Abstract

Telemedicine describes the use of Information and Communication Technologies (ICT) for the delivery of medical services. It aims at equal access to medical expertise irrespective of the geographical location of the person in need. New developments in ICT have enabled the transmission of medical images in sufficiently high quality that allows for a reliable diagnosis to be determined by the expert at the receiving site (Pande et al., 2003; Lacroix et al., 2002). Through Telemedicine patients can get access to medical expertise that may not be available at the patients’ site. Networks for Telemedicine enable the integration of distributed medical competence and contribute to the improvement of the quality of medical care, to the cost-effective use of medical resources and to quick and reliable decisions. For optimal performance of telemedical applications, the networks and communication tools used must be optimised for medical applications, both with respect to the Quality-of-Service (QoS, a set of parameters characterising the performance of the communication channel per se, such as transmission bandwidth, delay, jitter, data loss, etc.) as well as to the Class-ofService (CoS; a set of terms specifying the medical services offered in the network, like Telesurgery, Telepathology, Telesonography, Tele-Teaching, -Training & -Education, etc.). The use of specifically designed networks for telemedicine (distributed medical intelligence) contributes to the continuous improvement of patient care. Experience over the last decade has shown that the goals of Telemedicine are not automatically reached by the introduction and use of singular new technologies per se, but rather require the implementation of integral services. At the same time, however, these innovative developments in ICT over the last decade bear the risk of creating and amplifying a digital divide in the world, creating a disparity in the quality of life, e.g. between the northern and the southern Euro-Mediterranean area (Graschew et al., 2003a; Dario et al., 2005; Graschew et al., 2004a). In recent years different projects have demonstrated how the digital divide is only one part of a more complex 6

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