TELEMEDICINE: INFRASTRUCTURE

The telemedicine centers could be broadly classified into the following classes: Primary Telemedicine Center (PTC), Secondary Telemedicine Center (STC), and Tertiary Telemedicine Center (TTC). PTCs would be based in Primary Health Centers, STCs in Secondary Medical Centers and TTCs in Tertiary Medical Centers. The Hardware requirements/standards will be referred in the context of the Telemedicine Consulting and Specialist Centers (TCC) and (TSC).

Telecommunication Technologies
The first among the challenging questions arising when planning a telemedicine network is that what is bandwidth? Bandwidth is the capacity that determines how quickly bits may be sent down the channels in a telecommunication medium. Bandwidth is proportional to the complexity of the data for a given level of system performance. The following technologies are currently in use:

Integrated Services Digital Network (ISDN): ISDN is a dial-up (not dedicated but used on a call-by-call basis) digital connection to the telecommunication carrier. An ISDN line can carry information at nearly five times the fastest rate achievable using analog modems over POTS (plain old telephone service).

T-1: This is the backbone of digital service provided to the end user (typically business) in USA today who transmits voice and data digitally at 1.554 Mbps. It can be used to carry analog and digital voice, data and video signals and can even be configured for ISDN service.

Plain Old Telephone Service (POTS): POTS transmit data at a rate of up to 56 kbps and are the most widely available telecommunication technology in the world. POTS can be suitable for audio conferencing, store and-forward communication, Internet and low bandwidth videophone conferencing.

Internet: The Internet has a strong impact in delivering certain kinds of care to patients. In a survey of 1,000 Chief Intelligence Officers (CIOs) conducted by Internet Health Care Magazine, 65% said their organization had a Web presence and another 24% had one in development. With the increasing proliferation of e-health sites on the Web today, many consumers are finding access to online patient scheduling, health education, and review of lab work and even e-mail consultations.