- Smart Healthcare, Wednesday 7 October 2009 09.00 BST
Watching for new ideas: video conferencing can be used for applications beyond telehealth. Photo: jiunlimited.com
As this week's announcement from the Scottish Government about the nationwide introduction of telehealth by NHS 24 confirms, the use of video conferencing for remote diagnosis is well established. But clinical needs are finding further uses for such technology.
The Princess Royal Maternity Hospital in Glasgow is using it to create 'babycams' that are used to link mothers to their newborns through video conferencing in situations where they have been separated by premature birth and other medical complications.
Chris Lilley, a neonatal consultant, was already using video conferencing units as part of a remote diagnostics system for babies with cardiac problems: "Then we thought that this would be a good way of matching up babies and mums that couldn't be together."
"The first case was a lady who was being treated about a quarter a mile away on the same site with a serious skin tumour," he says. "She was going to be there for about 12 weeks and there were problems with her care that meant she was not able to visit the unit and had given birth to a very premature baby who also could not move from the unit."
The video link has been credited with helping mothers bond with their babies and begin breastfeeding, despite not being in physical contact with their babies. "With premature babies we need to get mums to produce a small amount of breast milk for us to start them on accepting milk and that is very important part of premature care," says Lilley.
Steve Woollett, head of public sector for Tandberg, which donated six bedside units for the project, says clinical staff are creating specialist uses such as the babycams. But away from telehealth, surgical training is set to be another big user of video conferencing.
He says that training in endoscopy – internal examinations using cameras on fibre optic cables – is set to be a particular growth area. "The government at the time didn't recognize how big endoscopy was going to be so training places were rather few and far between initially.
"Now when people are at the stage where they need to be supervised in operations, rather than taking the day out and having to visit another site customers now can work in their own hospital and at the allotted time can dial in from a desktop video unit to supervise the procedure." More network capacity, including England and Scotland's N3 health network, and better video coding has increased the quality of video shared between organisations, making surgical training viable.
Watching Eurovision
Elsewhere in Europe, such work is already underway. In June the Temdec project (Telemedicine Development Centre of Asia) at the Medical School of Kyushu University in Japan linked hospitals in Norway, Italy and Spain through the pan-European GÉANT research network. This transmitted at 30Mbps using digital video transport system (DVTS) equipment that can be run from a standard personal computer. Staff at the three hospitals were able to show how endoscopic surgery can be transmitted across borders for training purposes.
Dr Shuji Shimizu, of the Kyushu University Hospital's department of endoscopic diagnostics and therapeutics, says that since the demonstration in June, there has been a move to adopt video conferencing for surgical training more widely in Europe although this is at an early stage in the UK: "As far as the UK is concerned, collaboration is just about to start.
"A key is to organise a collaborating team between doctors and engineers in each hospital. But usually doctors do not know engineers and engineers do not know doctors. And they do not know their interests and expertise. So to make a good team is essential but it is sometimes difficult," he says.
He points to two technological drivers for the wider adoption of video in healthcare: the development of the GÉANT academic network dedicated for research and the DVTS, which can transform digital video signals directly into internet protocol. "As a result, we can transmit surgical video with the preservation of its quality," he says.
Kable senior analyst Victor Almeida describes the take-up of video conferencing outside of diagnostics so far as "very niche and very slow". He adds: "My view is this is a growth area as you move care from the hospital into the community and the patient's home.
"It is not a technical issue at all. The technology has been there for a long time but video conferencing has not happened. The time is right and it is key to the modernisation of the NHS. Trusts are paid by results and once they realise how they can cut costs and improve patient care they will embrace it."
