1. TELEHEALTH : Prof. S. Yunkap Kwankam, PhD CEO, Global eHealth Consultants, Switzerland Executive Director, International Society for Telemedicine and eHealth (ISfTeH) A global view of Health services any time and everywhere

2. Modern Telemedicine : transforming an old model with new tools A Canadian TeleCare pilot project (Credits: March Networks Corporation) ‏ First integrated circuit and modern day IC. A stylized replica of the first transistor

3. Modern Telemedicine kit: traction-free mobile clinic? Up to 7 days use without grid power with Li battery pack and solar charger

4. Telemedicine application areas Primary healthcare services  All PHC services, with local provider support Remote patient monitoring  Capture and transfer of measurements - decisions and actions Knowledge & skills transfer  Mentoring

5. Why provide services at a distance?  Health workers save lives  But workforce unevenly distributed  Inequalities in access  Need for health workers to provide services beyond their physical reach

6. Characteristics of Telemedicine  Teleradiology  Telepsychiatry  Teledermatology  Telepathology  Teleophathalmology Increased access  Reaching the previously unreached  Reducing inequities in health Improved quality  Transfer of skills Reduced cost  Unnecessary referrals Medical specialtiesBenefits

7. Digital health space  Chemistry 19 th century  Pharmaceuticals  Physics 20 th century  Imaging systems and equipment  ICT 21 st century  knowledge-based systems for health Third pillar of Health Industry Major paradigm shift

8. Opportunities for connected health  Top 5 conditions amenable to behavior change  Selective dissemination of personalized health education

9. Growth of Telemedicine Grew from  $9.8 billion in 2010 to $11.6 billion in 2011 and is expected to reach $27.3 billion in 2016 Segmentation into  telehospital / clinic  telehomecare Telemedicine market

10. Telemedicine patients worldwide Grew worldwide from  308,000 patients in 2012 remotely monitored by their healthcare provider for congestive heart failure (CHF), chronic obstructive pulmonary disease (COPD), diabetes, hypertension and mental health conditions  Projected to reach 1.8 million patients by 2017 People served

11. Drivers of Telemedicine  Telehome care – chronic-care patients with COPD, CHF, etc.  More people living longer with conditions requiring chronic attention, such as hypertension, diabetes, etc. and the  Increasing labour costs of chronic care  More economic and developmental, less epidemiological  Phone-based telemedicine will become the most practised form of remotely caring for people’s health. Developed worldDeveloping world

12. Shift in paradigm - prevention  Subtle but hugely significant shift has appeared on the Telemedicine landscape – towards the scenario of health services “any time anywhere”  Example of MAMA (Mobile Alliance for Maternal Action) – targeted text messages to women at various stages of pregnancy

13. Implications for Hospitals  “The hospital designer's task-much like the task of microprocessor chip layout has been to arrange a lot of identical storage units and a few specialized, central processing facilities for the greatest possible circulation efficiency under statistically predicted patterns of use.”  “The physician need no longer be present in the same room, or even in the same country, as the patient or specimen.”  Transformation the hospital catchment area from an identifiable geographic region to a potentially boundless virtual community.

14. Conclusions  Telemedicine – extending the care-giving capacity of health professionals beyond their physical reach  Phone-based telemedicine will become the most common form of telemedicine  In terms of its public health impact phone-based telehealth (which includes non-clinical interventions) is likely to be the next major achievement of ICT in health  “Help the previously helpless share in the benefits of an improved social environment where they live.”  mHealth seen by both WHO and the ITU as the flagship of their joint program in the next major public health battleground – the fight against non-communicable diseases (NCDs).