MS(ENT), MS(GEN SURG), DIPLOMA IN LASER SURGERY

(SPAIN), LLB.

INDIA
TELEMEDICINE PROJECTS IN INDIA
•INTRODUCTION
•BENEFITS/UTILITIES
•TYPES
•PRESENT DAY SCENARIO
•INFRASTRUCTURE
•GOALS
•NEEDS
•CHALLENGES
•RESULTS
•DISCUSSIONS
•CONCLUSIONS
TELEMEDICINE
 Benefits to Healthcare Professionals

11 Click to add
Improved Titleand better treatment management
diagnosis

22 Click to add
Continuing Title and training
education

13 Click to add Title

Quick and timely follow-up of discharged patients

24 Click
Accessto add Title
to computerized comprehensive data of
patients, both offline & real time
1
 Benefits to patients

• Access to specialized health care services to under-served

rural, semi-urban and remote areas
• Early diagnosis and treatment
• Access to expertise of Medical Specialists
• Reduced physician’s fees and cost of medicine
• Reduced visits to specialty hospitals
• Reduced travel expenses
• Early detection of disease
• Reduced burden of morbidity
Benefits to Government
 Types of technology

For non –
emergency
situations
Store and forward
Teleradiography, tel
eradiopathy &
2 types teledermatolgy

Video-conferencing.
Two-way interactive Almost equivalent to a
television face to face ‘real time’
consultation
 HEALTHCARE IN RURAL INDIA
•70 % of India’s population live in rural
areas
Other
19%
•90% of secondary & tertiary care facility Psychiatry
Nutrition
are in cities and towns 34%
Services
4%
•Low penetration of healthcare services
Neurology
•Lack of investment in health care in rural Peds
5%
areas
Endocrinology
Dermatology
•Inadequate medical facilities in rural areas 9%
29%

• Problem of retaining doctors in rural areas

SUPERSPECIALITY SERVICES
specially the specialist doctors
REQUIRED (besides the basic
medical health services)
Public Health Care Delivery Model

242 Medical colleges

205 Dental colleges

3,346 CHC
4,400 Dist. Hospitals
1200 Other Public Hospitals

23,236 PHC
1,46,026 Sub centers

Source : K. Park, 20th Ed.

 Telemedicine: Ideal for India

• Area : 32,87,268 Sq. Km.• Strong Fiber Backbone

• Population : over 1 • Indigenous satellite
Billion Communication
• Urban Rural Divide technology in place
• Inaccessible hilly • IT trained Human
regions, islands, desert, c resource
oasts, tribal areas • Pilot Projects with
Successful outcomes
 SUPPORT

In India, telemedicine programs are being

actively supported by:
• Department of Information Technology (DIT)
• Indian Space Research Organization
• NEC Telemedicine program for North-Eastern states
• Apollo Hospitals
• Asia Heart Foundation
• State governments
• Telemedicine technology also supported by some other
private organizations
 Evolution of telemedicine
• One patient
connected to one
Point to doctor
Point
• Within same
hospital

Telemedicine :
• One patient end at a
Point to time connected to
Multi many specialist doctors
ways of Point • Within the same
hospital
communication
• Several patient ends
connected to several
Multipoint different specialist
to doctors
Multipoint • At different hospitals, in
different geographical
distances
 DIT INITIATIVES

DIT has taken following leads in Telemedicine:

 Development of Technology

 Initiation of pilot schemes

 Selected Specialty e.g. Oncology, Tropical Diseases
 General telemedicine system covering all specialties

 Standardization

 Framework for building IT Infrastructure in health

National Task Force on Telemedicine(2005)
 Includes members from the following departments

• Health, Communication & Benefits to

patients
Information Technology
Benefits to Health
•Indian Space Research Organization Care Professionals

•Indian Council of Medical Research

Benefits for Health
•Medical Council of India Care Delivery System

•Center for Development of Advanced

Computing
•Academic medical institutions and Utility of NRTN
corporate hospitals
 PROPOSED OBJECTIVES OF NRTN

•To provide access to timely and quality specialty medical care

to the people living in rural & remote areas.
•To reduce rural urban divide in delivery of medical care
•To improve diagnosis and treatment facilities in rural areas
•To mitigate the obstacles due to geographical isolation
• To provide continuous medical education and training to the
healthcare professionals working in rural/remote areas
 Tele-consultation room
 Patient engagement facilities (bed, scopes, etc.)
 Selective medical and medico-IT equipments, preferably IT
compatible, with interface to Telemedicine and/or other
software / hardware
 Computer hardware / software platform (PC, switch, etc.) and
IT electronics equipments
 Mobile vans are a part of
telemedicine service
 LEVEL-1:Software &Hardware

1 Desktop PC platform with Laser Printer

IP Video Conferencing Kit

2
Tele medicine software
3
Digital ECG
4
A3 Film Scanner
5
6 Digital Microscope & Camera
Glucometer & Haemogram analyzer
7
8 Non-invasive Pulse & Blood Pressure unit
Connectivity device & Router
9
 GOALS AND NEEDS
Looking to the past experience for
success of telemedicine:
• Video conferencing

•Accompanied by data and image

transfer (live)

• Common software usage at both

ends, thus globalization of a single
database software

•Role of trained technical personnel is

equally important and necessary at
the patient end.

•Successful remuneration system to

attract private practitioners
 Plus points

•It is feasible to set up a National Health Grid to be shared by healthcare

providers, trainers & beneficiaries taking the advantage of a
•strong fiber backbone
•indigenous satellite communication technology
•large trained manpower

•The ground work has also been established by

•ISRO
• DIT
•State Governments
•Specialty Institutes/ Hospitals

•National Rural Telemedicine network will help to provide quality healthcare

where there is none and will improve healthcare where there is some
 CHALLENGES
• Low bandwidth
Neither telephone lines nor electricity in rural
areas
International bandwidth of RAFT countries is very
limited
End 2004: 18 Mbps for the entire country, 1,34
bps/capita (Mali)
Switzerland 2002: 66.000 Mbps, 9.040 bps per
capita
(Source: ITU World Telecommunication
Indicators Database)
Satellite transmission can help but is pricey
Mobile communication is gaining ground
• Unstable electricity supply.
 CHALLENGES

• Patients' fear and unfamiliarity

• Financial unavailability
• Lack of basic amenities
• Literacy rate and diversity in languages
• Quality aspect
• Government Support
• Perspective of medical practitioners
 DISCUSSIONS

Pragmatism and the realism with tools adapted to the

context must remain the rule.

India is a booming economy

Telemedicine is a new yet

extremely lucrative concept

With the right marketing

and government approach,
combined with hard efforts in
the right direction, this can be
a huge success!
 CONCLUSION

Paraphrasing Neil Armstrong,

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