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Recent advancements in, and increasing availability and utilization of, ICTs by the general population have been the biggest drivers of telemedicine over the past decade, rapidly creating new possibilities for health care service and delivery. This has been true for developing countries and underserved areas of industrialized nations. The replacement of analogue forms of communication with digital methods, combined with a rapid drop in the cost of ICTs, have sparked wide interest in the application of telemedicine among health-care providers, and have enabled health care organizations to envision and implement new and more efficient ways of providing care. The introduction and popularization of the Internet has further accelerated the pace of ICT advancements, thereby expanding the scope of telemedicine to encompass Web-based applications (e.g. e-mail, teleconsultations and conferences via the Internet) and multimedia approaches (e.g. digital imagery and video). These advancements have led to the creation of a rich tapestry of telemedicine applications that the world is coming to use. INTRODUCTION: OVERVIEW OF TELEMEDICINE Applications and services for diverse contexts Telemedicine applications can be classified into two basic types, according to the timing of the information transmitted and the interaction between the individuals involved—be it health professional-to-health professional or health professional-to-patient. Store-and-forward, or asynchronous, telemedicine involves the exchange of prerecorded data between two or more individuals at different times. For example, the patient or referring health professional sends an e-mail description of a medical case to an expert who later sends back an opinion regarding diagnosis and optimal management. In contrast, real time, or synchronous, telemedicine requires the involved individuals to be simultaneously present for immediate exchange of information, as in the case of videoconferencing. In both synchronous and asynchronous telemedicine, relevant information may be transmitted in a variety of media, such as text, audio, video, or still images. These two basic approaches to telemedicine are applied to a wide array of services in diverse settings, including teledermatology, telepathology, and teleradiology. The majority of telemedicine services, most of which focus on diagnosis and clinical management, are routinely offered in industrialized regions including, but not limited to the United Kingdom of Great Britain and Northern Ireland, Scandinavia, North America, and Australia. In addition, biometric measuring devices such as equipment monitoring heart rate, blood pressure and blood glucose levels are increasingly used to remotely monitor and manage patients with acute and chronic illnesses.
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