53
Author Prof. Dr. A.S. Fernando Giusio. Medical Journalist. Forensic Physician – Head of the Legal and Occupational Area of the Ophthalmology Service of the Italian Hospital of Buenos Aires. M.N. N° 90.355 M.P. N° 330.272
When I began to give conferences on telemedicine and the advantages that I might perceive in the use of this new informatics tool associated with health, many colleagues said that what I was promoting was going to get doctors out of work. At that time I understood that any disruptive change in a society entails resistance.
Telemedicine is nothing more than the provision of medical services at a distance, either synchronously (real time between two people) or asynchronous (deferred time, that is, an answer is given in a second time).
If we go back in history, telemedicine is related to the use of telecommunications, that is, the sending of information over long distances by means of electromagnetic signals. It is worth clarifying that it was at the beginning of the 19th century when the telegraph appeared.
As curiosities we can mention the Stetophone (1890) which was a mix between a stethoscope (device to listen to the heartbeat) and the telephone, which was used to capture the noises of the larynx; Biotelemetry (1883), that is, the monitoring of vital signs. And we cannot fail to mention “El Doctor Radio” (1924), which with a futuristic vision, almost science fiction, was included in Radio News magazine, a magazine focused on the world of radio. Within a report from the April issue, it was already anticipated that in the near future human beings would have devices similar to a television through which we might consult the doctor and receive a diagnosis without having to go to the hospital. As we can see, science has made fiction become a promising reality.
As far as the first uses of telemedicine as such are concerned, they were made to transmit video, images and medical data. In the late 1950s, early 1960s, and 1959, the University of Nebraska began transmitting telemedicine neurological exams, and it was thought of as an excellent way to connect patients far from urban areas.
Within traditional medicine, radiology was the first specialty strongly linked to telemedicine. And in the 1960s/70s telemedicine got a big boost from NASA research programs, as astronauts mightn’t travel with a doctor by their side.
It was without a doubt with the rise of the Internet in the 1990s that a real revolution in telemedicine came regarding, not only for the virtual consultation that we all know, but also for patient education, the transmission of medical images, medical consultations, audio and video in real time, continuous medical education, vital sign measurements, among many other utilities.
In times of pandemic, technology played a fundamental role as it allowed us to remain connected with our patients, especially those with chronic diseases or those with difficult access. At the Italian Hospital in Buenos Aires, we developed an On-Call Teletriage, which allowed us to triage pathologies that might be treated by telemedicine, reducing the physical access of patients to emergency rooms, thus avoiding contagion from colleagues .
I return to the words at the beginning of these lines, telemedicine did not arrive to supplant traditional medicine, but to complement it with technology, improving the quality of care for the general population and improving our health systems.
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