[Health] VideoChat is working now - hooray!

[repyke at infionline.net]

I agree that low cost , low tech, open source e-health/telehealth apps is the best way to go  in remote areas of the world as written about and demonstrated by Paul's partner in crime over at Partners Health Care, Dr Joe Kvedar. In those settings the above is ideal, but I can also make a case for a more powerful platform at the major medical centers or hubs. One of the problems in the US and to lesser extent the rest of the world, is that the vendors of telehealth/e-health are pushing te high end eqiupment and apps and thats part of the disconnect in what we really want to do , i.e provide low cost telehealth solutions to the world.
imho,


----- Original Message ----- 
From: Paul Heinzelmann 
To: bens at alum.mit.edu
Cc: Bob Pyke Jr.,RN,CPNP; health; Grassroots OLPC; OLPC Devel; Pia Waugh
Sent: 10/13/2008 4:46:31 PM 
Subject: Re: [Health] VideoChat is working now - hooray!


I think its very exciting to see telemedicne applications being developed for this platform. But I also think you need to be very careful here.  There are multiple studies on resolutuion of images and utility for various telemedicine purposes. (ie Still images from a 2 megapixel camera are likely mimimal for wound care, follow up, etc.)  In that scenario, video at 1 or 2 fps wouldnt be very good for assessing wounds. I think Bob is on target when it comes to the value add of video when it comes to doing evidence-based telemedicine.  

For example, if you are assessing a movement disorder, or trying to assess non-verbal cues in a psych patient, this will not be possible at 1-2fps.  It certainly adds a 'gee whiz" factor to "see" the doctor from the patient's perspective, but the value to the doctor in terms of diagnosis will be minimal in my opinion.

That being said, the challenge is to find low bandwidth applications that make sense for patients and health workers and I think this will be very case-specific. Cudos to those seeking to develop them! 


On Mon, Oct 13, 2008 at 4:31 PM, Benjamin M. Schwartz <bmschwar at fas.harvard.edu> wrote:

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Bob Pyke Jr.,RN,CPNP wrote:
| It aappears to be interestimg. But if your doing remote telehealth you
need to have 30 fps for video.


I think this is a misunderstanding.

We are not talking about robotic remote surgery here, or anything
requiring low-latency feedback.  "Telehealth" in this context refers to an
interview between a patient and a medic.  For example, a patient might
hold up an injury and ask the doctor if it looks infected.

In fact, for health applications, I would make the unusual tradeoff of
sending the full resolution of the camera (640x480) at high quality, even
if this means that we can only achieve 1 or 2 fps.

- --Ben


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-- 
Paul Heinzelmann, MD
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