Bringing faraway patients closer to specialist care


Telemedicine is revolutionising healthcare in many spheres including clinical applications, medical education and helping provide equity of access to medical care. Andrew Graley, the healthcare director, Europe, Middle East and Africa, Polycom, discusses the various applications and benefits of telemedicine.

There’s no doubt that any healthcare specialty in the Middle East can embrace videoconferencing, as well as the benefits of unified communications (UC). However, those most likely to use these solutions – commonly known in the medical field as telemedicine – are specialties that provide accelerated responses, access to advanced specialist services or out-of-hours availability.

Telemedicine is a rapidly developing area of clinical medicine, where medical information is transferred through live, interactive media such as videoconferencing, for the purpose of consulting and sometimes for remote medical procedures or examinations. It works by providing the link between the patient and the doctor, despite the distance between them. For example, in the same way businesses use videoconferencing technology to make decisions, manage projects, and develop their services or products faster, healthcare organisations can use telemedicine to provide access to specialist medical knowledge. The access to medical knowledge can reduce the waiting time of a patient, and therefore their treatment time.

There are a plethora of advantages to using telemedicine, and these include reducing waiting times for specialist clinics; providing services in the community of the patients; as well as reducing expensive medical transport for patients and staff. The benefits of videoconferencing solutions have been especially realised in three distinct areas of the healthcare industry: patient consultation, administration, and medical education.

Telemedicine for medical education

Telemedicine can play a large role in the area of medical education. The production of qualified medical staff is a constant requirement for healthcare systems across the globe, and UC can aid with the education of new medical staff by sharing access to medical lectures, clinical skills and remote tuition, virtually connecting students and lecturers.

Whether knowledge transfer takes place at the bedside, in the operating room, in the classroom, or at a remote site, video and audio conferencing technology can bring the classroom to the medical professional. This is thanks to desktop solutions enabling healthcare professionals to use their PCs for high definition video calls with colleagues from anywhere. The physician or practitioner can easily control the far-end camera, sharing medical content live over video.

Furthermore, the ongoing professional development of clinicians is a legal requirement, with many professionals obliged to publish research materials, deliver lectures and attend society seminars. Educators would be able to attend video CME events from their home office or desktop, conduct video rounds, sharing PC content, live patient encounters, or recorded procedures, or connect to nursing schools for up-to-date training and medical information. Other advantages include conducting administrative training and medical education using live or streamed video, as well as attending or delivering disaster preparedness training over a collaborative voice and video network.

One example of a project that has benefited remote communities is that of the International Virtual e-Hospital (IVeH), which was established in 2001 by Dr Rifat Latifi to create sustainable telemedicine and e-health programmes around the world and to rebuild medical systems in developing countries.

The project was originally launched as the Telemedicine Program of Kosovo (TPK) after the medical infrastructure of Kosovo was left in a poor state by wars, underfunding and bad management. An entire generation of medical graduates after the Balkan wars of the 1990s had not seen a patient in a clinical environment throughout their entire education, and many medical school classes were held in the basements of homes.

Additionally, many older professors, surgeons, and other doctors had not practiced advanced medicine or surgery for more than a decade. For Dr Latifi, telemedicine and medical distance learning were the only practical solutions for developing countries such as Kosovo.

A decade later, the programme has connected seven Kosovan hospitals via telemedicine and provided access to an electronic medical library for distance learning with video facilities in Albania, Austria, Brazil, Canada, Finland, Germany, Italy, Norway, Saudi Arabia, Switzerland, UK, and US. Furthermore, each telemedicine centre now contains video collaboration rooms, tele-consultation rooms, and telemedicine training rooms, as well as mobile telepresence units in patient rooms which results in better patient care and improved training and resources for hospital physicians and staff.

Telemedicine in remote and underserved areas

Equity of access to healthcare services is considered a human right in most of the Western world, but providing healthcare services, specialist medical treatment or a consultation with a nurse or doctor in every city is a growing problem for public healthcare systems. Using UC in telemedicine applications will enable organisations to deliver basic services speedily and on a regular basis.

For remote areas, telemedicine is becoming a lifeline for the community; not only does it serve to provide timely medical advice without long travel, but it is also keeping the community together, removing the need to migrate from remote to populated metropolitan areas when a citizen encounters ill health.

With government approval in place, as well as backing by the European Agency for Reconstruction (EAR), the IveH was able to ensure mobile Polycom units are located at patients’ bedsides in Kosovan hospitals to allow real-time collaboration with specialist physicians in other countries. This contributes to better consultations and improved patient care.

Requirements for telemedicine

There are three requirements that are key to integrating telemedicine into today’s health system and in medical education, and these are: training, the ability to create a secure platform, and bandwidth availability.


Very little training is required in order for a physician to use telemedicine. Medical systems and other devices in the hospital are often far more complicated to operate in comparison to using a telemedicine solution. With as little as a 30-minute training session, a physician can be shown how to make a call, manipulate the remote camera, and send or receive vital signs or other patient modalities.

In addition to training the user, the solution itself can be simplified by using an intuitive touch screen, which is often used in large scale deployments, such as oncology meeting rooms, lecture theatres or operating rooms. The touch screen remote can perform many tasks by selecting a single on-screen button, therefore users can quickly select the single or multiple modalities they need to discuss while in their call. Using the touch screen has the added benefit of letting the users concentrate on the subject in hand.

Training should be provided by the integrator as a standard part of the telemedicine solution, with scheduled refresher courses planned in advance to aid with familiarisation.

Creating a secure platform

Hospitals can stipulate, by default, that all videoconference-based telemedicine calls are encrypted as standard practice. Encryption is built-in to the telemedicine hardware, the network infrastructure and even the recording devices (should they be implemented) thereby raising the level of security.

In addition, there are extra techniques network administrators can employ to take security a step further. These include identifying and managing telemedicine calls through a gatekeeper – a standard network automated manager setup to allow or deny consultations automatically.

Bandwidth requirements

The same gatekeeper network devices can also be used for ‘shaping’ the speed of telemedicine calls across the hospital network and to other locations. Network shaping can involve setting maximum bandwidths for certain types of calls. For example, a clinician using a mobile telemedicine cart in the accident and emergency rooms, such as the Polycom Practitioner Cart, will connect at the best possible network bandwidth and apply a quality of service to the network traffic, whereas a PC-based user on Microsoft Lync/OCS or Polycom’s CMA Desktop solution will be allowed to call at a maximum speed of 512Kbps.

However, Polycom’s extraordinary developments of network protocols for high definition videoconferencing have resulted in bandwidth requirements being reduced by half. Where 1Mbps was required to connect a high definition call, Polycom solutions can now achieve the same high quality result using 512Kbps. Consequently, the cost of ownership for network bandwidth can be reduced accordingly. Deploying videoconferencing- based telemedicine solutions doesn’t require a total network upgrade from day one. Physicians are pro-telemedicine

In my travels around Europe, the Middle East and Africa, motivating physicians to use telemedicine does not seem to be a problem. Recent history has shown how technology can be adopted in healthcare for the good of the patient. Robotic devices, large databases, picture messaging – I’ve seen all of these technologies put to use for improved healthcare in many places. The issue seems to be more about the initial cost of purchase along with the ongoing cost of keeping a service running.

Taking in to account the various financial options available for establishing a service, the return on the initial investment can be faster than expected.

For example, use of a telemedicine solution to offer an out-of-hours emergency response for cardiac, stroke or similar episodes will not only save vital minutes in the treatment plan for a patient, but it can also have a dramatic financial affect on the recovery and medical or social care budget required during rehabilitation. Failure to use a telemedicine solution will see more hospital systems failing to meet the needs of citizens, especially the elderly. As population numbers are growing steadily, so is life expectancy, due in part to better medical science, but also down to the higher standard of living we have experienced since the Second World War.

UC in a telemedicine application can augment existing processes for patient care and will change the way doctors and patients interact.


Polycom is the global leader in standards- based unified communications (UC) solutions for telepresence, video and voice powered by the Polycom RealPresence Platform. The RealPresence Platform interoperates with the broadest range of business, mobile, and social applications and devices. More than 400,000 organisations trust Polycom solutions to collaborate and meet face-to-face from any location for more productive and effective engagement with colleagues, partners, customers, and prospects. Polycom, together with its broad partner ecosystem, provides customers with the best TCO, scalability, and security – onpremises, hosted, or cloud delivered.


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 Date of upload: 15th Nov 2011


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