CHRONIC INJURIES PRIMARILY CONTAIN WOUNDS LIKE DIABETIC FOOT ULCERS, VENOUS LEG ULCERS, PRESSURE ULCERS, AND SOME OTHER CHRONIC WOUNDS. THE DIABETES-RELATED WOUNDS CREATE MAJOR COMPLICATIONS FOR THE PATIENTS AS DIABETES DECELERATES THE HEALING PROCESS AND TAKES MORE TIME TO HEAL, WHICH WILL INCREASE THE CONSUMPTION OF MEDICAL TAPES AND BANDAGES USED FOR DRESSINGS AND RE-DRESSINGS OF WOUNDS. IN SOME CASES, DUE TO PROLONGED HEALING TIME, MINOR CUTS ALSO TURN INTO CHRONIC WOUNDS AND BOOST THE DEMAND FOR DRESSINGS. FOR INSTANCE, ACCORDING TO IDF DIABETES ATLAS NINTH EDITION 2019, MORE THAN 463 MILLION ADULTS AGED BETWEEN 20-79 YEARS WERE LIVING WITH DIABETES AND BY 2045 THIS NUMBER IS EXPECTED TO INCREASE TO 700 MILLION. FURTHERMORE, GROWING GERIATRIC POPULATION IS ALSO A MAJOR REASON THAT IS INCREASING THE CHANCES OF CHRONIC DISEASES AND INJURIES. ACCORDING TO THE UNITED STATES DEPARTMENT OF ECONOMIC AND SOCIAL AFFAIRS, GLOBALLY THERE WERE AROUND 727 MILLION PEOPLE AGED 65 YEARS OR MORE IN 2020. AND THIS SHARE OF THE GLOBAL POPULATION AGED 65 YEARS OR ABOVE IS EXPECTED TO INCREASE FROM 9.3% IN 2020 TO 16% BY 2050.
SEVERAL ADVANCEMENTS IN MEDICAL TAPES AND BANDAGES HAVE TAKEN PLACE TO REDUCE THE TIME OF HEALING. FOR EXAMPLE, ACCORDING TO THE RESEARCHERS AT KING'S COLLEGE LONDON IN SEPTEMBER 2020, THEY DEVELOPED A BANDAGE THAT ALLOWS THE TRANSPLANTATION OF BONE-FORMING STEM CELLS INTO SEVERE BONE FRACTURES AND SPEEDS UP THE HEALING PROCESS. THIS NEW METHOD IMPROVES REPAIR AND WILL CHANGE HOW BROKEN BONES ARE TREATED.
THE COVID-19 PANDEMIC HAS LED TO MAJOR DISTURBANCES IN ROUTINE HOSPITAL SERVICES GLOBALLY. DURING THE PANDEMIC, MANY HOSPITALS HAVE REDUCED THEIR ELECTIVE SURGERIES IN THE INTEREST OF PATIENT SAFETY AND SUPPORTING THE WIDER RESPONSE. THE REDUCED NUMBER OF SURGERIES DIMINISHED THE USE OF MEDICAL TAPES OR BANDAGES AND NEGATIVELY IMPACTED THIS INDUSTRY DURING THE COVID-19 PERIOD. FOR INSTANCE, ACCORDING TO THE WILLEY ONLINE LIBRARY IN MAY 2020, ALMOST 28,404,603 OPERATIONS WERE CANCELED OR POSTPONED DURING THE PEAK 12?WEEKS OF DISRUPTIONS DUE TO COVID-19 AND MOST CANCELED OPERATIONS IE.E 90.2% WERE FOR BENIGN DISEASES. ALSO, THE OVERALL 12-WEEK SURGICAL OPERATIONS CANCELLATION RATE WERE 72.3%. GLOBALLY, 81.7% OF OPERATIONS CANCELED WERE FOR BENIGN CONDITIONS, 37.7% FOR CANCER OPERATIONS, AND 25.44% FOR ELECTIVE CESAREAN SECTIONS WOULD BE CANCELED OR POSTPONED.
TELEMEDICINE IS THE DELIVERY OF HEALTH CARE SERVICES, WHERE
DISTANCE IS A CRITICAL FACTOR, BY ALL HEALTH CARE PROFESSIONALS
USING INFORMATION AND COMMUNICATIONS TECHNOLOGIES FOR
THE EXCHANGE OF VALID INFORMATION FOR THE DIAGNOSIS, TREATMENT
AND PREVENTION OF DISEASE AND INJURIES, RESEARCH AND
EVALUATION, AND FOR THE CONTINUING EDUCATION OF HEALTH
CARE PROVIDERS, ALL IN THE INTERESTS OF ADVANCING THE HEALTH
OF INDIVIDUALS AND THEIR COMMUNITIES.
TELEMEDICINE IS THE DELIVERY OF HEALTH CARE SERVICES, WHERE
DISTANCE IS A CRITICAL FACTOR, BY ALL HEALTH CARE PROFESSIONALS
USING INFORMATION AND COMMUNICATIONS TECHNOLOGIES FOR
THE EXCHANGE OF VALID INFORMATION FOR DIAGNOSIS, TREATMENT
AND PREVENTION OF DISEASE AND INJURIES, RESEARCH AND
EVALUATION, AND FOR THE CONTINUING EDUCATION OF HEALTH
CARE PROVIDERS, ALL IN THE INTERESTS OF ADVANCING THE HEALTH
OF INDIVIDUALS AND THEIR COMMUNITIES.
TELEMEDICINE IS THE DELIVERY OF HEALTH CARE SERVICES, WHERE
DISTANCE IS A CRITICAL FACTOR, BY ALL HEALTH CARE PROFESSIONALS
USING INFORMATION AND COMMUNICATIONS TECHNOLOGIES FOR
THE EXCHANGE OF VALID INFORMATION FOR DIAGNOSIS, TREATMENT
AND PREVENTION OF DISEASE AND INJURIES, RESEARCH AND
EVALUATION, AND FOR THE CONTINUING EDUCATION OF HEALTH
CARE PROVIDERS, ALL IN THE INTERESTS OF ADVANCING THE HEALTH
OF INDIVIDUALS AND THEIR COMMUNITIES.
TELEMEDICINE IS THE DELIVERY OF HEALTH CARE SERVICES, WHERE
DISTANCE IS A CRITICAL FACTOR, BY ALL HEALTH CARE PROFESSIONALS
USING INFORMATION AND COMMUNICATIONS TECHNOLOGIES FOR
THE EXCHANGE OF VALID INFORMATION FOR DIAGNOSIS, TREATMENT
AND PREVENTION OF DISEASE AND INJURIES, RESEARCH AND
EVALUATION, AND FOR THE CONTINUING EDUCATION OF HEALTH
CARE PROVIDERS, ALL IN THE INTERESTS OF ADVANCING THE HEALTH
OF INDIVIDUALS AND THEIR COMMUNITIES.
TELEMEDICINE IS THE DELIVERY OF HEALTH CARE SERVICES, WHERE
DISTANCE IS A CRITICAL FACTOR, BY ALL HEALTH CARE PROFESSIONALS
USING INFORMATION AND COMMUNICATIONS TECHNOLOGIES FOR
THE EXCHANGE OF VALID INFORMATION FOR DIAGNOSIS, TREATMENT
AND PREVENTION OF DISEASE AND INJURIES, RESEARCH AND
EVALUATION, AND FOR THE CONTINUING EDUCATION OF HEALTH
CARE PROVIDERS, ALL IN THE INTERESTS OF ADVANCING THE HEALTH
OF INDIVIDUALS AND THEIR COMMUNITIES.
TELEMEDICINE IS THE DELIVERY OF HEALTH CARE SERVICES, WHERE
DISTANCE IS A CRITICAL FACTOR, BY ALL HEALTH CARE PROFESSIONALS
USING INFORMATION AND COMMUNICATIONS TECHNOLOGIES FOR
THE EXCHANGE OF VALID INFORMATION FOR DIAGNOSIS, TREATMENT
AND PREVENTION OF DISEASE AND INJURIES, RESEARCH AND
EVALUATION, AND FOR THE CONTINUING EDUCATION OF HEALTH
CARE PROVIDERS, ALL IN THE INTERESTS OF ADVANCING THE HEALTH
OF INDIVIDUALS AND THEIR COMMUNITIES.
TELEMEDICINE IS THE DELIVERY OF HEALTH CARE SERVICES, WHERE
DISTANCE IS A CRITICAL FACTOR, BY ALL HEALTH CARE PROFESSIONALS
USING INFORMATION AND COMMUNICATIONS TECHNOLOGIES FOR
THE EXCHANGE OF VALID INFORMATION FOR DIAGNOSIS, TREATMENT
AND PREVENTION OF DISEASE AND INJURIES, RESEARCH AND
EVALUATION, AND FOR THE CONTINUING EDUCATION OF HEALTH
CARE PROVIDERS, ALL IN THE INTERESTS OF ADVANCING THE HEALTH
OF INDIVIDUALS AND THEIR COMMUNITIES.
TELEMEDICINE IS THE DELIVERY OF HEALTH CARE SERVICES, WHERE
DISTANCE IS A CRITICAL FACTOR, BY ALL HEALTH CARE PROFESSIONALS
USING INFORMATION AND COMMUNICATIONS TECHNOLOGIES FOR
THE EXCHANGE OF VALID INFORMATION FOR DIAGNOSIS, TREATMENT
AND PREVENTION OF DISEASE AND INJURIES, RESEARCH AND
EVALUATION, AND FOR THE CONTINUING EDUCATION OF HEALTH
CARE PROVIDERS, ALL IN THE INTERESTS OF ADVANCING THE HEALTH
OF INDIVIDUALS AND THEIR COMMUNITIES.
TELEMEDICINE CAN BE DETERMINED AS AN INTEGRATION
OF SEVERAL COMPONENTS INCLUDING INFORMATION AND
COMMUNICATION TECHNOLOGIES, HARDWARE AND SO?WARE
TECHNOLOGIES AND MEDICAL SERVICES OPERATING TOGETHER IN
ORDER TO PROVIDE REQUIRED FEATURES OR SERVICES TO USERS
TELEMEDICINE CAN BE DETERMINED AS AN INTEGRATION
OF SEVERAL COMPONENTS INCLUDING INFORMATION AND
COMMUNICATION TECHNOLOGIES, HARDWARE AND SO?WARE
TECHNOLOGIES AND MEDICAL SERVICES OPERATING TOGETHER IN
ORDER TO PROVIDE REQUIRED FEATURES OR SERVICES TO USERS
TELEMEDICINE CAN BE DETERMINED AS AN INTEGRATION
OF SEVERAL COMPONENTS INCLUDING INFORMATION AND
COMMUNICATION TECHNOLOGIES, HARDWARE AND SO?WARE
TECHNOLOGIES AND MEDICAL SERVICES OPERATING TOGETHER IN
ORDER TO PROVIDE REQUIRED FEATURES OR SERVICES TO USERS
AS SHOWN IN FIG 1. ?E UNDERLYING TECHNOLOGIES ARE SEEN
AS A BLACK BOX TO THE USERS AND THEY ARE RESPONSIBLE FOR
FACILITATING PROCESSES OF EACH PROPOSED SERVICE
.......... .......... ........... .......... ........... .......... ........... .......... ........... .......... ........... .......... ........... ...........
....................................... ................................
EDUCATION AND PRACTICE FUNDAMENTALS
" INTRODUCTION TO THE PRACTICE OF TELEMEDICINE
JOHN CRAIG* AND VICTOR PATTERSON*
W
?
DEPARTMENT OF NEUROLOGY, ROYAL VICTORIA HOSPITAL, BELFAST, UK;
W
CENTRE FOR ONLINE HEALTH, UNIVERSITY OF QUEENSLAND, BRISBANE,
AUSTRALIA
SUMMARY
TELEMEDICINE IS THE DELIVERY OF HEALTH CARE AND THE EXCHANGE OF HEALTH-CARE INFORMATION ACROSS DISTANCES. IT IS NOT
A TECHNOLOGY OR A SEPARATE OR NEW BRANCH OF MEDICINE. TELEMEDICINE EPISODES MAY BE CLASSI?ED ON THE BASIS OF:
(1) THE INTERACTION BETWEEN THE CLIENT AND THE EXPERT (I.E. REALTIME OR PRERECORDED), AND (2) THE TYPE OF
INFORMATION BEING TRANSMITTED (E.G. TEXT, AUDIO, VIDEO). MUCH OF THE TELEMEDICINE WHICH IS NOW PRACTISED IS
PERFORMED IN INDUSTRIALIZED COUNTRIES, SUCH AS THE USA, BUT THERE IS INCREASING INTEREST IN THE USE OF TELEMEDICINE
IN DEVELOPING COUNTRIES. THERE ARE BASICALLY TWO CONDITIONS UNDER WHICH TELEMEDICINE SHOULD BE CONSIDERED:
(1) WHEN THERE IS NO ALTERNATIVE (E.G. IN EMERGENCIES IN REMOTE ENVIRONMENTS), AND (2) WHEN IT IS BETTER THAN
EXISTING CONVENTIONAL SERVICES (E.G. TELERADIOLOGY FOR RURAL HOSPITALS). FOR EXAMPLE, TELEMEDICINE CAN BE EXPECTED
TO IMPROVE EQUITY OF ACCESS TO HEALTH CARE, THE QUALITY OF THAT CARE, AND THE EF?CIENCY BY WHICH IT IS DELIVERED.
RESEARCH IN TELEMEDICINE INCREASED STEADILY IN THE LATE 1990S, ALTHOUGH THE QUALITY OF THE RESEARCH COULD BE
IMPROVED THERE HAVE BEEN FEW RANDOMIZED CONTROLLED TRIALS TO DATE.
INTRODUCTION
ONE OF THE GREAT CHALLENGES FACING HUMANKIND IN THE
21ST CENTURY IS TO MAKE HIGH-QUALITY HEALTH CARE AVAILABLE
TO ALL. SUCH A VISION HAS BEEN EXPRESSED BY THE WORLD
HEALTH ORGANIZATION (WHO) IN ITS HEALTH-FOR-ALL STRATEGY
IN THE 21ST CENTURY.
1
REALIZING THIS VISION WILL BE DIF?CULT,
PERHAPS IMPOSSIBLE, BECAUSE OF THE BURDENS IMPOSED ON
A GROWING WORLD POPULATION BY OLD AND NEW DISEASES,
RISING EXPECTATIONS FOR HEALTH, AND SOCIOECONOMIC
CONDITIONS THAT HAVE, IF ANYTHING, INCREASED DISPARITIES IN
HEALTH STATUS BETWEEN AND WITHIN COUNTRIES.
TRADITIONALLY, PART OF THE DIF?CULTY IN ACHIEVING
EQUITABLE ACCESS TO HEALTH CARE HAS BEEN THAT THE
PROVIDER AND THE RECIPIENT MUST BE PRESENT IN THE SAME
PLACE AND AT THE SAME TIME. RECENT ADVANCES IN
INFORMATION AND COMMUNICATION TECHNOLOGIES,
HOWEVER, HAVE CREATED UNPRECEDENTED OPPORTUNITIES FOR
OVERCOMING THIS BY INCREASING THE NUMBER OF WAYS THAT
HEALTH CARE CAN BE DELIVERED. THIS APPLIES BOTH TO
DEVELOPING COUNTRIES WITH WEAK OR UNSTABLE ECONOMIES
AND TO INDUSTRIALIZED COUNTRIES. THE POSSIBILITIES FOR
USING INFORMATION AND COMMUNICATION TECHNOLOGIES TO
IMPROVE HEALTH-CARE DELIVERY ( HEALTH TELEMATICS ) ARE
INCREASINGLY BEING RECOGNIZED. THE WHO HAS STATED THAT
WITH REGARD TO ITS HEALTH-FOR-ALL STRATEGY IT RECOMMENDS
THAT THE WHO AND ITS MEMBER STATES SHOULD:
INTEGRATE THE APPROPRIATE USE OF HEALTH TELEMATICS IN
THE OVERALL POLICY AND STRATEGY FOR THE ATTAINMENT OF
HEALTH FOR ALL IN THE 21ST CENTURY, THUS FUL?LLING THE
VISION OF A WORLD IN WHICH THE BENE?TS OF SCIENCE,
TECHNOLOGY AND PUBLIC HEALTH DEVELOPMENT ARE MADE
EQUITABLY AVAILABLE TO ALL PEOPLE EVERYWHERE.
2
SUCH A COMMITMENT TO IMPROVE HEALTH-CARE DELIVERY,
BY UTILIZING INFORMATION AND TELECOMMUNICATIONS
TECHNOLOGIES, IS ALSO BEING CONSIDERED BY THOSE WITH THE
?NANCIAL MEANS TO DO SO, FOR EXAMPLE, THE PARTICIPANTS
IN VARIOUS EUROPEAN COMMISSION PROJECTS. AT THE
NATIONAL AND SUBNATIONAL LEVEL, THERE IS ALSO EVIDENCE OF
GOVERNMENTAL INTEREST IN THE BENE?TS THAT THESE
TECHNOLOGIES MIGHT BRING TO HEALTH CARE. FOR EXAMPLE,
IN THE UK, INFORMATION TECHNOLOGY INCLUDING
TELEMEDICINE IS AT THE HEART OF THE GOVERNMENT S
STRATEGY TO MODERNIZE AND IMPROVE THE NHS.
3
TELEMEDICINE, THE AREA WHERE MEDICINE AND INFOR-
MATION AND TELECOMMUNICATIONS TECHNOLOGY MEET, IS
PROBABLY THE PART OF THIS REVOLUTION THAT COULD HAVE THE
GREATEST IMPACT ON HEALTHCARE DELIBASED ON SERVICE, THE MARKET IS FRAGMENTED INTO TELE-CONSULTING, TELE-MONITORING, AND TELE-EDUCATION. THE TELE-CONSULTING SEGMENT GENERATED MORE THAN 45% REVENUE IN 2020. THE MARKET IS EXPECTED TO GROW AT A SIGNIFICANT RATE DURING THE FORECAST PERIOD. AS IT PERMITS PATIENTS TO HAVE APPOINTMENTS WITH EXPERTS AT ANY INSTANCE OF TIME, WITHOUT ANY WAITING PERIOD.
BASED ON PRODUCTS, THE MARKET IS BIFURCATED INTO MEDICAL TAPES AND MEDICAL BANDAGES. FURTHER, THE MEDICAL TAPES SEGMENT IS SUB-DIVIDED INTO FABRIC TAPES, PAPER TAPES, PLASTIC TAPES, AND OTHER TAPES. MEDICAL BANDAGES SEGMENT IS FURTHER DIVIDED INTO MUSLIN BANDAGE ROLLS, ELASTIC BANDAGE ROLLS, TRIANGULAR BANDAGES, ORTHOPEDIC BANDAGES, ELASTIC PLASTER BANDAGES, AND OTHER BANDAGES. THE MEDICAL BANDAGES SEGMENT GRABBED THE MAJOR MARKET IN 2020 AND IT IS ANTICIPATED TO UPSURGE IN THE FORECAST PERIOD. THE BANDAGES PROTECT WOUNDS, INJURIES, BACTERIAL INFECTIONS, AND DIRT. ALSO, IT ABSORBS FLUIDS FROM DRAINING WOUNDS AND SUSTAINS A MOIST ATMOSPHERE TO ACCELERATE HEALING. BASED ON APPLICATION, THE MARKET IS BIFURCATED INTO SURGICAL WOUNDS, TRAUMATIC WOUNDS, ULCERS, SPORTS INJURIES, BURN INJURY AND OTHER INJURIES. THE SURGICAL WOUNDS SEGMENT ACCOUNTED FOR THE MAJOR REVENUE PORTION IN 2020 OWING TO THE INCREASING INSTANCES OF DIFFERENT TYPES OF SURGERIES ACROSS THE WORLD. BASED ON END-USER, THE MARKET IS BIFURCATED INTO HOSPITALS & CLINICS, AMBULATORY SURGERY CENTERS, RETAIL, AND OTHERS. THE HOSPITALS & CLINICS SEGMENT IS ANTICIPATED TO OBSERVE LUCRATIVE GROWTH IN 2020. AS, HOSPITALS HAVE THE SIGNIFICANT INFRASTRUCTURE AND FACILITIES TO TREAT ANY TYPES OF DISEASES.
FOR A BETTER UNDERSTANDING OF THE MARKET ADOPTION OF THE MEDICAL TAPES AND BANDAGES MARKET IS ANALYZED FOR MAJOR REHIONS INCLUDING NORTH AMERICA (US, CANADA, AND THE REST OF NORTH AMERICA), EUROPE (GERMANY, FRANCE, ITALY, SPAIN, UK AND REST OF EUROPE), ASIA-PACIFIC (CHINA, JAPAN, INDIA, AUSTRALIA, AND REST OF APAC), AND REST OF WORLD. NORTH AMERICA CONSTITUTES A MAJOR MARKET FOR MEDICAL TAPES & BANDAGES AND GENERATED REVENUE IN 2020. SOME OF THE MAJOR PLAYERS OPERATING IN THE MARKET INCLUDE MEDTRONIC PLC, SMITH & NEPHEW PLC, 3M HEALTHCARE, JOHNSON & JOHNSON, CARDINAL HEALTH, INC., MEDLINE INDUSTRIES, INC., DERMA SCIENCES INC., MOLNLYCKE HEALTH CARE AB, MCKESSON CORPORATION, 3L MEDICINAL PRODUCTS GROUP, ETC.
THE GLOBAL MEDICAL TAPES AND BANDAGES MARKET WAS GROWING AT A SIGNIFICANT RATE IN 2020 AND IS PROJECTED TO EXPAND CONSIDERABLY FROM 2021F TO 2027F. THE GLOBAL MEDICAL TAPES AND BANDAGES MARKET IS EXPECTED TO WITNESS A BOOST ON ACCOUNT OF THE RISING PREVALENCE OF DISEASES, ACCIDENTS, SURGERIES, AND CONDITIONS AFFECTING WOUND HEALING CAPABILITIES ACROSS THE GLOBE.
