{"id":5230,"date":"2019-05-27T14:24:34","date_gmt":"2019-05-27T12:24:34","guid":{"rendered":"http:\/\/www.easistent.ro\/?p=5230"},"modified":"2019-06-26T09:52:46","modified_gmt":"2019-06-26T07:52:46","slug":"istoria-telemedicinei","status":"publish","type":"post","link":"https:\/\/www.easistent.ro\/?p=5230","title":{"rendered":"Istoria telemedicinei"},"content":{"rendered":"<p><a href=\"http:\/\/www.easistent.ro\/new\/wp-content\/uploads\/2019\/05\/telemedicina.png\"><img class=\"alignleft size-medium wp-image-5210\" src=\"http:\/\/www.easistent.ro\/new\/wp-content\/uploads\/2019\/05\/telemedicina-300x145.png\" alt=\"telemedicina\" width=\"300\" height=\"145\" srcset=\"https:\/\/www.easistent.ro\/new\/wp-content\/uploads\/2019\/05\/telemedicina-300x145.png 300w, https:\/\/www.easistent.ro\/new\/wp-content\/uploads\/2019\/05\/telemedicina-870x418.png 870w, https:\/\/www.easistent.ro\/new\/wp-content\/uploads\/2019\/05\/telemedicina.png 900w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/a>De la apelurile neprogramate c\u0103tre medic, la dezvoltarea clinicilor de medicin\u0103 de urgen\u021b\u0103, \u00eengrijirile medicale la cerere au fost mereu la mare c\u0103utare.<\/p>\n<p>Pacientul modern se a\u0219teapt\u0103 la un acces de tipul 24\/7 la medicul lor, iar profesioni\u0219tii din ziua de azi pot folosi telemedicina pentru a oferi asisten\u021b\u0103 la distan\u021b\u0103.<\/p>\n<p>Telemedicina \u00eenseamn\u0103 furnizarea virtual\u0103 a asisten\u021bei medicale, f\u0103r\u0103 o \u00eent\u00e2lnire fa\u021b\u0103 \u00een fa\u021b\u0103 a pacientului cu medicul sau asistentul medical.<\/p>\n<p>Istoria telemedicinei moderne a \u00eenceput odat\u0103 cu inven\u021biile telegrafului electric \u0219i telefonului. Odat\u0103 cu telefonul, medicii din spitalele \u0219i cabinetele mai mari au putut s\u0103 vorbeasc\u0103 cu pacien\u021bii lor \u0219i s\u0103 le dea sfaturi medicale \u00een direct.\u00a0 \u00cen plus, medicii au \u00eenceput s\u0103 vorbeasc\u0103 \u00eentre ei pentru a se consulta \u0219i a schimba informa\u021bii.<\/p>\n<p>Telefonul a fost temelia pentru tehnologiile de comunicare \u0219i telemedicin\u0103 ulterioare. S\u0103 nu uit\u0103m nici de apari\u021bia, \u00een 1968, \u00een Statele Unite ale Americii, a num\u0103rului 9-1-1, primul num\u0103r pentru asisten\u021ba de urgen\u021b\u0103. Acest num\u0103r a putut fi folosit, de la \u00eenceput, pentru a raporta un incendiu, a cere ajutorul poli\u021biei sau a semnala o urgen\u021b\u0103 medical\u0103.<\/p>\n<p>\u00cencerc\u0103ri de a transmite citirile stetoscopului \u0219i ale altor dispozitive cu ajutorul mijloacelor de comunicare existente (telefon, radio) au existat \u00eenc\u0103 din anii 1900. \u0218i, totu\u0219i, telemedicina a reu\u0219it transmiterea imaginilor video \u0219i a unor date medicale complexe la sf\u00e2r\u0219itul anilor 1950 \u0219i \u00eenceputul anilor 1960.<\/p>\n<p>\u00cen 1959, Universitatea din Nebraska a folosit telemedicina interactiv\u0103 pentru a transmite examin\u0103ri neurologice, primul caz al unei consulta\u021bii de telemedicin\u0103 cu video live. Apoi au urmat \u0219i alte programe de aceast\u0103 natur\u0103, de obicei desf\u0103\u0219urate \u00een mediul academic, care s-au axat pe transmiterea unor date medicale precum imaginile fluoroscopice, radiografiile, sunetele de stetoscop \u0219i electrocardiogramele (ECG).<\/p>\n<p>Avansul luat de internet \u00een anii 1990 a adus o explozie informa\u021bional\u0103, un trafic informational f\u0103r\u0103 precedent \u0219i o dezvoltare rapid\u0103 a telemedicinei, care a \u00eenceput s\u0103 cuprind\u0103:<\/p>\n<p>&#8211;\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Educa\u021bia pacien\u021bilor<\/p>\n<p>&#8211;\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Transmiterea unor imagini medicale complexe<\/p>\n<p>&#8211;\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Desf\u0103\u0219urarea unor consulta\u021bii video, la distan\u021b\u0103<\/p>\n<p>&#8211;\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Efectuarea de m\u0103sur\u0103tori ale semnelor vitale ale corpului<\/p>\n<p>Au ap\u0103rut dosarele medicale electronice \u0219i, de asemenea, \u00een ultimul deceniu, s-au dezvoltat \u0219i software-urile cu aplica\u021bii medicale, care au permis schimbul \u0219i stocarea datelor clinice. \u00cen plus, au ap\u0103rut portalurile web pentru transmiterea c\u0103tre pacien\u021bi a rezultatelor testelor de laborator sau a unor mesaje c\u0103tre medici \u00een condi\u021bii de siguran\u021b\u0103 ridicat\u0103.<\/p>\n<p>Telemedicina folose\u0219te acum dispozitive smart \u0219i inteligen\u021ba artificial\u0103.<\/p>\n<p>Un exemplu? G\u0103sirea unui algoritm pentru construirea dietei personalizate. P\u00e2n\u0103 acum, speciali\u0219tii \u00een nutri\u021bie au avut de \u00eenfruntat provoc\u0103ri importante \u00een urm\u0103rirea acestui obiectiv. De exemplu, era foarte greu s\u0103 desf\u0103\u0219ori studii randomizate: acestea cer ca participan\u021bii s\u0103 aib\u0103 aceea\u0219i diet\u0103 ani la r\u00e2nd, \u00eenainte ca evaluarea consecin\u021belor ei pe plan medical s\u0103 fie posibil\u0103.<\/p>\n<p>Abia recent, odat\u0103 cu abilitatea inteligen\u021bei artificiale de a analiza mari seturi de date, cercet\u0103torii au descoperit c\u0103 dietele trebuie personalizate \u2013 metabolismul uman, microbiomul \u0219i mediul sunt de o eterogenitate remarcabil\u0103 pentru fiecare dintre noi, ca s\u0103 numim doar c\u00e2teva dintre dimensiunile care ne fac unici. A\u0219a c\u0103 o diet\u0103 potrivit\u0103 nu are cum s\u0103 nu fie individualizat\u0103.<\/p>\n<p>Prima descoperire major\u0103 \u00een aceast\u0103 privin\u021b\u0103 a fost f\u0103cut\u0103 acum c\u00e2\u021biva ani de Eran Segal, Eran Elinav \u0219i colegii lor de la Institutul de \u0218tiin\u021be Weizmann din Israel. Ace\u0219tia au ar\u0103tat, \u00een lucrarea Personalized Nutrition by Prediction of Glycemic Reponses (<em>Nutri\u021bie personalizat\u0103 prin prognozarea r\u0103spunsurilor glicemice<\/em>) publicat\u0103 \u00een revista <em>Cell<\/em>, c\u0103 exploziile nivelului glicemiei dup\u0103 ce m\u00e2nc\u0103m sunt considerate un indicator al riscului de diabet, de\u0219i nu se \u0219tie dac\u0103 evitarea lor elimin\u0103 acel risc. Aceste cre\u0219teri bru\u0219te ale glicemiei sunt doar un aspect al r\u0103spunsului nostru individualizat la alimenta\u021bie.\u00a0 Dar ele reprezint\u0103 prima dovad\u0103 obiectiv\u0103 c\u0103 reac\u021bion\u0103m \u00eentr-adev\u0103r diferit la alimenta\u021bie, chiar dac\u0103 consum\u0103m acelea\u0219i alimente, \u00een aceea\u0219i cantitate.<\/p>\n<p>Studiul a inclus 800 de persoane f\u0103r\u0103 diabet. Datele colectate pentru fiecare participant au cuprins ora mesei, cantitatea \u0219i con\u021binutul m\u00e2nc\u0103rurilor \u0219i b\u0103uturilor consumate, activitatea fizic\u0103, \u00een\u0103l\u021bimea, greutatea \u0219i tiparele de somn. Participan\u021bilor li s-au evaluat timp de o s\u0103pt\u0103m\u00e2n\u0103 s\u00e2ngele, con\u021binutul microbiomului intestinal \u0219i glicemia. Ace\u0219ti participan\u021bi au consumat mai mult de 5000 de mese standard furnizate de cercet\u0103tori, care au con\u021binut alimente populare precum ciocolata sau \u00eenghe\u021bata, precum \u0219i aproape 47 000 de mese care au con\u021binut alimentele pe care obi\u0219nuiau s\u0103 le consume. \u00cen total, au fost f\u0103cute mai mult de 1.5 milioane de m\u0103sur\u0103tori ale glicemiei.<\/p>\n<p>Apoi, folosind inteligen\u021ba artificial\u0103, toate aceste date au fost analizate pentru a se \u00een\u021belege ce determin\u0103 r\u0103spunsul glicemic la anumite alimente pentru fiecare dintre participan\u021bi. \u00cen felul acesta, s-a construit un algoritm \u2013 acesta arat\u0103 c\u0103 mai mult de 100 de factori sunt implica\u021bi \u00een r\u0103spunsul glicemic, dar determinantul principal nu este alimentul consumat, ci flora intestinal\u0103, care joac\u0103 un rol deosebit de important \u00een r\u0103spunsul unic al fiec\u0103ruia dintre noi la alimenta\u021bie.<\/p>\n<p>Iar faptul c\u0103 inteligen\u021ba artificial\u0103 a f\u0103cut posibil\u0103 aceast\u0103 descoperire reprezint\u0103 un moment special \u00een istoria inteligen\u021bei artificiale, dar \u0219i a medicinei. Speciali\u0219tii sper\u0103 ca, mul\u021bumit\u0103 unor noi aplica\u021bii care pot fi instalate pe telefoanele mobile smart \u0219i care sunt capabile s\u0103 scaneze m\u00e2ncarea din farfurie \u0219i s\u0103 trimit\u0103 datele spre servere cu acces la bazele de date cu r\u0103spunsul nostru glicemic la diverse alimente, inteligen\u021ba artificial\u0103 s\u0103 ne ajute s\u0103 \u00een\u021belegem cum va reac\u021biona metabolismul nostru \u00een cazul anumitor alimente \u0219i s\u0103 ne putem construi o diet\u0103 cu adev\u0103rat individualizat\u0103.<\/p>\n<p>\u00cen plus, exist\u0103 speran\u021ba, exprimat\u0103 chiar de c\u0103tre Directorul General al Organiza\u021biei Mondiale a S\u0103n\u0103t\u0103\u021bii, Dr Tedros Adhanom Ghebreyesus, c\u0103 folosirea tehnologiilor digitale va \u00eent\u0103ri telemedicina \u0219i va permite atingerea unui obiectiv primordial de dezvoltare durabil\u0103 \u2013 accesul universal la serviciile de s\u0103n\u0103tate.<\/p>\n<p>\u00cen ultimii doi ani, OMS a analizat rezultatele folosirii tehnologiilor digitale \u00een medicin\u0103 \u0219i s-a consultat cu exper\u021bi pentru a dezvolta recomand\u0103ri cu privire la folosirea lor optim\u0103 pentru generarea unui impact pozitiv maxim asupra s\u0103n\u0103t\u0103\u021bii oamenilor \u0219i a eficien\u021bei sistemelor de s\u0103n\u0103tate.<\/p>\n<p>Printre exemplele pozitive notate sunt incluse \u0219i aplica\u021bii digitale care \u00eei sprijin\u0103 pe practicieni s\u0103 ia decizii mai bune \u00een timpul acord\u0103rii \u00eengrijirilor medicale sau prin care ace\u0219tia se pot consulta rapid cu exper\u021bi \u00eentr-un anumit domeniu sau pot comunica rapid cu pacien\u021bii afla\u021bi \u00een diferite loca\u021bii.<\/p>\n<p>&nbsp;<\/p>\n<p><em>Mirela Musta\u021b\u0103 \u2013 Redactor executiv E-asistent <\/em><\/p>\n<p>&nbsp;<\/p>\n<p>Surse de documentare:<\/p>\n<p><a href=\"https:\/\/www.nytimes.com\/2019\/03\/02\/opinion\/sunday\/diet-artificial-intelligence-diabetes.html?smtyp=cur&amp;smid=tw-nythealth\">https:\/\/www.nytimes.com\/2019\/03\/02\/opinion\/sunday\/diet-artificial-intelligence-diabetes.html?smtyp=cur&amp;smid=tw-nythealth<\/a><\/p>\n<p><a href=\"https:\/\/www.who.int\/news-room\/detail\/10-05-2019-who-is-establishing-technical-advisory-group-and-roster-of-experts-on-digital-health\">https:\/\/www.who.int\/news-room\/detail\/10-05-2019-who-is-establishing-technical-advisory-group-and-roster-of-experts-on-digital-health<\/a><\/p>\n<p><a href=\"https:\/\/www.who.int\/news-room\/detail\/10-05-2019-who-is-establishing-technical-advisory-group-and-roster-of-experts-on-digital-health\">https:\/\/www.who.int\/news-room\/detail\/10-05-2019-who-is-establishing-technical-advisory-group-and-roster-of-experts-on-digital-health<\/a><\/p>\n<p><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC3089841\/\">https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC3089841\/<\/a><\/p>\n<p><a href=\"https:\/\/evisit.com\/resources\/history-of-telemedicine\/\">https:\/\/evisit.com\/resources\/history-of-telemedicine\/<\/a><\/p>\n<p><a href=\"http:\/\/mdportal.com\/education\/history-of-telemedicine\/\">http:\/\/mdportal.com\/education\/history-of-telemedicine\/<\/a><\/p>\n<p>\u201c<a href=\"https:\/\/www.cell.com\/cell\/fulltext\/S0092-8674(15)01481-6\">Personalized Nutrition by Prediction of Glycemic Responses<\/a>\u201d de Eran Segal, Eran Elinav et co. publicat in revista Cell<\/p>\n<p>Sursa foto &#8211; <a href=\"https:\/\/www.who.int\/news-room\/detail\/17-04-2019-who-releases-first-guideline-on-digital-health-interventions\">https:\/\/www.who.int\/news-room\/detail\/17-04-2019-who-releases-first-guideline-on-digital-health-interventions<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>De la apelurile neprogramate c\u0103tre medic, la dezvoltarea clinicilor de medicin\u0103 de urgen\u021b\u0103, \u00eengrijirile medicale la cerere au fost mereu la mare c\u0103utare. Pacientul modern se a\u0219teapt\u0103 la un acces de tipul 24\/7 la medicul lor, iar profesioni\u0219tii din ziua de azi pot folosi telemedicina pentru a oferi asisten\u021b\u0103 la distan\u021b\u0103. Telemedicina \u00eenseamn\u0103 furnizarea virtual\u0103 [&hellip;]<\/p>\n","protected":false},"author":3,"featured_media":5210,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[152,13],"tags":[],"_links":{"self":[{"href":"https:\/\/www.easistent.ro\/index.php?rest_route=\/wp\/v2\/posts\/5230"}],"collection":[{"href":"https:\/\/www.easistent.ro\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.easistent.ro\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.easistent.ro\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/www.easistent.ro\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=5230"}],"version-history":[{"count":1,"href":"https:\/\/www.easistent.ro\/index.php?rest_route=\/wp\/v2\/posts\/5230\/revisions"}],"predecessor-version":[{"id":5231,"href":"https:\/\/www.easistent.ro\/index.php?rest_route=\/wp\/v2\/posts\/5230\/revisions\/5231"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.easistent.ro\/index.php?rest_route=\/wp\/v2\/media\/5210"}],"wp:attachment":[{"href":"https:\/\/www.easistent.ro\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=5230"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.easistent.ro\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=5230"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.easistent.ro\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=5230"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}