Introduction - ECG Acquisition and Automated Remote Processing - page 10

recommended), and it generates the impression by a moving stylus controlled by
amplifier output. Each smallest square on the paper record along x-axis (time)
represents 40 ms, and same along y-axis (millivolt amplitudes) represents 0.1 mV.
A physician can calculate the wave amplitudes, durations, and intervals from the
graduations very easily. Old or traditional recordings facilitate sequential
recording, i.e., one lead plot can be obtained at a time by mechanical switching
arrangement. However, most modern electrocardiograph machines are enabled
with direct computer interface and allow simultaneous, multilead recording.
1.7 Evolution and Practice of Telemedicine
and Telecardiology
Biotelemetry is the common technique which involves collection of physiological
data at one place and its transmission to another place using a suitable communi-
cation media for recording, interpretation, and analysis [ 6 , 7 ]. In clinical practice,
however, the term 'telemedicine' [ 8 ] is more frequently used. Telemedicine is the
integrated technology platform where a remote patient can be examined and mon-
itored through a communication link by a remote physician. American Telemedicine
Association (ATA) [ 9 ], one of the leading professional organization advocating the
use of remote diagnostics to improve quality, equity, and affordability of health care
throughout the world, defines the telemedicine as, ''Telemedicine is the use of
medical information exchanged from one site to another via electronic communi-
cations to improve patients' health status. Closely associated with telemedicine is
the term 'telehealth,' which is often used to encompass a broader definition of
remote health care that does not always involve clinical services. Videoconfer-
encing, transmission of still images, e-health including patient portals, remote
monitoring of vital signs, continuing medical education and nursing call centers are
all considered part of telemedicine and telehealth''. Use of information and com-
munication technology (ICT) for health-care service is well established in advanced
nations, where the basic health and supporting infrastructure are adequate to deliver
a quality health-care service to the common people. However, in most of the
developing nations like India, the patient-to-doctor ratio is very high. The advanced
health-care facilities are city centric. The following reasons can be identified as the
principal causes for promotion of telehealth services in developing nations:
1. Disparity in health-care service distribution among rural and urban areas.
2. Poor rural health-care infrastructure.
3. Inadequate number of medical practitioners and paramedics in rural health-care
centers.
4. Poor road connectivity of city-based hospitals with remote districts.
5. Tendency of city-based medical specialists to practice their profession around
densely populated city areas.
6. Poor doctor-to-patient ratio.