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Research Challenges and Opportunities Towards a Holistic View of Telemedicine Systems: A Systematic Review

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Enhanced Telemedicine and e-Health

Part of the book series: Studies in Fuzziness and Soft Computing ((STUDFUZZ,volume 410))

Abstract

The latest advances in information technologies have fostered more innovative Telemedicine systems that provide high-quality medical screening and diagnostics to patients anytime, anywhere. These new developments have drawn significant attention, especially in underserved communities as well as during crises and emergencies. However, in order to successfully implement these technologies and provide adequate care, various challenges need to be tackled. For instance, networking techniques must be improved to optimize bandwidth, frequency, and data transmission. In addition, these technologies must implement robust security features in order to maintain patients’ privacy. Throughout this chapter, the authors present recent developments in Telemedicine and provide a detailed taxonomy to classify the different components forming Telemedicine. Additionally, we investigate the challenges in designing effective Telemedicine systems for all types of users. Furthermore, we highlight a holistic view that can guide the future development and design of Telemedicine systems, enhancing the user experience of both patients and healthcare providers. This research effort suggests the need for systematic perspectives to enhance the current Telemedicine systems with regards to models, frameworks, guidelines, and management decision-making processes. Nevertheless, several challenges respect to design strategies, communication management, reliability, availability, and maintainability still exist.

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References

  1. J. Craig, V. Petterson, Introduction to the practice of telemedicine. J. Telemed. Telecare 11(1), 3–9 (2005)

    Article  Google Scholar 

  2. A. Panayides, I. Eleftheriou, M. Pantziaris, Open-source telemedicine platform for wireless medical video communication. Int. J. Telemed. Appl. (2013)

    Google Scholar 

  3. R.L. Bashshur, G.W. Shannon, B.R. Smith, D.C. Alverson, N. Antoniotti, W.G. Barsan, N. Bashshur et al., The empirical foundations of telemedicine interventions for chronic disease management. Telemed. e-Health 20(9), 769–800 (2014)

    Article  Google Scholar 

  4. C. Combi, G. Pozzani, G. Pozzi, Telemedicine for developing countries: a survey and some design issues. Appl. Clin. Inf. 7(4), 1025 (2016)

    Article  Google Scholar 

  5. L. Russo, I. Campagna, B. Ferretti, E. Pandolfi, E. Carloni, A. D’Ambrosio, F. Gesualdo, A. Tozzi et al., What drives attitude towards telemedicine among families of pediatric patients? A survey. BMC Pediatri. 17(1), 21 (2017)

    Article  Google Scholar 

  6. K.C. Vranas, C.G. Slatore, M.P. Kerlin, Telemedicine coverage of intensive care units: a narrative review. Ann. Am. Thorac. Soc. 15(11), 1256–1264 (2018)

    Article  Google Scholar 

  7. J. Bains, P.W. Greenwald, M.R. Mulcare, D. Leyden, J. Kim, A.J. Shemesh, D. Bodnar, et al., Utilizing telemedicine in a novel approach to Covid-19 management and patient experience in the emergency department. Telemed. E-Health (2020)

    Google Scholar 

  8. K.N. Ray, L.E. Ashcraft, A. Mehrotra, E. Miller, J.M. Kahn, Family perspectives on telemedicine for pediatric subspecialty care. Telemed. E-Health 23(10), 852–862 (2017)

    Article  Google Scholar 

  9. Y.J. Chuna, P.E. Patterson, A suggestion for future research on interface design of an internet-based telemedicine system for the elderly. Work 41(Supplement 1), 353–356 (2012)

    Article  Google Scholar 

  10. J. Gogan, M. Garfield, R. Baxter, Seeing a patient’s eyes: system trust in telemedicine. BLED 2009 Proc. 33 (2009)

    Google Scholar 

  11. L. Van Velsen, S. Wildevuur, I. Flierman, B. Van Schooten, M. Tabak, H. Hermens, Trust in telemedicine portals for rehabilitation care: an exploratory focus group study with patients and healthcare professionals. BMC Med. Inform. Decis. Mak. 16(1), 1–12 (2015)

    Article  Google Scholar 

  12. G.-M. Breen, J. Matusitz, An evolutionary examination of telemedicine: a health and computer-mediated communication perspective. Soc. Work Pub. Health 25(1), 59–71 (2010)

    Article  Google Scholar 

  13. B. Kitchenham, O. Pearl Brereton, D. Budgen, M. Turner, J. Bailey, S. Linkman, Systematic literature reviews in software engineering—a systematic literature review. Inf. Softw. Technol. 51(1), 7–15 (2009)

    Article  Google Scholar 

  14. I.S. Bajwa, Virtual telemedicine using natural language processing. Int. J. Inf. Technol. Web Eng. (IJITWE) 5(1), 43–55 (2010)

    Article  MathSciNet  Google Scholar 

  15. C. Kuziemsky, A.J. Maeder, O. John, S.B. Gogia, A. Basu, S. Meher, M. Ito, Role of artificial intelligence within the telehealth domain: official 2019 yearbook contribution by the members of Imia telehealth working group. Yearb. Med. Inf. 28(1), 35 (2019)

    Article  Google Scholar 

  16. K. Seetharam, N. Kagiyama, P.P. Sengupta, Application of mobile health, telemedicine and artificial intelligence to echocardiography. Echo Res. Pract. 6(2), R41–R52 (2019)

    Article  Google Scholar 

  17. D.M.M. Pacis, E.D.C. Subido Jr, N.T. Bugtai, in AIP Conference Proceedings. Trends in Telemedicine Utilizing Artificial Intelligence, vol. 1, 1933:040009 (AIP Publishing LLC, 2018)

    Google Scholar 

  18. A. Fadhil, Beyond Patient Monitoring: Conversational Agents Role in Telemedicine & Healthcare Support for Home-Living Elderly Individuals (2018). arXiv Preprint arXiv:1803.06000

  19. D.S.J. Ting, M. Ang, J.S. Mehta, D. Shu Wei Ting, in Artificial Intelligence-Assisted Telemedicine Platform for Cataract Screening and Management: A Potential Model of Care for Global Eye Health (BMJ Publishing Group Ltd., 2019)

    Google Scholar 

  20. Y. Rivenson, H.C. Koydemir, H. Wang, Z. Wei, Z. Ren, H. Günaydın, Y. Zhang et al., Deep learning enhanced mobile-phone microscopy. Acs Photonics 5(6), 2354–2364 (2018)

    Article  Google Scholar 

  21. E.T. Chen, in Impacts of Information Technology on Patient Care and Empowerment. Deep Learning and Sustainable Telemedicine (IGI Global, 2020), pp. 137–154

    Google Scholar 

  22. D.S.J. Ting, V.H.X. Foo, L.W.Y. Yang, J.T. Sia, M. Ang, H. Lin, J. Chodosh, J. Mehta, D.S.W. Ting, Artificial intelligence for anterior segment diseases: emerging applications in ophthalmology. Br. J. Ophthalmol. (2020)

    Google Scholar 

  23. X. Wu, Y. Huang, Z. Liu, W. Lai, E. Long, K. Zhang, J. Jiang et al., Universal artificial intelligence platform for collaborative management of cataracts. Br. J. Ophthalmol. 103(11), 1553–1560 (2019)

    Article  Google Scholar 

  24. A. Eren, A. Subasi, O. Coskun, A decision support system for telemedicine through the mobile telecommunications platform. J. Med. Syst. 32(1), 31–35 (2008)

    Article  Google Scholar 

  25. G. Pravettoni, R. Folgieri, C. Lucchiari, in Tele-Oncology. Cognitive Science in Telemedicine: From Psychology to Artificial Intelligence (Springer, 2015), pp. 5–22

    Google Scholar 

  26. D. D’Amario, F. Canonico, D. Rodolico, J.A. Borovac, R. Vergallo, R. Antonio Montone, M. Galli, et al., Telemedicine, artificial intelligence and humanisation of clinical pathways in heart failure management: back to the future and beyond. Card. Fail. Rev. 6 (2020)

    Google Scholar 

  27. R.D. Kindle, O. Badawi, L.A. Celi, S. Sturland, Intensive care unit telemedicine in the era of big data, artificial intelligence, and computer clinical decision support systems. Crit. Care Clin. 35(3), 483–495 (2019)

    Article  Google Scholar 

  28. F.E. Ferrante, Evolving telemedicine/ehealth technology. Telemed. J. E-Health 11(3), 370–383 (2005)

    Article  Google Scholar 

  29. N. Ali, O. Khalifa, A. Abd Manaf, ICT in telemedicine: conquering privacy and security issues in health care services. Electron. J. Comput. Sci. Inf. Technol. eJCIST 4(1) (2013)

    Google Scholar 

  30. W.R. Smith, A.J. Atala, R.P. Terlecki, E.E. Kelly, C.A. Matthews, Implementation guide for rapid integration of an outpatient telemedicine program during the Covid-19 pandemic. J. Am. Coll. Surg. (2020)

    Google Scholar 

  31. M.J.C. Samonte, V. Aguilar, A.K. Marino, R. Tolentino, InTelect: interactive telemedicine communication technologies mobile App. MS&E 482(1), 012022 (2019)

    Google Scholar 

  32. K.A. Kessel, M.M.E. Vogel, F. Schmidt-Graf, S.E. Combs, Mobile apps in oncology: a survey on health care professionals’ attitude toward telemedicine, mHealth, and oncological apps. J. Med. Int. Res. 18(11), e312 (2016)

    Google Scholar 

  33. F.-A. Allaert, N. Louis Legrand, A. Carime, C. Quantin, Will applications on smartphones allow a generalization of telemedicine? BMC Med. Inform. Decis. Mak. 20(1), 30 (2020)

    Article  Google Scholar 

  34. D.-w. Kim, J.-y. Choi, K.-h. Han, Risk management-based security evaluation model for telemedicine systems. BMC Med. Inform. Decis. Mak. 20(1), 1–14 (2020)

    Article  Google Scholar 

  35. Wei-Yen Hsu, Brain–computer interface connected to telemedicine and telecommunication in virtual reality applications. Telemat. Inform. 34(4), 224–238 (2017)

    Article  Google Scholar 

  36. H. Ji, J. Wang, J. Gao, X. Liu, in 2016 Ieee Advanced Information Management, Communicates, Electronic and Automation Control Conference (Imcec). Research on Telemedicine Technology and Implement Based on Virtual Reality (IEEE, 2016), pp. 1581–1586

    Google Scholar 

  37. R.P. Singh, M. Javaid, R. Kataria, M. Tyagi, A. Haleem, R. Suman, Significant applications of virtual reality for Covid-19 pandemic. Diab. Metab. Syndr. Clin. Res. Rev. (2020)

    Google Scholar 

  38. S. Wang, M. Parsons, J. Stone-McLean, P. Rogers, S. Boyd, K. Hoover, O. Meruvia-Pastor, M. Gong, A. Smith, Augmented reality as a telemedicine platform for remote procedural training. Sensors 17(10), 2294 (2017)

    Article  Google Scholar 

  39. D. Anton, G. Kurillo, A.Y. Yang, R. Bajcsy, in International Conference on Multimedia Modeling. Augmented Telemedicine Platform for Real-Time Remote Medical Consultation (Springer, 2017), pp. 77–89

    Google Scholar 

  40. P. Bifulco, F. Narducci, R. Vertucci, P. Ambruosi, M. Cesarelli, M. Romano, Telemedicine supported by augmented reality: an interactive guide for untrained people in performing an Ecg test. Biomed. Eng. Online 13(1), 153 (2014)

    Article  Google Scholar 

  41. J. Wosik, M. Fudim, B. Cameron, Z. Gellad, A. Cho, D. Phinney, S. Curtis et al., Telehealth transformation: COVID-19 and the rise of virtual care. J. Am. Med. Inform. Assoc. 27(6), 957–962 (2020)

    Article  Google Scholar 

  42. S. Saravanan, P. Sudhakar, Telemedicine system using mobile internet communication. Int. J. Pervasive Comput. Commun. (2020)

    Google Scholar 

  43. C.S. Kruse, K. Lee, J.B. Watson, L.G. Lobo, A.G. Stoppelmoor, S.E. Oyibo, Measures of effectiveness, efficiency, and quality of telemedicine in the management of alcohol abuse, addiction, and rehabilitation: systematic review. J. Med. Internet Res. 22(1), e13252 (2020)

    Article  Google Scholar 

  44. R.S. Weinstein, A.M. Lopez, B.A. Joseph, K.A. Erps, M. Holcomb, G.P. Barker, E.A. Krupinski, Telemedicine, telehealth, and mobile health applications that work: opportunities and barriers. Am. J. Med. 127(3), 183–187 (2014)

    Article  Google Scholar 

  45. K.G. Mayoka, A.S. Rwashana, V.W. Mbarika, S. Isabalija, A framework for designing sustainable telemedicine information systems in developing countries. J. Syst. Inform. Technol. (2012)

    Google Scholar 

  46. A. Galletta, L. Carnevale, A. Bramanti, M. Fazio, An innovative methodology for big data visualization for telemedicine. IEEE Trans. Industr. Inf. 15(1), 490–497 (2018)

    Article  Google Scholar 

  47. W. Xiang, G. Wang, M. Pickering, Y. Zhang, Big video data for light-field-based 3D telemedicine. IEEE Netw. 30(3), 30–38 (2016)

    Article  Google Scholar 

  48. R.A. Dixit, S. Hurst, K.T. Adams, C. Boxley, K. Lysen-Hendershot, S.S. Bennett, E. Booker, R.M. Ratwani, Case report: rapid development of visualization dashboards to enhance situation awareness of Covid-19 telehealth initiatives at a multi-hospital healthcare system. J. Am. Med. Inform. Ass. (2020)

    Google Scholar 

  49. K.S. Gill, S. Saxena, A. Sharma, in 2019 Amity International Conference on Artificial Intelligence (Aicai) (IEEE, 2019). Taxonomy of Security Attacks on Cloud Environment: A Case Study on Telemedicine, pp. 454–460

    Google Scholar 

  50. Zhang Qikun, Gan Yong, Zhang Quanxin, Wang Ruifang, Tan Yu-An, A dynamic and cross-domain authentication asymmetric group key agreement in telemedicine application. IEEE Access 6, 24064–24074 (2018)

    Article  Google Scholar 

  51. D. Mahto, D.K. Yadav, Cloud-based secure telemedicine information system using crypto-biometric techniques. EAI Endorsed Trans. Pervasive Health Technol. 5(20), e3 (2020)

    Article  Google Scholar 

  52. T. Buldakova, D. Krivosheeva, S. Suyatinov (2019), in 2019 Xxi International Conference Complex Systems: Control and Modeling Problems (Cscmp). Hierarchical Model of the Network Interaction Representation in the Telemedicine System (IEEE, 2019), pp. 379–383

    Google Scholar 

  53. M. Kamel, S. Fawzy, A. El-Bialy, A. Kandil, in 2011 1st Middle East Conference on Biomedical Engineering (IEEE, 2011). Secure Remote Patient Monitoring System, pp. 339–342

    Google Scholar 

  54. S.J. Devaraj, K. Ezra, in 2011 3rd International Conference on Electronics Computer Technology. Current Trends and Future Challenges in Wireless Telemedicine System, vol. 4 (IEEE, 2011), pp. 417–421

    Google Scholar 

  55. M. Nakamura, S. Kubota, H. Takagi, K. Einaga, M. Yokoyama, K. Mochizuki, M. Takizawa, S. Murase, Development of long-range and high-speed wireless lan for the transmission of telemedicine from disaster areas. EURASIP J. Wirel. Commun. Networking 2008, 1–13 (2007)

    Google Scholar 

  56. A. Hamid, H. Abdulaziz, S. Mizanur, M.S. Rahman, A.A. Hossain, A. Alamri, A security model for preserving the privacy of medical big data in a healthcare cloud using a fog computing facility with pairing-based cryptography. IEEE Access 5, 22313–22328 (2017)

    Article  Google Scholar 

  57. R.M. Seepers, C. Strydis, I. Sourdis, C. De Zeeuw, Enhancing heart-beat-based security for Mhealth applications. IEEE J. Biomed. Health Inform. 21(1), 254–262 (2015)

    Article  Google Scholar 

  58. T. Li, Y. Liu, N.N. Xiong, A. Liu, Z. Cai, H. Song, Privacy-preserving protocol for sink node location in telemedicine networks. IEEE Access 6, 42886–42903 (2018)

    Article  Google Scholar 

  59. M. Li, Y. Shucheng, Y. Zheng, K. Ren, W. Lou, Scalable and secure sharing of personal health records in cloud computing using attribute-based encryption. IEEE Trans. Parallel Distrib. Syst. 24(1), 131–143 (2012)

    Article  Google Scholar 

  60. R. Sánchez-Guerrero, F.A. Mendoza, D. Diaz-Sanchez, P.A. Cabarcos, A. Marı́n López, Collaborative Ehealth meets security: privacy-enhancing patient profile management. IEEE J. Biomed. Health Inform. 21(6), 1741–1749 (2017)

    Article  Google Scholar 

  61. A. Roehrs, C. André da Costa, R. da Rosa Righi, OmniPHR: a distributed architecture model to integrate personal health records. J. Biomed. Inform. 71, 70–81 (2017)

    Article  Google Scholar 

  62. F. Rezaeibagha, M. Yi, Practical and secure telemedicine systems for user mobility. J. Biomed. Inform. 78, 24–32 (2018)

    Article  Google Scholar 

  63. M.A. Simplicio, L.H. Iwaya, B.M. Barros, T.C.M.B. Carvalho, M. Näslund, SecourHealth: a delay-tolerant security framework for mobile health data collection. IEEE J. Biomed. Health Inform. 19(2), 761–772 (2014)

    Article  Google Scholar 

  64. N.M. Thamrin, I. Ahmad, M.K. Hani, in International Conference on Information Society (I-Society 2011). A Secure Field Programmable Gate Array Based System-on-Chip for Telemedicine Application (IEEE, 2011), pp. 105–109

    Google Scholar 

  65. S. Al-Sharhan, E. Omran, K. Lari, An integrated holistic model for an ehealth system: a national implementation approach and a new cloud-based security model. Int. J. Inf. Manage. 47, 121–130 (2019)

    Article  Google Scholar 

  66. R. Guo, H. Shi, D. Zheng, C. Jing, C. Zhuang, Z. Wang, Flexible and efficient blockchain-based abe scheme with multi-authority for medical on demand in telemedicine system. IEEE Access 7, 88012–88025 (2019)

    Article  Google Scholar 

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Correspondence to Asadullah Shaikh .

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Alelyani, T., Shaikh, A., Sulaiman, A.A., Asiri, Y., Alshahrani, H., Almakdi, S. (2021). Research Challenges and Opportunities Towards a Holistic View of Telemedicine Systems: A Systematic Review. In: Marques, G., Kumar Bhoi, A., de la Torre Díez, I., Garcia-Zapirain, B. (eds) Enhanced Telemedicine and e-Health. Studies in Fuzziness and Soft Computing, vol 410. Springer, Cham. https://doi.org/10.1007/978-3-030-70111-6_1

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