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Nursing Home Telemedicine: Geriatrics

Through a contract with Samsung SDS of Korea, a team at the University of Iowa has developed a Nursing Home Telemedicine system. Team members were Gerald Jogerst, MD and Jeanette Daly, RN, PhD from the Department of Family Medicine, John Park, MD a visiting physician from Korea, Daniel Kang and Taehee Bae from Samsung SDS, Seoul, Korea. 

The nursing home telehealth system has been branded as e-TeleHealth. It is a rollabout system that houses electronic equipment including a computer, monitor on a moveable arm, and video-conferencing system (See Figure 1). It also includes an electronic stethoscope, otoscope, dermascope, dentalscope, and EKG (See Figure 2). Transmission for the rollabout is a wireless network system and equipment can be plugged into any electrical outlet. The rollabout was developed to move around in the nursing home allowing it to be taken to a resident's bedside. 

The system provides full interactive live video and audio capacity. A nurse practitioner, dentist, or physician can be in their office or home and access the e-TeleHealth web site with their own personal computer system to carry out a live telehealth visit. The nursing home telehealth system hardware configuration consists of two units: the base station unit at the nursing home and a consultant's unit. The consultant's unit is used at the consulting provider's end (nurse practitioner, specialist, physician, dentist, pharmacist, etc.). At the facility, the base station unit includes the rollabout, information management program for the resident's data, and the network for broadband Internet. The base station can accept variable Internet lines such as cable modem, Digital Subscriber Line (DSL), T-carrier system (FT1, T1) or a satellite Internet (see Figure 3). The unique feature of this system is the capability to connect to cable modem or DSL. At the consulting provider's end it includes a computer with a videoconferencing system, telehealth program for consulting provider, stethoscope receiver and Internet connection (preference is for a broadband Internet line). 

Each piece of equipment on the rollabout operates independently of the other. The otoscope, dermascope and dental scope are connected to a main unit that provides a light source that is easily adjusted for illumination. There is a focus mechanism on the device and for safety there is a protective cap to place on the end of the otoscope. The 12-lead ECG has the operation modes of monitoring, recording and copying. Its application is the same as other ECG machines. 

At this time, a test site with e-TeleHealth is ongoing at Colonial Manor in Amana, Iowa. 
Figure 1. e-TeleHealthTM (Rollabout with Electronic Equipment)
Figure 2. Electronic Medical Equipment and Captured Images
Figure 3. Rollabout in the Nursing Home and Internet Connection