I definitely would NOT want to see my doctor over a video link when I need him. The technology is simply not up to providing realistic telepresense, and a lot of diagnostically relevant information is carried by things like smell and touch, and little details. So telemedicine is a poor substitute for having a doctor on site; and should be used only when it is absolutely the only option (i.e. emergency on an airplane, etc). (As a side note - that also explains reluctance of doctors to rely on computerized diagnostic systems: they feel that the system does not have all relevant information (which is true) and that they have to follow its advice anyway, or run a chance of being accused of malpractice. This is certainly the case with textbooks - if a doctor does something clearly against a textbook advice, with negative outcome, lawyers have a feast - but doctors never get rewarded for following their common sense when outcome is positive. And automated diagnostic systems are a lot more specific with their recommendations than textbooks!). Emergency situations, of course, require some pre-emptive engineering to handle, but by no means require major investment to allow a major percentage of traffic to be handled as emergeny traffic. As with VoIP, simple prioritization is more than sufficient for telemedicine apps. (Note that radiology applications are simply bulk file transfers, no interactivity). --vadim On Mon, 18 Nov 2002, Stephen Sprunk wrote:
Thus spake "David Diaz" <techlist@smoton.net>
I agree with everything said Stephen except the part about the medical industry. There are a couple of very large companies doing views over an IP backbone down here. Radiology is very big on networking. They send your films or videos over the network to where the Radiologist is. For example one hospital owns about 6 others down here, and during off hours like weekends etc, the 5 hospitals transmit their films to where the 1 radiologist on duty is.
I meant my reply to be directed only at "telemedecine", where the patient is at home and consults their general practitioner or primary care physician via broadband for things like the flu or a broken arm. While there's lots of talk about this in sci-fi books, there's no sign of this making any significant inroads today, nor does it qualify as a "killer app" for home broadband.
I do work with several medical companies who push radiology etc. around on the back end for resource-sharing and other purposes. This is quite real today, and is driving massive bandwidth upgrades for healthcare providers. However, I don't think it qualifies under most people's idea of telemedecine.
S