OMD553 TELEHEALTH TECHNOLOGY

2 MARKS QUESTIONS WITH ANSWERS

UNIT I
1. Define telemedicine.
Use of information and communication technologies to transfer medical information
for the delivery of clinical and educational services.
2. What are the drivers of telemedicine?

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Technological Drivers
Computing and information Technology
Network and telecommunication infrastructure
Technology-led society
Non- Technological drivers
Extension to access to healthcare services

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Healthcare provision for travellers
Military applications
Home telecare
Cost reduction

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Market development
Health policy and strategy
3. State any three ethical and legal aspects of telemedicine.
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Confidentiality and security
Patients right to access
Data protection
Duty of care
Standards of care
Malpractice
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4. What are the advantages of implementing telehealth in rural areas?

Better access to healthcare
Access to better healthcare
Improved communication between careers
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Easier and better continuing education

Better access to information
Better resource utilization
Reduced costs
5. What are the limitations of telemedicine?
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Poor patient-carer relationships

Poor relationship between healthcare professionals
Impersonal technology
Organisational disruption
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Additional training needs

Difficult protocol development
Uncertain quality of health information
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Low rates of utilisation

6. Distinguish between telehealth and telecare.
Telehealth - Use of information and communication technologies to transfer medical
information for the delivery of clinical, administrative and educational services.
Telecare - Use of information and communication technologies to transfer medical
information for the delivery of clinical services to patients in their place of domicile.
 7. State any three recent advances in telemedicine.
Wearable Medical Devices
Smartphones as Diagnostic Tools
Health Informatics
Digital Therapy and Advice
New Apps Save Patients Money and Time

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UNIT II
1. Distinguish between EHR and PHR.
An electronic health record (EHR) is a digital version of a patient’s paper chart. EHRs
are real-time, patient-centered records that make information available instantly and
securely to authorized users. While an EHR does contain the medical and treatment

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histories of patients, an EHR system is built to go beyond standard clinical data
collected in a provider’s office and can be inclusive of a broader view of a patient’s
care.
PHR- Personal Health Record

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2. What is the need for image compression?
To reduce the amount of memory required for storage
To reduce transmission time
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Compression is applied by eliminating gaps, empty fields, similar coloured areas and
redundancies within an image
Data compression is also refers to as data encoding
3. List the factors to be taken into account while selecting telemedicine technology.
The type of the information
The quantity of information
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Security and privacy issues

4. Define EMR.
An electronic Medical record (EMR) is the systematized collection of patient and
population electronically-stored health information in a digital format.[1] These
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records can be shared across different health care settings. Records are shared through
network-connected, enterprise-wide information systems or other information
networks and exchanges. EMRs may include a range of data, including demographics,
medical history, medication and allergies, immunization status, laboratory test results,
radiology images, vital signs, personal statistics like age and weight, and billing
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information.

5. What are the types of information used in telemedicine?

Data, Audio, Still images and Video
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6. What are the data standard, communication standard and imaging standard for clinical
data exchange?
data standard – HL7
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imaging standard – DICOM

7. Distinguish between lossless and lossy compression techniques.
Lossless compression
• Data is compressed without any loss of information in the compression process
• The data after decompression is exactly the same as it was before compression
Text files are stored employing lossless compression
Lossy compression
 • Lossy compression works on the assumption that data does not have to be stored
perfectly and some loss of information is acceptable
• Much information from audio, video and image can be discarded.
• In this case, a compressed and decompressed image is likely to appear different from
the original one.
• Lossy compression is widely used in video conferencing
8. Give any three examples for lossless compression algorithms
Arithmetic coding

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JPEG 2000
Run length coding
Lempel-Ziv-Welch (LZW) algorithm
Huffman coding
9. Name any four video compression methods
Discrete cosine transform(DCT)

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Vector quantisation(VQ)
Fractal compression(FC)
Wavelet transform(WT)
10. What are the different audio formats used in telemedicine?

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ITU G.711
ITU G.712
ITU G.723.1
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ITU G.728
MPEG-1 Audio standard
11. What is a satellite?
A satellite is any physical object that revolves around the earth in a known orbit at a
known height. The path followed by the satellite is called its orbit
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A communication satellite system has two segments

Space Segment i.e., Satellite
Ground Segment, i.e., earth station
Space segment consists of three units
Fuel system
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Telemetry control system

Transponders
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 UNIT III
1. What is encryption?
• A process of encoding a message or information in such a way that only authorized
parties can access it and those who are not authorized cannot

2. Distinguish between symmetric and asymmetric encryption.

Symmetric/ Private Key Encryption
• Uses a single number key to encode and decode the data. Both the sender and receiver

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must know the key
Symmetric/ Private Key Encryption
• Uses a single number key to encode and decode the data. Both the sender and receiver
must know the key

3. What are the objectives of DICOM standard?

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To have a general standard so that it can be applied to the entire range of medical images
encountered in the healthcare field
To standardise communication of digital image information regardless of manufacturer of
imaging equipment

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To facilitate the development and expansion of PACS that can interface with other systems
To promote creation of diagnostic information data bases that can be accessed by a wide
variety of devices and users distributed geographically
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4. Name any four reference categories for HL7 standard.
Section 1: Primary standards
• most popular standard for system integrations, inter-operability and compliance
Section 2: Foundational Standards
• Defines the fundamental tools and building blocks used to build the standards and the
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technology infrastructure
Section 3: Clinical and administrative domains
• Messaging and document standard for clinical specialities and groups are included in this
section
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Section 4: EHR Profile

• These standards provide functional model and profile that enable management of electronic
health records

5. What is cryptography? What is the role of cryptography in telemedicine?

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Cryptography - study of methods to encrypt text.

Cryptanalysis - study of how to decode an encrypted text.
6. What are the cyber laws related to telemedicine?
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These cyber laws include:

• Digital Signature Act 1997
• Computer Crimes Act 1997
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• Telemedicine Act 1997

• Communications and Multimedia Act 1998

Beside these cyber laws, there are three other cyber laws being drafted.
• Private Data Protection Bill
• Electronic Government Activities Bill
• Electronic Transactions Bill
 7. Why do we need cyber laws in telemedicine?
• Integrity and Security of Information
• Legal Status of Online Transactions
• Privacy and Confidentially of Information Security of Government Data
• Intellectual Property Rights
8. How security and confidentiality is ensured in medical records?

UNIT IV

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1. What is teleradiology?

Teleradiology is the electronic transmission of radiologic images from one

location to another for the purpose of interpretation and/or consultation.
2. List out any four applications of telemedicine.
Teleradiology, Telecardiology, telepathology, teleneurology

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3. What are the goals of teleradiology?
Providing consultative and inter relative radiologic services
Providing timely availability of radiologic interpretation in emergent clinical care

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situations
Enhancing continuing educational opportunities for practicing radiologists
4. Give the steps involved in teleradiology system.
i. Producing digital image
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ii. Interfacing patient information
iii. Compressing images and other data
iv. Transmission of images
v. Reconstruction of images
6. What are the components of a teleradiology system?
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Three basic components

i. An image sending station

ii. A transmission network

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iii. A receiving / image review station

7. Define telepathology.
Three basic components
i. An image sending station
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ii. A transmission network

iii. A receiving / image review station
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8. What are the components of a telepathology system?

Telepathology workstation
Image management system – image acquisition, database file storage
High resolution video camera
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Telecommunication
9. Distinguish between static telepathology and dynamic telepathology.

Static Telepathology
• In a static telepathology system, a small number of slide images of interest are
selected by the doctor
 • Images are captured in a digital format on an image frame grabber board and sent to
the specialist located at a remote site
Dynamic Telepathology
• In a dynamic system, a real-time live images of a specimen are transmitted from the
microscope to the monitor at a remote site.
10. How is medical information stored in telemedicine?
A number of models have been developed to help assess or describe the current level

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of information technology adoption in the health sector.
• Capability Maturity Model
• Enterprise Architecture
• Australian National eHealth Interoperability Maturity Model
• Interoperability Maturity Model levels
• The HIMSS EMR Adoption Model

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UNIT V
1. What is telecardiology?

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• Telecardiology is the transmission of cardiac data to a remote location from the
patient site
• Telecardiology is the effort to merge technology with cardiology in order to provide
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the patient with proper and accurate medical advice and medical care
2. List out the essential equipment for telecardiology.
Personal computer / laptop computer
Complete patient electronic health record
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Digital ECG recorder connected to the PC by serial port, equipped with

computerised diagnostic ECG interpretation software
Digital stethoscope
Dedicated phone line with modem including mobile communication facility
Videoconferencing equipment
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Document camera
3. Define telesurgery
Telesurgery is basically surgery performed from a distance by an operating surgeon
with direct, real-time visualisation of the operating field
The surgeon is not physically present in the operating theatre but operates with the
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help of a console located remotely from patient site

4. What are the components of a telerobotic system?
Sensors – sensing minute movement of surgeon’s hand in real-time with precision
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Cameras – should be capable of delivering high resolution clear images of the patient
without any kind of obstruction or instruction
Actuators – exactly replicate 3D hand movements as interpreted by the sensors
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without any delay. Accurate location capabilities with 3D reconstruction model,

robotics representation, stereotaxic and visual reality capability
Communication network – a fast communication network is required to deliver
multimedia data in both directions. It should be highly reliable so as to ensure that it is
free of transmission errors throughout the entire operating procedure
5. Define teleoncology.
 Access to quality cancer care is often unavailable not only in low- and middle-income
countries but also in rural or remote areas of high-income countries.
Teleoncology has the potential to enhance both access to and the quality of clinical
cancer care as well as education and training.
6. Define Teleneurology.
Teleneurology is the use of telecommunications to improve the delivery of neurology
services. A wide range of telecommunications techniques may be used, including the
telephone, email, the Internet and videoconferencing. Teleneurology can improve

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access to specialist neurological services for patients all over the world.
7. Distinguish between horizontal and vertical implementation of telemedicine.
HorizontalImplementation - providing as many sites as possible with a very limited
amount of capability in each site.
Vertical Implementation - start with very few sites with very extensive capability in
each site.

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