EVOLUTION OF TELEMEDICINE

According to American Journal of Health System-Pharmacy, telemedicine has been

defined as "the use of electronic information and communications technologies to provide and
support health care when distance separates the participants" (Angaram, 1999, p. 1406). Many
technologies are involved within telemedicine some include, videoconferencing, telephones,
computers, the Internet, fax, radio, and television.
Categories of Telemedicine
* Telecardiology
* Telepsychiatry
* Telerehabilitation
* Telepharmacy
Types of Telemedicine
Remote Monitoring: This will allow doctors to monitor their patients condition if the
client is living far or is travelling to other countries.
Interactive telemedicine services: This service offers concurrent interactions
between patient and doctor. This service includes phone conversations, online communication
and home visits.
Imaging services: The radiology service prolongs to make the greatest use of telemedicine
with thousands of images read by remote providers annually (Breen & Matusitz, 2010).
Benefits
Telemedicine technology will improve the health care in 2025. Some of the major benefits of
Telemedicine include:
Improved access to health care
Increased and efficient diagnosis of diseases and their treatments
Higher productivity
Market positioning
Telemedicine along with telecommunication could be used for healthcare at
a distance.
Patients could send their reports to doctors or physicians or research
laboratories at a distance.
Drawbacks
Confidentiality - In telemedicine or telecommunication, there will be a risk of
breach of confidentiality of the client (Roman, 2013). Clients information can get
misplaced or leaked.
Ethical - Legal issues about physician licensing, liability, and patient confidentiality
exist. As physicians are licensed by states, this presents a legal problem when physician
consults cross state lines (Roman, 2013).
Cost is an important obstacle to access. Initially, the start-up cost of this technology
might be high (Roman, 2013).

ROBOTS IN SURGURIES

First robotic surgery was performed in 1985 with robot PUMA 560 and the development of
surgical robots continued with PROBOT, ROBODEC, Da Vinci and Zeus systems.

PUMA 560 PROBOT
(Robotics and Biology Laboratory, 2012). (Smith, 2009).
By 2025, approximately 15% of all surgeries will be performed by robots (Manyika, Chui,
Bughin, Dobbs, Bisson & Marrs, 2013).
By 2025 robots in surgery will play a great role as follows:
Minimally invasive procedure (Staub, Panin, Knoll, Bauernschmitt, 2010)
Great precision, flexibility and dexterity
Less internal and external bleeding
Less stay in hospital
Increase in human resources output
Reduction in error and death rate
Increase in economic value to the tune of $200-600 billion (Manyika, Chui, Bughin,
Dobbs, Bisson & Marrs, 2013).
Additional degree of freedom
Self-awareness to prevent collisions
Better navigation towards the target using auto-guided path finding
Pre-programmed semi to auto surgical robots, this is limited to certain areas and certain
functions only (Shubber, 2013).
Current robots are still in big size but by 2025 robots will become small in size and will
assist surgeons reducing the surgery time and invasive procedures even using tele
(Manyika, Chui, Bughin, Dobbs, Bisson & Marrs, 2013).
By 2025, telerobotics will develop and advance significantly which will help to erase boundaries
existing in the medical field. For example, a surgeon sitting thousands of kilometers away can
still operate the robot and perform the surgery successfully.

(Tele-World, 2014).
Past to Future:

(Medgadget, 2012)

(Medgadget, 2012)
New techniques in robotic surgery by 2025:
By 2025, robots will play a greater role in surgery with new techniques such as:
Advanced robot control
- The surgeon controls the robots arms which are capable of moving in multiple
directions, allowing the surgeon to maneuver around the organs easily and precisely
(Cedars-Sinai, 2014).
Robotic and automated single Port minimal invasive Surgery (Better surgery, 2010)
- Using robots with miniaturized surgical instruments and mounted cameras which
perfectly fit into quarter-inch incisions, the surgeon is granted maximum range of
motion and precision to perform the surgery in such a constricted environment (The
Robotic Surgery Center, 2012).
Navigation Assistance based on Vision and Knowledge (Thielman et all, 2010).
Auto-guided Path finding (Thielman et all, 2010)
Advanced Surgery Guard (Robotic Nurses, 2011).
Automated Nurse
- Robotic nurses which help patients physically move around and perform simple
procedures such as checking their vital signs and delivering medications (Robotic
Nurses, 2011).
(Semi-) Automated Surgery (Thielman et all, 2010).
Centorobotics
Worldwide Telesurgery
- A surgery performed by a surgeon, who is at a considerable distance
(transcontinental) from the patient in the operating room, using a robotic system
consisting of robotic arms which reads the surgeons input entered from a computer
system and translate them into actual instrument manipulation, performing the
surgical procedures (Marescaux et al., 2002, p. 488).
In-situ Surgery (Robotic SurgePedia, 2012).
Disadvantages of robots in surgery
Lack of compatible equipment and instruments (Bednar, 2009).
Initial high cost of robot
The size of the robot with regards to the space in the operating room (Bednar, 2009).
Robots cannot replace doctors as no surgery will go as planned; hence mandatory
involvement of doctors
This development of robotics in health care will have an economic impact along with
manufacturing and services to the tune of $1.7 to $4.5 trillions (Manyika, Chui, Bughin,
Dobbs, Bisson & Marrs, 2013).
Future implications of robotic surgeries
Current developments of robots will lead to greater dexterity, mobility, flexibility and
adaptability and apart from this; the robots will interact with humans which will make robotics
expand quickly in surgeries. Instead of two doctors performing a surgery, two robots can interact
with each other and perform the surgery simultaneously. Currently 3% of major surgeries are
resulting in deaths. By 2025 surgeries in developed healthcare countries are expected to reach
around 200 million and reduce the death rate by as much as 20% (Manyika, Chui, Bughin,
Dobbs, Bisson & Marrs, 2013). Apart from this, the patient recovery time will be very less due to
less invasive procedures and decreased internal and external bleeding. By 2025 robots can be
used to manage up to 15% of surgeries performed throughout the world, which can be lead to the
saving of 60000 to 180000 lives of people. Apart from this, sick days will be less and the same
way hospital days will also be low due to less invasive procedures, which will all lead to the
economic impact to the tune of 200-600 billion dollars (Manyika, Chui, Bughin, Dobbs, Bisson
& Marrs, 2013).
Mobile medical applications & gadgets
APPS
Healthcare is in the middle of a mobile revolution (Peterson, S. 2012). By the year 2025, we
can expect to see a huge change in the delivery of healthcare via mobile applications. What
exactly are mobile medical apps? They are software programs that run on mobile communication
devices such as smartphones, they can be a medical device or an accessory to a regulated
medical device (FDA, 2014). Doctors are benefitting too, they are able to incorporate apps into
their practice and by doing so they are becoming more efficient (Peterson, S. 2012). For both
doctors and patients, medical apps are proving to be an effective way at staying in touch and
exchange information. Currently if you search health apps on your smartphone, you will be
inundated with hundreds of different healthcare related apps that it may be overwhelming.
The following are some examples of how mobile medical apps are currently being used to
benefit health and wellness:
Monitor of daily caloric intake
Diagnose heart abnormalities
Language translation making it possible to communicate in foreign countries
Track vaccinations
(Peterson, S. 2012)



Currently, every year the mobile health technology market is growing by 44%, given that
information it is realistic to believe that by 2025 mobile applications will have had a major
impact on healthcare. Experts are foreseeing that by the year 2025 we will have apps that allow
Example of a lifesaving translator
(Peterson, S. 2012)
us to send our vital signs, weight etc. through a mobile device to the doctor and can get a
prescription change or refill all wirelessly and without leaving the house (Bednar, J. 2009).
Gadgets
Google Glass is one of the biggest gadgets to emerge in the last couple of years; it will
have a major impact on how doctors will perform their jobs. For example, physicians will be able
to take a picture of a patient and immediately load it to their file, they can run through their days
appointments and they can skim through their patients medical history (Diana, A. 2014).
Physicians are benefitting from Google Glass by using an interface that does not interfere with
patient face time and allowing them to complete 90% of their paperwork before the patient
leaves the room (Diana, A. 2014). The future of Google Glass is bright, by 2025 it is fair to
assume most physicians, nurse practitioners and nurses will be using Google Glass in their
everyday patient care. Another gadget of our future: smart pill bottles. It is predicted that these
bottles will be the norm for prescription drugs. The bottles are send a signal to a repository to
track the time taken, frequency etc. monitoring for adherence (Bednar, J. 2009).