Telemedicine means the use of different telecommunications and information technologies such as the Internet, telephones, satellites, video-conferencing equipment and so on to transfer medical data. It allows patients to consult physicians at a distant.
It is unknown when telecommunication was first used in health care. The idea of its application in such a field may have appeared centuries ago. For example, people used bonfires to warn about the approach of enemy troops. In the same way they could inform of the spread of an epidemic. After the invention of a telegraph it was used not only for war purposes, but also for transmission of casualty lists and ordering of medical supplies. In the end of the 19th century physician began to use the telephone. It was the main means of medical communications for a half a century and it is still a major force. In addition to the telephone physicians made use of the radio by the 1930. With its help they transferred medical information, dispatched medical teams and helicopters.
Current telemedicine has been developed since the 1960s. The National Aeronautics and Space Administration played a significant part in its evolution. NASA used telemedicine technology in the first spacecrafts. Physicians, being on Earth, monitored physiological functions, such as heart rate, temperature, blood pressure, for astronauts in space. This took place due to development of difficult biomedical telemetry and telecommunications systems. Another great impact on the development of telemedicine was made by the invention of television. The first two-way TV link was established between the Nebraska Psychiatric Institute and Norfolk State Hospital about 112 miles away in 1964. Specialists and general practitioners used it for consultations. In 1967 the medical station at Boston’s Logan International Airport was linked up to Massachusetts General Hospital. Physicians from hospital provided medical care to patients at the airport using a 2 way audiovisual microwave circuit. This shoed that medical data could be transmitted successfully and that illnesses could be diagnosed at a distant through interactive television. In 1971 satellite communications were used in Alaska.

During the 1970s the US government funded telemedicine research and demonstration projects. They helped to determine capabilities of equipment and their clinical applicability. These projects estimated availability of telemedicine for solving various problems in medical care. Many of such demonstration programs were launched in rural areas, where there was a lack of physicians. All these projects and programs showed that telecommunications could be used instead of travel to obtain medical care, especially in emergency situations when it was impossible to get access to a physician. The first international telemedicine program, Space Bridge to Armenia/Ufa, was conducted by NASA in 1989 after a massive earthquake in the Soviet Republic of Armenia in December of 1988. The U.S. offered the Soviet Union use of a one-way international telemedicine network for consultations between Yerevan, Armenia, and four medical centers in the U.S. This program was later extended to Ufa, Russia to assist victims after a terrible railway accident. Due to “Space Bridge to Armenia/Ufa” the world saw how medical consultation could be held over a satellite network in spite of political, cultural, social, and economic borders. Next years the number of telemedicine projects has been increasing throughout the world. The main reasons for this are that technologies become cheaper and that governments make more investment. That’s why telemedicine is available for a wider group of users.
Obviously telemedicine has a lot of advantages. It helps people all over the world. Wherever the patient live, he or she can visit with physicians live over video for immediate care. It allows the specialist, patient and provider to communicate all together to achieve the best result for the patient. All pictures and videos are attached for diagnosis. These data are placed on a server to which a specialist has access.
Nevertheless in spite of all benefits telemedicine has disadvantages as well. There is a possibility that private medical information can be viewed by unauthorized people who can steal or even alter it and perpetrate fraud. Dishonest providers and third parties can bill for nonexistent services and patients. During a long-distant consultation personnel that maintain telemedicine equipment can be privy to the conversation and data. The consultation can be videotaped, and the patient does not know who may see the consultation besides the physician. As for Medicaid fraud it may occur when somebody borrows a Medicaid card in order to receive free care. Stolen or counterfeit cards may even be used to fraudulently obtain controlled drugs for sale on the street. There are also concerns that some private insurers will not reimburse, though they must reimburse the same as for face-to-face consultations. All these factors prejudice against the use of telemedicine services, especially for treating conditions that carry a social stigma, such as substance abuse, mental illness and so on. That’s why some laws that protect sensitive patient information have been worked out.
In the USA legal protections for health information are adopted as a rule in every state it its own way and therefore the level of protection can be different from state to state. Several states have accepted exhaustive health-care information confidentiality statutes. Montana and Washington have passed the Uniform Health-Care Information Act of the National Conference of Commissioners on Uniform State Laws, (NCCUSL) (1985). Many state statutes govern specific classes of health information, such as HIV-infection and AIDS patient information, mental health information, and communicable disease information held by public health agencies. Unfortunately federal protection of privacy is more restricted. Constitution does not guarantee definite rights to privacy. There are many federal laws that protect electronic patient information, but they pay little attention to issues related to telemedicine. There is one Federal health record confidentiality law that controls disclosure of substance abuse patient information and covers only specialized substance abuse facilities and units. In 1996 the U.S. Congress passed the Health Insurance Portability and Accountability Act (HIPAA). According to this act all organizations that deal with private medical information must adopt security and privacy standards and guarantee confidentiality.
Some private firms and providers use their own methods for ensuring confidentiality. For example, eMedicalfiles uses fingerprint authentication that positively identifies the health plan enrollee and prevents access by unauthorized persons. The firm also offers Smart Card technology, which stores information about the user’s health plan, demographics, allergies, prescribed medications, and medical conditions on a device similar to a credit card.
So, there are still many questions concerning telemedicine. It has a lot of advantages, but enough negative aspects as well. Nevertheless it has a great potential and should be developed. Technologies are being improved constantly and our world can not exist without them. Telecommunication is an integral part of the future of the medicine.
Works Cited:
1. Herrick, Devon. “Telemedicine Provides Benefits, but Security and Privacy Risks Abound”. National Center for Policy Analysis, June 01, 2006.
2. NATIONAL TELECOMMUNICATIONS AND INFORMATION ADMINISTRATION. January 31, 1997. “PRIVACY, SECURITY AND CONFIDENTIALITY IN TELEMEDICINE”. May 10, 2009. http://www.ntia.doc.gov/
3. Allan, Roger. “A Brief History Of Telemedicine”. Electronic design, June 29, 2006
4. Zundel, Karen. “Telemedicine: history, applications, and impact on librarianship.” Bull Med Libr Assoc. 1996 January; 84(1): 71–79.

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