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TELEMEDICINE: INDIAN PERSPECTIVE

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90% of secondary & tertiary healthcare facilities in ... Kanpur. Ahmedabad. Baroda. Goa. Pune. Nagpur. CBE. Erode. Chenganoor. Salem. Madurai. Thirunelvelli ... – PowerPoint PPT presentation

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Title: TELEMEDICINE: INDIAN PERSPECTIVE


1
TELE-MEDICINE INDIAN PERSPECTIVE DIT
INITIATIVES  
  • B.S.Bedi,
  • Adviser C-DAC

ISRO-UNOOSA WORKSHOP 21 OCT 2008
2
Telemedicine in India The Perspective
  • India characterized by low penetration of
    healthcare services
  • 90 of secondary tertiary healthcare facilities
    in cities and towns away from rural India where
    68 of population lives
  • Primary health care facilities for rural
    population highly inadequate
  • Despite several initiatives by Government
    private sector the rural and remote areas
    continue to suffer from absence of quality
    healthcare
  • Significant proportion of patients in remote
    locations could be successfully managed locally
    with advice/ guidance from specialists/
    super-specialists in cities, without having to
    travel to the specialists.

3
Telemedicine The Promise
  • Majority of diseases not requiring surgery
    conducive to telemedicine
  • Can also play a significant role in training of
    medical personnel across the country
  • Decrease in price and complexity of this
    technology over last five years makes it
    economically viable
  • Increasing availability of communication
    infrastructure
  • Strong capability in terms of technical and
    medical expertise
  • Key driver of publicprivate partnership for
    health care delivery to the people of India
  • Major opportunity for cross border business for
    India considering these strengths

4
Telemedicine - Applications
Second Opinion Complex Interpretations
Telementored procedures/ Surgery - Robotics
Remote Consultation Critical Care Monitoring
Telemedicine
Home Care Ambulatory monitoring
Disease Surveillance Program tracking
Disease Management
Continuing Medical Education Public Awareness
Disaster Management
5
Current Efforts
  • Many programs worldwide using variety of
    telemedicine technologies
  • In India telemedicine programs actively supported
    by
  • Dept. of Information Technology
  • Indian Space Research Organization (ISRO)
  • Media Lab Asia
  • NEC Telemedicine program for North-Eastern states
  • Apollo Hospitals
  • Asia Heart Foundation
  • State governments
  • Telemedicine technology also supported by some
    other private organizations and Hospitals.
  • Major Communication infrastructure support by
    ISRO BSNL
  • Ownership by Ministry of Health Family
    Welfare-To Plan ahead by Setting up of National
    Task Force

6
DIT Initiatives
  • As a Facilitator, with long term objective of
    effective utilization/incorporation of IT in all
    major sectors , DIT has taken following leads in
    Telemedicine
  • Development of Technology-CDAC, IITs
  • Initiation of pilot schemes
  • Selected Specialty e.g. Oncology, Tropical
    Diseases
  • General telemedicine system covering all
    specialties
  • - Disaster management/Prevention
  • Standardization
  • Framework for building IT Infrastructure in health

7
Development of Telemedicine Technology
DIT Initiatives
  • Considerations
  • - Cost effective
  • - Compatible with available communication
    infrastructure like
  • -VSAT, ISDN, Leased Lines, POTS etc.
  • - Conformity to Standards
  • -Interoperability with existing vendors
  • - Benchmarking by clinical specialists

8
Telemedicine in Kerala
DIT Initiatives Pilot Schemes
  • Setting up of Telemedicine Telehealth Education
    facilities
  • OncoNet Telemedicine system for Cancer Patients
    in Kerala
  • More than 5000 patients treated/consulted at
    these nodal centres
  • System upgraded with high bandwidth VSAT
    connectivity
  • Major financial benefit to patients
  • Major Roll out planned by MoHFW to cover 25 RCCs
    100 outreach centres

Telemedicine System in West Bengal
  • Telemedicine for Tropical Diseases
  • Telemedicine projects to cover five referral
    hospitals and nine District hospitals

Telemedicine Network for Himachal Pradesh (HP)
  • 20 remote hospitals being connected with IGMC
    Shimla to be further connected with PGIMER

9
Telemedicine in North East States in India
  • Need Remote area and lacks Specialty
    Healthcare
  • Kohima Turnkey Project
  • Implementation of Telemedicine Solution at Kohima
    Hospital in Nagaland
  • Partnership between Govt. of Nagaland, Marubeni
    India Ltd, Apollo and M C I T. System in
    operation.
  • Two telemedicine centres connecting district
    hospitals in Sikkim Mizoram with Apollo,New
    Delhi operational
  • Telemedicine facilities in Tripura connecting
    Referral Hospitals at Agartala with four
    sub-divisional hospitals.
  • -Network inaugurated in June 2005
  • -Enthusiastic response from remote
    hospitals
  • -Network being expanded to cover six
    more remote hospitals
  • - Major scheme is planned by N E C and ISRO to
    cover all 75 districts in seven states through
    Telemedicine

10
Media Lab Asia Initiative for Rural eHealth
  • Sehat Sathi Portable/ mobile model of
    healthcare services and delivery- Provides
    Tele-consultation and information on health and
    disease through empowered rural health worker
  • CaSh A replicable model for IT based health
    management information system using handheld
    devices at grassroots. Plans for major
    development pilot deployment to cover full
    district
  • Pilot projects on mobile rural Telemedicine

11
Other Current Initiatives…
  • Telemedicine Network in Tamil Nadu-Six remote
    centres being connected with Specialty hospital
    in Chennai
  • A Telemedicine Network System under
    implementation at Cancer Institute (WIA), Adyar
    and at seven peripheral centres in Tamil Nadu
    Andhra Pradesh
  • Punjab Rural Telemedicine Network- More than 20
    rural hospitals being linked with Referral
    hospitals
  • Telehealth one of the major agenda for
    incorporation in 100,000 Common Service Centres
    (CSC) being set up as e-Governance delivery points

12
Telemedicine Standardisation
  • Need
  • Large number of Telemedicine networks being
    installed in the country
  • Lack of uniform, multipurpose telemedicine
    standards meeting needs of diverse user groups at
    different hierarchical levels hamper effective
    use of telemedicine
  • Important for promoting International business
  • Adherence/adoption to standards ensures
  • Telemedicine Systems are interoperable
  • Compatibility with new version of technology
  • Scalability of systems without total replacement
    while expanding capability
  • Recommended Guidelines and standards for
    Telemedicine Technology Practice in India
    evolved under a high level committee of DIT.
  • Document released and under wider circulation
    with excellent response
  • Major attention and follow up by MoHFW National
    Task Force for arriving at mandatory Standards

13
DIT Initiatives
Framework for Information Technology
Infrastructure for Health (ITIH)
  • Primary aim of building an Information Technology
    Infrastructure for Health (ITIH) to efficiently
    address all information needs of different
    stakeholders (government, hospitals, insurance
    companies, patients, vendors and others) in the
    healthcare industry.
  • Addresses the key elements of Standards, Legal
    Framework and Medical Informatics Education.
  • DIT has taken a major exercise in defining a
    framework for ITIH in India with involvement of
    a large number of concerned stake holders
  • Some Recommendations considered and accepted by
    Insurance Regulatory Dev. Authoritys Working
    Group
  • Base document for National Knowledge Commissions
    WG India-Health Information Network Dev (I-HIND)

14
Task Force for Telemedicine in India Current
activity
  • Task Force has met and initiated action on the
    terms of reference by setting up following five
    Subgroups to cover major terms of reference
  • Sub group on Telemedicine Standards (covers EMR)
  • Sub Group for formation of National Telemedicine
    Grid.
  • Sub Group for evaluation framework for projects,
    prepare pilot projects like National Medical
    College Network, National Cancer Network
  • Sub Group for utilization of existing tele
    linkages, training, CMEs in Telemedicine, human
    resources medical informatics.
  • Sub Group for preparation of National Policy on
    Telemedicine and tele medical education and to
    prepare central scheme for 11th Five Year Plan
  • Some Sub Groups including at 1 have submitted
    final Reports

15
Vision Defining a National Telemedicine Network
  • Vision for National Telemedicine Network to
    cover large population. A three tier hierarchical
    connectivity structure can be contemplated for
    implementation in phases to include
  • A Primary Health Centre (PHC)/Community Health
    Centre connected to District level hospital
  • A District level Hospital connected to a State
    Level Hospital/ Selected Specialty Hospital
  • State Hospitals and selective District hospitals
    being connected to a super specialty hospital at
    the National level
  • Possibility of inclusion of hospitals/Health
    centres in private sector
  • Issue being addressed by National Task Force

16
Chandigarh
Ludhiana
Bhubaneshwar
Jamshedpur
Delhi
Ranchi
Bilaspur
Jaipur
Guwahati
Bhopal
Indore
Kanpur
Kolkatta
Lucknow
Siliguri
Goa
Kakinada
Vizag
Mumbai
Pune
Hyderabad
Vijayawada
Nagpur
Ahmedabad
Tirupathi
Bangalore
Nellore
Chennai
Baroda
Madurai
Erode
CBE
Anantapur
Mysore
Davengere
Thirunelvelli
Belgaum
Hampi
Ramanathapurar
Trichy
Chenganoor
Bhavnagar
Salem
17
Chandigarh (State Hospital)
Delhi (Super Specialty Hospital)
Jaipur
Bhopal
Faridabad (District Hospital)
Lucknow
Kolkatta
Ayodhya (PHC)
18
National Telemedicine Network Major
Challenges
  • Resource requirement evaluation
  • Connectivity/ Bandwidth (B/W) provision
    reliability
  • Telemedicine cost consideration /affordability
  • - Telemedicine platform-H/W,S/W,Video
    Conferencing
  • - Basic Equipment (depending on
    Centre-scanner,digital med. equipment
  • Adherence to open platforms and open architecture
    standards
  • Sustainability
  • Sourcing Specialist availability
  • Trained manpower
  • Crucial Role being now played by Ministry of
    Health Family Welfare to Plan the National
    Telemedicine Grid

19
Thank you
  • bedi11_at_yahoo.com
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