PAIX

Mon Nov 18 21:18:26 UTC 2002

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 at 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
> 