Remote-presence devices hold promise for future of healthcare delivery

Mobile devices are poised to improve access to healthcare in the developing world and in remote regions of developed countries, finds an article in the Canadian Medical Association Journal.

"Mobile remote-presence devices for telemedicine have the potential to change the way healthcare is delivered in developed and developing nations," write the authors. "The availability of cellular network signals around the globe and rapidly increasing bandwidth will provide the telecommunication platform for a wide range of mobile telemedicine applications. The use of low-cost, dedicated remote-presence devices will increase access to medical expertise for anybody living in a geographical area with a cellphone signal."

In pilot tests, the authors used a mobile device in a remote area of the Bolivian Andes mountains to enable an obstetrician in his office in Halifax, Nova Scotia to provide a complete prenatal ultrasonographic assessment of a pregnant woman. Leveraging a mobile device with an attached portable ultrasound system, the obstetrician successfully monitored the baby's heartbeat, communicated with the mother and conducted the assessment with the help of an on-site nurse.

"This switch from the current model of centralized diagnosis in large medical facilities to point-of-care diagnosis could dramatically increase medical efficacy by removing barriers of time and distance, reducing wait times and decreasing the cost of health care delivery," states the article.

The authors note, however, that there are some barriers to implementation of these mobile health solutions, including costs. The price for the device plus connectivity charges in the pilot tests was $25,000. In addition, they cite medical liability, patient confidentiality, physician payment and other policy issues as potential obstacles to implementation. Nevertheless, they predict that these devices could revolutionize healthcare delivery, even in areas with well-established medical services.

"Although mobile telemedicine may be applied initially to emergency situations, remote locations and the developing world, its major impact may be in the delivery of primary healthcare," the article concludes. "We can envision the use of mobile remote-presence devices by allied health personnel in a wide range of scenarios, from home care visits to follow-up sessions for mental health care, in which access to medical expertise in real time would be just a phone call away."

In related news, British researchers at Newcastle University have developed a portable ultrasound scanner that can be manufactured for around $65, which could bring affordable imaging to women and babies in the developing world. The hand-held device, roughly the size of a computer mouse, can be plugged into a USB for imaging at power up to 100 times lower than conventional hospital ultrasounds. Hospital scanners typically cost anywhere from $32,000 to $160,000. To keep the cost at a minimum, the new device relies on a single fixed-focus transducer.

To learn more:
- read the article
- read the announcement