# Ultrasound in Telemedicine: A Brief Overview
## 3 Results
### Weaknesses and Threats  
As far as weaknesses and threats are concerned, we analyzed issues that might need further development or deep consideration, such as new software that is not yet commercially available in comparison to traditional ultrasound (Table 2). Generally, in a tele-scenario with a remote expert, securing the multidimensional problem of \"transducer angles\", \"transducer position\", \"patient body posture\", and \"patient breathing state\" may be difficult. Furthermore, the device settings, device type, and transducer type all have an impact on whether or not a representation is useful. As a result, the use of tele-ultrasound may be contingent not only on the technological infrastructure and individual abilities of the two linked examiners, but also on the capacity of the two remote persons to interact successfully as a team.  
\begin{table}
\begin{tabular}{c c c} \hline \hline - & **Traditional Ultrasound Teaching** & **Tele-Ultrasound Teaching** \\ \hline Image acquisition & Trained provider & Untrained provider with real-time remote expert supervision \\ \hline Image optimization & Directly possible by expert provider/educator, including manual intervention and correction of probe movements & Indirectly possible via verbal commands by expert provider/educator \\ \hline Operation of complex ultrasound & Direct & Not possible or indirect \\ applications/functions/measurements & Direct & Clinical context must be communicated, personal impression limited, correlation possible & Clinical context must be communicated, personal impression limited, correlation limited \\ \hline Situational perception & Physical presence of supervisor & Tele-presence, perception reduced to 2D visual and audio \\ \hline Integration into patient management & Direct interaction of provider with team (e.g., when pausing chest compression during CPR) & Indirect interaction \\ \hline Availability in austere settings & Reduced in terms of equipment, providers, experts and educators. Sometimes unavailable. & Enhanced by technology \\ \hline Availability of experts & Lmitting factor in education. Need travel, accommodation, time. & Higher Low threshold, no travel time. \\ \hline Equipment requirement & Ultrasound device & Ultrasound device and transmission technology Network capability \\ \hline Additional expenses & Expert funding, travel, accommodation & No travel and accommodation costs \\ \hline Geographical distance & Device with patient and diagnostic & Distance between tele-medicine sites only limited by data transfer range \\ \hline Time lag & None & Ranges between none and significant \\ \hline Data transfer & Normally wired and a data transfer rate in the gigabit range & Wireless or wired, with mega or gigabit per second speeds. \\ \hline Data security & Local storage, general data protection considerations & Special considerations required, especially in case of transmission and processing of health-related personal data across different legislative spaces and IT-solutions \\ \hline Legal framework, liability & Local framework applies & Special considerations required, as provider and supervisor may operate under different legislations \\ \hline \hline \end{tabular}
\end{table}
Table 2: Advantages and disadvantages of conventional ultrasound versus tele-ultrasound.