Telemedicine Training Outline

This training programme is aimed at both health workers who will be using Telemedicine techniques as part of their clinical practice and key support
personnel working in the field of telemedicine or telehealth. It is intended that the training programme will be flexible and modular allowing units to be
selected and combined depending on the participating target group.

Mission

To develop a workforce with a practical working knowledge of Telemedicine and competence in the ethical use of Telemedicine and Tele-education.

Objectives

By the end of the Training the participants should be able to competently:

 Access and search for information on the internet
 Send and receive emails (including attachments)
 Take and forward high quality digital photographs
 Demonstrate the ability to perform basic picture editing
 Demonstrate skill in the use of digital scanning equipment
 Demonstrate skill in the use of a document camera
 Use programs such as Skype or similar VOIP software
 Apply various techniques involved in synchronous telemedicine
 Apply various techniques involved in store and forward telemedicine
 Understand how to design and set up a telemedicine consultation venue
 Understand how to design and set up a tele-education videoconference venue
 Understand how to use and troubleshoot videoconferencing equipment
 Be able to set up point to point and multipoint videoconference using ISDN, IP and mixed ISDN and IP links
 Demonstrate the use of video camera technology, camera placement, lighting, angles and framing.
 Demonstrate an understanding and the use of; microphone technology; the range of available microphones; microphone set up; and solving audio
problems associated with videoconferencing.
 Understand the use of peripheral diagnostic equipment (tele-stethoscopes, ophthalmoscopes, dermascopes, ENT scopes, hand-held cameras and
ultrasound probes)
 Demonstrate skill in use of peripheral diagnostic equipment (tele-stethoscopes, ophthalmoscopes, dermascopes, ENT scopes, hand-held cameras
and ultrasound probes) where appropriate
 Apply any Telemedicine activity according to relevant ethical and clinical guidelines
 Demonstrate an understanding of ethical issues relating to telemedicine
 Demonstrate an understanding of ethical issues relating to the practice of telemedicine
 Demonstrate an understanding of relevant local and regional legislative issues
 Demonstrate an understanding of financial and administrative issues relevant to the practice of telemedicine in their region
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Pre-requisite

A basic level of computer literacy (see outcomes listed in unit 1). If participants do not meet these basic criteria – the pre-module Unit 1 has to be
completed.

Teaching Methodology

A mixture of information sessions / lectures and practical sessions

Units

The programme is made up of units, which can be combined depending on the learning needs of the target groups.
The programme also has key strands, which thread through all the modules and require reflection at the end of each module:
- Ethics in Telemedicine
- Computer skills

The units, including the introduction to computing, total up to 21 hours and can be put together to create workshops ranging from a half day to 3 days
depending on the target group and the purpose of the training.

In addition, specialist Telemedicine Units can be made available in the specialist areas of:

 Telepsychiatry
 Teledermatology
 Teleradiology
 Ultrasonography
 Ophthalmology

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Unit Outcomes Training Strategies Resources

On completion of the unit participants will Information Session: 1 hour PowerPoint Slides
Unit 1
be able to: Data projector
Introduction to  What is a computer Computer
Computers.  Identify the relevant components of a  Basic Internet and email Resource manual
computer  Basic filing (Intel training disk)
3 hours  Use a mouse  Basic MS Word
 Create a word document  Introduction to the Web
Prerequisite: None  Send an email
 Save a document to hard drive Practical Session: 2 hours
 Save a document to a memory stick
 Open web browser Individual sessions in front of a computer
- Computer: 1 per
 Conduct a Google search Activities
participant
 Turning on a computer - Internet access
 Do a mouse exercise - email address
 Create a word document - Web browser
 Create a folder and file word document - MS Office or
 Search for „Telemedicine” on the Web equivalent
 Print out article - Memory stick
 Transfer files to a memory stick - Intel or similar
 Send an email training CD

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Unit Outcomes Training Strategies Resources

On completion of the unit participants will
Unit 2
be able to:
Introduction to  Differentiate between telemedicine,
Telemedicine tele-education and teleconferencing
 Differentiate between synchronous and
1 hour asynchronous Telemedicine
 Describe the features of synchronous
Prerequisite: telemedicine
Unit 1  Describe the features of store and
forward telemedicine
 Identify core obstacles to the
implementation of Telemedicine in
their own country
 Identify the cost and administration
implications of Telemedicine
 Discuss the requirements of a needs
assessment
 Discuss the requirements of programme
evaluation
Information Session: 1 hour PowerPoint Slides
Data projector
 History of telemedicine Computer
 Concepts, Definitions / acronyms Resource manual
 Features of synchronous telemedicine
 Features of store and forward telemedicine
 Types of Telemedicine
 Costs and administration
 Images, DICOM and PACS
 Tele-education
 Strengths and Weaknesses of telemedicine – what evidence?
 Telemedicine needs assessment
 Telemedicine evaluation
 Ethics, law and standards as issues
 Medical informatics and the Electronic patient record
 Specialties: Radiology, Dermatology, Home-based Care,
Ultrasound, Psychiatry
 The Future

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Unit Outcomes Training Strategies Resources

On completion of the unit participants will Information Session: 1 hour PowerPoint Slides
Unit 3
be able to: Data projector
Ethics and Law in  Patient physician relationship Computer
Telemedicine  List and discuss the key ethical issues  Informed Consent Resource manual
in Telemedicine  Confidentiality and privacy Case studies
1 hour  Identify the relevant Health Legislation  Quality of care
that governs the practice of  Standards - adequacy and quality of data Readings
Prerequisite: Telemedicine  Continuum of care Ethics
Unit 1  Identify issues relating to international Legislation
 Data security
practice of telemedicine  Liability
 Licensure
 Record keeping
 Protocols
 Tele-medical Law
 Prescriptions and electronic signatures

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Unit Outcomes Training Strategies Resources

On completion of the unit participants will Information Session: 1 hour (In the absence of equipment) PowerPoint Slides
Unit 4
be able to: Data projector
Setting up venues Practical Session: 2 hours Computer
 Set up a telemedicine consultation Resource manual
2 hours venue  Set up a Telemedicine venue and discuss
 Set up a tele-education videoconference o Location Reading:
Prerequisite: (VC) venue o Access Telemedicine & Tel-
Unit 1  Use and troubleshoot VC equipment o Equipment as per small clinic education venue
 Set up point to point and multipoint VC o Physical characteristics (sound proofing, lighting) design principles
using ISDN, IP and mixed ISDN and IP o Equipment (video conference equipment, accessory video-
links camera, portable microphone) Equipment
 Demonstrate an understanding of: the o Telemedicine diagnostic equipment Telemedicine and
use of video camera technology; o Room layout Tele-education rooms
camera placement; lighting; angles and o Connect available tele-diagnostic equipment - VC equipment,
framing. o Basic trouble shhoting Accessory video-
 Demonstrate an understanding of the : camera
the use of microphone technology; the  Set up Tele-education venue and discuss - Portable
range of microphones; microphone set o Location microphone
up; and solving audio problems o Access - Document camera
associated with VC o Size of target group - Phone
o Equipment as per teaching - Fax
 Understand the connection of
peripheral diagnostic equipment (tele- o Physical characteristics (sound proofing, lighting, - Computer
acoustics) - External speakers,
stethoscopes, opthalmoscopes,
o Equipment (video conference equipment, external Radio
dermascopes, etc)
speakers, radio microphones, data projector, audiomixer) microphones,
o Room layout - Data projector,
o Basic trouble shooting Audiomixer
- Tele-diagnostic
equipment

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Unit Outcomes Training Strategies Resources

On completion of the unit participants will Information Session and demos: 1 hour PowerPoint Slides
Unit 5
be able to: Data projector
Basic Telemedicine :  How do you get access – communication options Computer
Skills - demystifying o Dial up, broad band, wireless, phone cards, phones Resource manual
the world of  Identify the different computer options o Modem, LANs, VPN
technology. available and the relevant advantages  What skills are needed Readings
and disadvantages of each  Computers
 Identify the different kinds of access to o Desktops vs Laptop vs Tablets vs PC vs Smart Phone Equipment:
1 hour Internet and email available locally  Basic requirements for PCs Flash cards
 Discuss different communication o Sound Laptop
options o Memory Tablets
Prerequisite:  Discuss the latest ICTs such as mobile o Monitor Smart Phone
Unit 1 phones, PDAs o Resolution PDA
o CD/DVDs Wired LAN
 Storage connection
o Hard drives Wireless connection
o Flash-cards, CD/DVDs 3G/GPRS card
 Good Practice
o Back up, Virus protection, Security
 mHealth
o Smart Phones
o PDAs
 Health Information Systems and Medical Informatics

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Unit Outcomes Training Strategies Resources

On completion of the unit participants will Information Session with demos: 30 minutes PowerPoint Slides
Unit 6
be able to: Data projector
Basic Skills – Use of  Internet history Computer
the Internet (1)  Understand how the internet work  How the internet works Resource manual
 Select an appropriate browser option o Browser options
1 hour and 30  Access the internet to: o Search engines
minutes o Do a literature search o Protocols
o Download software  What is available
Prerequisite: o Use an IP based educational o Literature search
Unit 1 software package o Internet distance learning
Unit 5 o Web pages
o E-learning packages
o Downloading software
o IP based internet educational software (Breeze, Illuminate)
o Blogs
o Future of Internet
- Computer: 1 per
Practical Session: 1 hour participant
- Internet access
 Individual activity - email address
 Access internet and do the following: - web access
o Do a literature search on Telemedicine on Pubmed, - web browser
Google, Google Scholar and Wikipedia - sound card
o Do an online educational activity - headphones
o View a blog - Online Educational
Package loaded

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Unit Outcomes Training Strategies Resources

On completion of the unit participants will Information session: 30 minutes PowerPoint Slides
Unit 7
be able to: Data projector
Basic Skills – Use of  Service Providers Computer
Email (2)  Set up a web based email address eg. o Costs Resource manual
Gmail o SMTP and POP
1 hour and 30  Send an email to another participant  Types of email servers
minutes  Send an email with an attachment to o Web based vs Outlook vs Express
another participant  Use of email
 Start a chat conversation with another o Contacts and groups
Prerequisite: participant o Attachments & file size (file compression)
Unit 1  Identify the risks and ethical issues of o File extensions eg. pdf, jpg, doc etc.
Unit 5 email communication.  Other communication technologies
Unit 6  Develop a contact list o Chat
 Develop a group contact list o VOIP
 Set up email rules o Podcasts
 Track the delivery and status of an  Managing emails
email o Filing
 Archive emails o Viruses & Security
 Use Skype o Tracking
o Archiving

Practical Session: 1 hour - Computer: 1 per

participant
 Set up a Gmail or similar account - Internet access
- email address
 Send an email
- web access
 Compression of attachments
- web browser
 Create a contact list and group
- sound card
 Chat - headphones
 Set up an email rule for going on holiday - Skype
 Listen to a podcast - Podcast on server
 Use Skype to call and chat

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Unit Outcomes Training Strategies Resources

Information Session (1 hrs) PowerPoint Slides

Unit 8
On completion of the unit participants will Data projector
be able to:  Comparison of digital and film cameras Computer
Basic Skills: Digital  Considerations when buying a camera Resource manual
photography  Choose a camera for their special needs o Budget
 Identify the main components of the o Ease of use
camera  Main Components of a digital camera
Time: 3 hours  Understand different types of memory  Memory and memory cards
 Select from a range of file formats  Graphic File formats for saving images
 Compress photographs to reduce file size  File size and image quality
 Edit picture to improve quality  When to use flash
Prerequisite:  Use a flash when appropriate  Macro Photography
Unit 1  Differentiate between optical and digital  Optical vs digital zoom
zoom  Transfer of images from the camera or memory card to a
 Use the macro feature computer
 Transfer image files from camera to  Enhancement of images using a computer and graphic software
computer  Storage
 Use a flat bed scanners  Flat Bed Scanners and PDF format
 Use 35mm slide and microscope o Advantages of PDF format
scanners  Cropping the image or text
 Describe the features of the DICOM  35mm slide and microscope slide scanners
standard  DICOM features
 Discuss issues related to image size and  Radiology image standards
quality for radiology  Video standards - Computer: 1 per
 Take a video using a digital camera participant
 Use cell phone to take a photograph Practical (2 hours) - Internet access
- email address
Small groups (2-3 people ) - web access
- web browser
Activities - Cameras
 Take photographs of each other - X-Ray Films
 Experiment with exposure and lighting - Flat Bed Scanners
 Take close up photographs (Macro ) - Photo-editor or
similar
 Copy X-Ray filmPreview pictures in the camera
- DICOM
 Transfer images to a memory stick or computer
conversion
 Basic image enhancement and cropping on a computer software
 Save an image in DICOM format

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Unit Outcomes Training Strategies Resources

On completion of the unit participants will Information session: 1 hour PowerPoint Slides
Unit 9
be able to: Data projector
Practical use of  Definition/explanation of store and forward telemedicine Computer
Store and Forward  Using a digital camera, save an image  Indications for use. Resource manual
on a computer and send it as an email  Special Telemedicine Software
3 hours attachment to a consultant at a different  Guidelines / contract for response time
site.  File size (picture image) and compression
 Identify the indications for store and  Ethics
Prerequisite: forward technology o Confidentiality
Unit 1  Recognize and address the ethical o Security of internet
Unit 2 issues in store and forward. o Clinical photography
Unit 3 Equipment
Unit 5 Practical Session: 2 hours
Unit 6 Small groups (2-3 people) - Computer: 1 per
Unit 7 participant
Activities - Internet access
- email address
 Take photographs of “skin condition” and a macro of the eye
- web access
 Save image on computer
- web browser
 Edit and compress picture
- Cameras
 Email to given address. - Photo Editor

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Unit Outcomes Training Strategies Resources

On completion of the unit participants will Information session: 1 hour PowerPoint Slides
Unit 10
be able to: Data projector
Tele-education  Reasons for using Tele-education Computer
 Understand the use of teleconferencing  Criteria for Tele-education implementation Resource manual
2 hours equipment for the use of tele-education.  Administration models for implementation
 Demonstrate skill in use of  Finance models for implementation
teleconferencing equipment for the use  Evaluation methodology
Prerequisite: of tele-education  Economic evaluation
Unit 1  Understand the benefits of using Scorm  Change management
Unit 2 compliant learning objects  Learning management systems
Unit 3  Understand key principles of Learning  Interoperabilibty – Scorm 1.2
Management Systems
Unit 5
Unit 6
Unit 7

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Unit Outcomes Training Strategies Resources
Unit 11
On completion of the unit participants will (Still to be developed)
Telemedicine and be able to:
homecare
introduction  Understand the use of peripheral
diagnostic equipment (tele-
2 hours stethoscopes, opthalmoscopes,
dermascopes, ENT scopes, hand-held
cameras and ultrasound probles)
Prerequisite:  Demonstrate skill in use of peripheral
Unit 1 diagnostic equipment (tele-
Unit 2 stethoscopes, opthalmoscopes,
dermascopes, ENT scopes, hand-held
Unit 3 cameras and ultrasound probes) where
Unit 5 appropriate.
Unit 6  Apply various techniques involved in
Unit 7 the synchronous ans store and forward
telemedicine according to the relevant
clinical guidelines.
 Recognise and address ethical issues in
the practice of Telemedicine

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