VISVESVARAYA TECHNOLOGICAL UNIVERSITY

“JnanaSangama”, Machhe, Belagavi, Karnataka-590018

A Seminar Report
On

“Telemedicine in the Healthcare Delivery System”

Submitted in partial fulfillment of the requirements for the award of the degree of

Bachelor of
Engineering in
Electronics & Instrumentation Engineering
Submitted by

Swathi R 4GW20EI011

Under the Guidance of

Internal guide
Smt. Sowjanya M N
Assistant Professor
Dept. of EIE, GSSSIETW

DEPARTMENT OF ELECTRONICS & INSTRUMENTATION

ENGINEERING
GSSS INSTITUTE OF ENGINEERING & TECHNOLOGY FOR WOMEN
(Affiliated to VTU, Belagavi, Approved by AICTE, New Delhi & Govt. of Karnataka)
K.R.S ROAD, METAGALLI, MYSURU-570016, KARNATAKA
Accredited with Grade “A” by NAAC
2024
 Geetha Shishu Shikshana Sangha(R )
GSSS INSTITUTE OF ENGINEERING & TECHNOLOGY FOR WOMEN
K.R.S Road, Mysuru-570016, Karnataka
(Affiliated to VTU, Belagavi, Approved by AICTE -New Delhi & Govt. of Karnataka)
Accredited with Grade “A” by NAAC

DEPARTMENT OF ELECTRONICS & INSTRUMENTATION

ENGINEERING

CERTIFICATE

Certified that Swathi R (4GW20EI011) has presented a Seminar on “Telemedicine in the

Healthcare Delivery System” in partial fulfillment for the award of degree of Bachelor of
Engineering in Electronics & Instrumentation Engineering of the Visvesvaraya
Technological University, Belagavi, during the year 2023-24. The seminar report has been
approved as it satisfies the academic requirements with respect to the seminar work prescribed
for Bachelor of Engineering Degree.

Signature of Guide Signature of HOD

(Smt. Sowjanya M N) (Dr. MV Sreenivas Rao)

ii
 ACKNOWLEDGEMENT
The joy and satisfaction that accompany the successful completion of any task would be
incomplete without the mentioning the people who made it possible.

First and foremost, we offer our sincere phrases of thanks to Smt. Vanaja B Pandit,
Honorary Secretary, GSSS(R) and the Management of GSSSIETW, Mysuru for
providing help and support to carry out the seminar.

We would like to express our gratitude to our Principal, Dr. Shivakumar M for
providing us a congenial environment for engineering studies and also for having showed us
the way to carry out the seminar.

We consider it is a privilege and honor to express our sincere phrase of thanks to our
Dr. M V Sreenivas Rao, Professor and Head, Department of Electronics & Instrumentation
Engineering for his support and invaluable guidance throughout the tenure of this seminar.

We would like to thank our Guide Smt. Sowjanya M N, Assistant Professor,

Department of Electronics & Instrumentation Engineering for her support, guidance,
motivation, encouragement for the successful completion of this seminar.

We would like to thank our Seminar Co-Ordinator Smt. Lalitha K, Assistant

Professor Department of Electronics & Instrumentation Engineering for their constant
monitoring, guidance & motivation throughout the tenure of this seminar.

We intend to thank all the teaching and non-teaching staffs of our Electronics &
Instrumentation Engineering for their immense help and co-operation.

Finally, we would like to express our gratitude to our parents and friends who
always stood us to complete this work successfully.

Swathi R
(4GW20EI011)

iii
 ABSTRACT

India's healthcare sector faces substantial challenges, with a notable issue being the
uneven distribution of healthcare infrastructure and professionals. This imbalance leads to a
scarcity of doctors and limited healthcare access, particularly in rural areas where a significant
portion of the population resides. The shortage of medical personnel not only affects the
quality of care but also necessitates long journeys for basic medical services, adding financial
burdens and delays for patients. These disparities in healthcare infrastructure and workforce
availability exacerbate health inequalities, impacting the wellbeing of millions in rural India.
This highlights the pressing need for comprehensive, inclusive solutions to ensure equitable
healthcare access throughout the country.
Telemedicine has become a vital solution to India's healthcare hurdles, a significance
further highlighted during the COVID-19 pandemic. This innovative method allows for the
remote delivery of healthcare, effectively bridging the gap between healthcare providers and
patients. Through telemedicine, healthcare professionals can efficiently reach underserved
populations, empowering them to access essential medical services without the need for
physical visits. This not only ensures continued care during crises such as the pandemic but
also provides a sustainable solution to the ongoing challenge of limited healthcare access,
particularly in rural and remote region of India.
Telemedicine offers a variety of methods to facilitate remote healthcare delivery. Real-
time video consultations enable live interactions between patients and doctors, allowing for
immediate medical advice and diagnosis. The store-and-forward approach enables
asynchronous sharing of medical data, enhancing diagnostic accuracy and treatment
planning. Mobile health apps empower patients by enabling them to track their health data,
schedule appointments, and access resources from their smartphones. Remote patient portals
provide convenient access to medical records and prescriptions, promoting patient
engagement in their healthcare. Additionally, telephone consultations offer basic care
remotely, providing a convenient and accessible option for patients seeking medical advice.
These diverse telemedicine methods collectively improve healthcare accessibility and
efficiency, particularly crucial in addressing India's healthcare challenges.

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 CONTENTS

Title Page i
Certificate ii
Acknowledgement iii
Abstract iv
Contents v
List of Figures vi

Chapter 1 Introduction 1
Chapter 2 Literature Survey 2
Chapter 3 Description about Seminar Topic 5
3.1 Introduction 5
3.2 Technologies 6
3.3 Advantages and Disadvantages 10
3.4 Applications 12
Chapter 4 Conclusion and Future Scope 13
References 14
 LIST OF FIGURES
Figure. No Description Page No.

Fig. 3.1 Telemedicine Concept 5

Fig. 3.2.1 Drivers of Growth 6

Fig. 3.2.2 Doctor to patient telemedicine system 8

deployed under Ayushman Bharat Scheme of
Government of India

Fig. 3.2.3 Doctors working in remote peripheral hospitals 9

 Telemedicine in the Healthcare Delivery System

Chapter 1

Introduction

"Tele," derived from the Greek word meaning "distance," and "medicine," from the Latin
"mederi" meaning "to heal," combine to form telemedicine. Time magazine aptly labeled it as
"healing by wire."
Telemedicine involves the use of electronic information and communication technologies
to provide and support healthcare, particularly when distance separates patients and healthcare
providers. This approach has become increasingly vital, offering a way for individuals to access
healthcare remotely, especially during times of crisis like the COVID-19 pandemic.
Taking the example of diabetes, a widespread chronic condition requiring continuous
monitoring and management, telemedicine presents a holistic solution. It allows patients to
connect with healthcare professionals from the comfort of their homes, offering convenience and
accessibility.
Through telemedicine, individuals with diabetes can receive timely care, guidance on
managing their condition, and necessary support without the need for frequent in-person visits.
This not only enhances patient experience but also improves health outcomes by ensuring regular
monitoring and early intervention when needed.
Advanced information and communication technology (ICT) tools such as Artificial
Intelligence (AI), Machine Learning (ML), data analytics, and robotics are pivotal in addressing
the challenges posed by healthcare crises like the pandemic.
These technologies drive innovation in healthcare delivery and research, enabling
remote monitoring of patients, predictive analytics for disease management, efficient allocation
of resources. It coupled with these cutting-edge technologies, holds promise for revolutionizing
healthcare access & delivery, ensuring that patients receive timely and effective care.

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 Telemedicine in the Healthcare Delivery System

Chapter 2

Literature survey

This chapter describes on the various papers of the seminar topic of Neuromorphic
Computing.

Telemedicine's Impact on Rural Healthcare Access

This paper explains telemedicine has been extensively studied for its role in
improving healthcare access, particularly in rural and remote areas. Research by Smith et
al. (2019) found that telemedicine interventions significantly increased access to
specialty care for rural patients, reducing travel time and costs. Similarly, a study by
Gupta and Pal (2020) highlighted how telemedicine services in rural India improved
patient outcomes by enabling timely consultations with specialists. These findings
underscore the transformative potential of telemedicine in overcoming geographical
barriers, ensuring that individuals in underserved areas can access a wide range of
healthcare services without the need for long-distance travel.

Patient Satisfaction and Acceptance of Telemedicine

This paper had an Understanding patient satisfaction and acceptance of
telemedicine is crucial for its successful integration into the healthcare delivery system.
Studies by Demartini et al. (2021) and Liu et al. (2018) have shown high levels of
patient satisfaction with telemedicine consultations, citing convenience, reduced waiting
times, and increased access to specialists as key factors. Moreover, research by Kruse et
al. (2018) revealed that patients with chronic conditions, such as hypertension, reported
improved adherence to treatment plans when utilizing telemedicine services. These
findings highlight not only the convenience of telemedicine for patients but also its
potential to enhance patient engagement, self-management of chronic conditions.

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 Telemedicine in the Healthcare Delivery System

Telemedicine's Role in Emergency and Disaster Response

This paper emphasizes telemedicine's critical role in emergency and disaster

response scenarios. Studies by Latifi et al. (2020) and Khan et al. (2019) have
demonstrated how telemedicine platforms enable rapid communication between
healthcare providers during emergencies, facilitating real-time decision-making and
improving patient outcomes. Furthermore, research by Mirzaei et al. (2018) highlighted
the effectiveness of telemedicine in providing remote triage and consultation services
during natural disasters, ensuring timely medical assistance to affected populations.
These studies underline telemedicine's potential as a vital tool for enhancing disaster
preparedness and response, especially in situations where immediate medical care is
essential.

Future Directions and Innovations in Telemedicine

This paper provides exciting developments and future directions for
telemedicine in healthcare delivery. Research by Bashshur et al. (2016) discussed the
potential of telemedicine in expanding access to mental healthcare, particularly in
underserved communities. Similarly, studies by Dorsey and Topol (2016) and Bokolo
Anthony Jr (2020) explored the integration of mobile health technologies and wearable
devices with telemedicine platforms, enabling continuous remote monitoring of
patients' health parameters. These innovative approaches hold promise for
personalized, patient-centered care and improved health outcomes. Additionally, the
emergence of AI-driven telemedicine systems, as discussed by Agarwal et al. (2019),
opens avenues for predictive analytics, early disease detection, and precision medicine.
These advancements highlight the evolving landscape of telemedicine and its potential
to revolutionize healthcare delivery, paving the way for a more accessible and efficient
healthcare system.

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 Telemedicine in the Healthcare Delivery System

Challenges and Barriers to Telemedicine Adoption

This paper proposes the adoption of telemedicine in healthcare delivery faces
several challenges. Studies by Polinski et al. (2020) and Scott Kruse et al. (2018) They
identified barriers such as limited reimbursement policies, The concerns about data
security and privacy, and also the digital divide among patients. Additionally, the
research by Tuckson et al. (2017) highlighted the need for healthcare providers to receive
adequate training and support for telemedicine implementation. These findings
underscore the importance of addressing policy, infrastructure, and training issues to
ensure the widespread adoption and success of telemedicine in healthcare systems.

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 Telemedicine in the Healthcare Delivery System

Chapter 3

Description about Seminar Topic

3.1 Introduction

Healthcare delivery over long distances, especially in rural areas like India, is
crucial for improving access to medical services. The Indian Space Research
Organization (ISRO) plays a significant role in this endeavor through its advanced
satellite technology. ISRO's projects, such as Telemedicine/Tele-health, focus on
enhancing healthcare access in remote areas. Telemedicine enables remote diagnosis
and treatment, which not only reduces costs but also addresses the professional
isolation often faced by rural doctors. Since initiating Telemedicine projects in 2001,
ISRO has connected urban specialty hospitals with rural centers. Pilot projects, like
those linking Apollo Hospital with rural hospitals in Andhra Pradesh and Narayana
Hrudayalaya with hospitals in Karnataka, have demonstrated the effectiveness of this
approach. ISRO's emphasis is on introducing Telemedicine Technology through pilot
projects, ensuring that hospitals receive training for sustainable operations. Ultimately,
the goal is to empower rural healthcare facilities to efficiently provide specialty care,
thus bridging the gap in healthcare access.

Fig 3.1: Telemedicine Concept

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 Telemedicine in the Healthcare Delivery System

3.2 Technologies

Growth Drives and Technology Trends

Drivers of Growth:
 COVID 19: Societal demand

 Higher mobile and Internet penetration

 Government Policies

 Advanced and Emerging Technologies

 Role of Private players

 Accessibility, Affordability and Convenience

Fig 3.2.1: Drivers of Growth

Technology Trends & Emerging Technologies

In modern times technology is the primary driver of functionality in human

society. The development of cutting-edge technology such as Artificial Intelligence,
Augmented reality, Virtual reality etc. has actually enhanced the way we perform
task in recent past. At the same time, the evolvement of digital platforms, mobile
and e-healthcare technologies are leading to generate huge volume of data.
Availability of huge volume of digital health records will lead to the emergence of
advanced IT tools like Artificial Intelligence, Machine Learning, Big Data
analytics and also the technologies like Blockchain to secure the transfer of data.
Artificial Intelligence and Machine learning will help doctors to make faster
and more accurate decision about patient's health. Blockchain technologies
provide highly secure data transfers and data storage, which is paramount for
healthcare apps that store sensitive patient data. Internet of Medical Things
(IoMT) is one of the key enablers in connecting the various medical devices using
communication technologies and wireless networks. IoMT is an ecosystem of
smart devices like monitoring systems, sensor machines, and detectors that can

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 Telemedicine in the Healthcare Delivery System

capture real-time health information and can communicate with each other in a
real-time environment and convey results. The IoT health monitoring system
involves three major functions:
a. Identification and authentication

b. Sensing and Data collection

c. Tracking an object or patient

IoMT has devices which have intelligence and can collect data intelligently; they
can process this data and send it to the network. It offers the following advantages
to its users:
a. Fast computation

b. Easy to understand and analyze

c. Easy to implement

d. Widely deployed and better industry support

On the other hand, the need for the concept of health-cloud has emerged. Cloud
computing is one of the enablers which provides the facility to access shared
resources and common infrastructure in a ubiquitous manner, it also offers,
services on demand over the network to perform operations in electronic
healthcare application.

India has witnessed a rapid penetration of smartphones and internet over the last
decade or so. And therefore, the adoption of e- health / Telemedicine by wider range
of people in India is not so far.

The need to collect, store, and analyze patient data has driven the healthcare
industry to embrace various trending digital technologies. Mobile telemedicine is a
new and evolving area of wherein cellular systems has significantly enhanced
telemedicine services through the creation of a flexible and heterogeneous network,
and improved the quality, availability, and effectiveness of telemedicine. However,
the integration of emerging wireless solutions into healthcare through mobile

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 Telemedicine in the Healthcare Delivery System

devices leads to several challenges, like data storage and management (e.g.,
physical storage issues, availability and maintenance), interoperability, security
and privacy, unified and ubiquitous access.

While, telemedicine helps in capturing the information and providing appropriate

health advice immediately. GIS, can help model spread of diseases through
satellite imagery by isolating areas that are more susceptible to the disease spread
and analyze health related events in a wider perspective. Information gathering
using GIS tools will lead to understand the outbreak of an emerging infection in the
region or locality and hence can be prevented / control / better managed.

Some of the future trends that will emerge through the integration of ICT tools and
digitized health data are - analyzing patient's health record to enable remote
diagnosis, early diagnosis of disease through the use of data mining of digital
records, AI and ML tools which will analyse and provide valuable insights in
decision making .Remote health monitoring and delivery of services efficiently,
like performing tele-surgery using robots for a patient situated in a remote area by
a very specialized doctor using virtual augmented reality and also to attend many
other medical emergencies through the use of Virtual doctor, chatbots, and online
patient engagement tools using inter-device and inter-system communication
through the use of Internet of Medical Things ( IoMT) are some of the applications
which will empower the health care system to be efficient , connected and cost
effective.

Fig 3.2.2: Doctor to patient telemedicine system deployed under Ayushman Bharat
Scheme of Government of India

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 Telemedicine in the Healthcare Delivery System

Fig 3.2.3: Doctors working in remote peripheral hospitals

How Telemedicine Work:

1) You wake up with a bad sore throat and decide to see your doctor.
2) Your doctor examines you and thinks you need help from a specialist.
3) Instead of traveling far to see the specialist, your doctor arranges a video call using
telemedicine.
4) Through telemedicine, the specialist talks to you and your doctor to understand your
situation.
5) Your doctor uses a special camera to show the inside of your throat to the specialist.
6) The specialist can see your throat and vocal cords clearly in real-time.
7) They might ask you to cough or say certain sounds to help with the diagnosis.
8) Using this information, the specialist can quickly diagnose your condition and suggest
treatment.
9) Your doctor also learns from the specialist during the call, which helps them treat other
patients better.

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 Telemedicine in the Healthcare Delivery System

3.3 Advantages and

Disadvantages Advantages:

1. Increased Access to Healthcare: Telemedicine increases healthcare access by

overcoming geographical barriers, benefiting rural patients. It eliminates travel needs,
letting patients receive care remotely, saving time and costs. This virtual approach
bridges gaps, especially for those in remote areas with limited healthcare options.
2. Convenient for Patient: Telemedicine allows consultations from home or work,
reducing time off and travel needs. Flexible scheduling reduces wait times, improving
access to care. This convenience enhances patient engagement and healthcare
efficiency.
3. Cost-Effectiveness: Telemedicine cuts costs by eliminating travel and infrastructure
expenses. Early intervention reduces ER visits, optimizing resource use. This efficient
model improves healthcare affordability and sustainability.
4. Improved Continuity of Care: Telemedicine improves chronic care with easier
follow-ups and monitoring. Seamless data sharing among providers enhances care
quality. This collaborative approach enhances patient outcomes and treatment
effectiveness.
5. Enhanced Patient Engagement: Telemedicine encourages open communication for
sensitive topics at home. Educational tools empower patients to understand and
manage their health. This approach promotes patient engagement and self-care.
6. Reduce Wait Time: Telemedicine offers swift access to consultations, minimizing
wait times for treatment. It optimizes emergency care by prioritizing urgent cases
through remote triage. This efficiency ensures timely care for patients, especially in
critical situations.
7. Support Public Health Initiatives: Telemedicine enables remote consultations,
reducing virus transmission risks in pandemics. It also facilitates public health
monitoring, tracking trends for effective responses. This virtual model supports
efficient crisis management and enhances healthcare safety during emergencies.

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 Telemedicine in the Healthcare Delivery System

Disadvantages:

1. Limited Physical Examination: Telemedicine's limitations include inadequate

assessments due to no hands-on exams. Certain conditions necessitate physical
interaction for accurate diagnosis, posing diagnostic challenges. These limitations
can lead to missed diagnoses or incomplete evaluations in virtual consultations.

2. Technological Barriers: Telemedicine faces digital disparities, excluding patients

without reliable internet or devices. Technical issues, such as connectivity
problems or software glitches, can disrupt consultations, affecting access to care.
These challenges highlight the importance of addressing digital inequalities for
equitable healthcare delivery.
3. Privacy and Security Risks: Telemedicine risks data breaches, threatening patient
confidentiality. Adherence to strict privacy laws like HIPAA is crucial for
regulatory compliance. These concerns emphasize the need for robust security
measures to protect patient information.
4. Inequality in Access: The digital divide disadvantages those without technology
or internet access in telemedicine. Platforms may not cater to diverse languages or
cultural nuances, creating language and cultural barriers. These challenges
underscore the need for inclusive telemedicine solutions to address accessibility
and cultural diversity.
5. Patient-Provider Relationship Challenges: Telemedicine's drawback includes
reduced personal connection without in-person interaction, impacting rapport.
Virtual consultations may miss non-verbal cues crucial for communication
nuances. These limitations highlight the importance of balancing technology with
maintaining patient-provider relationships.

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 Telemedicine in the Healthcare Delivery System

3.4 Applications:

1. Remote Consultations:
Telemedicine enables patients to receive medical advice and diagnoses remotely.
Through video calls or phone consultations, healthcare providers offer treatment
recommendations. This virtual approach enhances accessibility and convenience for
patients. It is especially beneficial for minor ailments and follow-up care, reducing the
need for in-person visits.
2. Chronic Disease Management:
Telemedicine facilitates remote monitoring for chronic conditions like diabetes
and hypertension. Healthcare providers can intervene promptly and adjust treatment plans
as needed. This approach improves patient outcomes by ensuring timely adjustments to
care. It also reduces the need for frequent in-person visits, enhancing convenience for
patients.
3. Telepsychiatry and Behavioral Health:
Telemedicine empowers mental health professionals to conduct therapy sessions
remotely. This allows for convenient access to care for patients, especially those in
remote areas. Remote assessments and consultations enhance mental health services'
reach and effectiveness. Patients can receive therapy from the comfort of their homes,
reducing barriers to seeking help. This virtual approach promotes better mental well-
being and treatment adherence.
4. Specialist Consultation:
Telemedicine enables patients to consult specialists remotely in fields like
cardiology and neurology. Expert opinions are accessible without the need for travel,
improving healthcare access. This virtual approach benefits patients by saving time and
costs associated with travel. Specialists can provide timely advice and recommendations
from a distance. It also enhances collaboration between primary care providers and
specialists for comprehensive care.

These applications demonstrate how telemedicine is utilized across various

healthcare settings to improve access, efficiently and quality of care for patients

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 Telemedicine in the Healthcare Delivery System

Chapter 4

Conclusion and Future Scope

The covid-19 pandemic has underscored the critical role of telemedicine in modern
healthcare delivery, demonstrating both its advantages and limitations to physicians and
patients alike. While technological and implementation challenges persist, the urgent
need for an enhanced digital communication infrastructure has become evident.
Addressing the rural-urban divide in access to healthcare through telemedicine
necessitates significant improvements in data communication infrastructure. Furthermore,
the shortage of adequately trained manpower presents a barrier to the widespread
adoption of digital health services. Overcoming these challenges requires a concerted
effort to ensure economic empowerment and educational accessibility for all members of
society, enabling the effective utilization of telemedicine technologies.

Despite existing barriers, telemedicine remains a vital component of modern

healthcare services. With the telemedicine industry projected to experience substantial
growth, there is immense potential for innovation and advancement in this field. India, as
a late entrant, has the opportunity to leverage global best practices and implement
emerging technologies tailored to its specific needs. Recommendations for the future
include the establishment of a connected healthcare system, adoption of interoperable
standardized data formats, and ensuring compliance with security and privacy
regulations. The deployment of 5G and satellite-based networks will further enhance
accessibility, enabling the efficient practice of telemedicine applications such as
telesurgery and tele-ICU. Collaboration between private players and the government,
along with the integration of telemedicine with homecare services, is essential for
ensuring affordability and efficiency. Leveraging advanced technologies such as AI,
analytics, and blockchain will drive the evolution of telemedicine towards Health 4.0. It is
imperative to ensure equitable access to telemedicine services, particularly for
marginalized communities, while leveraging open-source libraries to reduce deployment
costs. Endorsing telemedicine within the medical insurance system and aligning
telehealth standards with global norms will further support its widespread adoption and
integration into mainstream healthcare practices.

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REFERENCES

[1] Ganapathy K. Neurosurgeon, Apollo Hospitals, Chennai, Telemedicine in

India-the Apollo experience, Neurosurgery on the Web. 2001.

[2] Bashshur RL, Armstrong PA, Youssef ZI. Telemedicine: Explorations in

the use of telecommunications in health care. Springfield, IL: Charles C

Thomas; 1975.

[3] Bashshur R, Lovett J. Assessment of telemedicine: Results of the initial

experience. Aviation Space Environ Med. 1977; 48:65-70.

[4] Bashshur R. Superintendent of Documents. Washington DC: US

Government Printing Office; 1980. Technology serves the people: The story

of a cooperative telemedicine project by NASA, the Indian Health Service

and the Papago people.

[5] Watson DS. Telemedicine. Med J Aust. 1989; 151:62-66. 8,71. [PubMed]

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