Telemedicine: A Brief History

In the mid-Nineties, telemedicine had started gaining attention and investment of time, money and energy by top-tier universities and healthcare institutions, especially in the US.

The two major practices utilizing telemedicine were radiology and pathology, giving rise to what was referred to as tele-radiology and tele-pathology, respectively.

In tele-radiology, a hard-copy of an X-Ray film would be scanned to produce a digital image. The image is compressed, stored on an image database, then transmitted over leased telephone lines to a reading center. These centers were members of a telemedicine network, offering second opinions on cases from locations that didn’t have the same level of medical expertise as the one available at the remote medical institution. Everyday, a radiologist at the reading center would view yesterday’s cases on proprietary, large monitors, make an assessment, then send back a consultation over fax lines to the requesting physician. Discussions of the consultation would take place over the phone between the two physicians/specialists, if needed.

Tele-Pathology worked in a similar fashion, yet both required specialized, usually large-sized equipment, trained staff, and long time for the whole process to conclude. A single X-ray sheet would take 40-60 minutes, between the time scanning started till the image would reach the reading center.

Today that has become history. Starting from having medical images already in digital format, which eliminated the need for scanning hard-copies, to the ultra speed, ubiquity and packet-switched architecture of the Internet, which cancelled the need to lease telecom circuits. A simple telemedicine session could take place between a doctor and a patient over a Skype video call. Expensive circuit-switching is replaced by cheap/available packet-switching.


In future posts we will shift the focus to a specific telemedicine service: Tele-Neurology Service (TNS).

The Wealth Maker