C t tt fT l di i Nt ki Current status of Telemedicine Network in India and Future perspective Prof. S K Mishra, MS, FACS Head Dept of Endocrine Surgery & Head, Dept. of Endocrine Surgery & Faculty I/C, SGPGI Telemedicine Programme Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGIMS) Lucknow,India [email protected]
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C t t t f T l di i N t k iCurrent status of Telemedicine Network in India and Future perspective
Prof. S K Mishra, MS, FACSHead Dept of Endocrine Surgery &Head, Dept. of Endocrine Surgery &
Faculty I/C, SGPGI Telemedicine ProgrammeSanjay Gandhi Postgraduate Institute of Medical Sciences
Update on 32nd APAN Meeting in New Delhi, India; 22-27 August 2011
http://www.cancerinstitutewia.in/
Tripura Tele-ophthalmology Projectp p gy j
• Tripura Tele-ophthalmology (Vision) Centres set up in Blocks top p gy ( ) pprovide eye-care to patients at door-steps
• Linked to IGM Hospital through Tele-medicine infrastructure.Started in April 2007; 35 Centres set up so far• Started in April 2007; 35 Centres set up so far
• 5 Blocks (Korbook, Jampui Hills, Dasda, Chawmanu and Bishalgarh)yet to be covered.
• Over 71,000 patients screened upto August 10, of which 5,092 patientsreferred to Referral Hospital (IGM Hospital)Average number of patients per Centre per month: around 100• Average number of patients per Centre per month: around 100.
• National e-Governance Gold Award for 2009.
Update on 32nd APAN Meeting in New Delhi, India; 22-27 August 20119
Update on 32nd APAN Meeting in New Delhi, India; 22-27 August 2011
Disease Surveillance Integrated Disease Surveillance Project (IDSP)- Year 2004
• EDUSAT Satellite Current status
• Decentralized state based surveillance
Current status
• Data Centre - 750 locations
system for communicable & non
communicable diseases
• Connectivity - 559 locations
• Training Centrecommunicable diseases
• Improve the efficiency of surveillance – NIC 218 / 400 sites
– ISRO 297 / 400 sites
activities, detect disease trends,
– ISRO 297 / 400 sites
• 38 Hi-End VC Equipments (Multi
f )evaluate control strategies of the
disease control programmes
conference 5 nodes) - between
CSU and States/UTs HQ
Update on 32nd APAN Meeting in New Delhi, India; 22-27 August 2011
disease control programmeshttp://idsp.nic.in/
National Rural Telemedicine Project National Rural Health Mission ( Framework developed)
• Design, development and implementation of– Low cost rural telemedicine infrastructure– Village Tele-ambulance System and rural emergency
healthcare services / Trauma care module– Rural Health Knowledge Resource through web portal and
e-CME modulef f– Technology platform for harvest, compilation, storage
(Data Base) at Regional District Hub and Central DataCenter at MOH & FW archive and distribution acrossCenter at MOH & FW, archive and distribution acrossnetwork
Update on 32nd APAN Meeting in New Delhi, India; 22-27 August 2011
www.mohfw.nic.inwww.mohfw.nic.in
ONCONET-IndiaMinistry of Health & Family Welfare (Govt. of India)
ONCONET KERALA ONCONET
INDIAINDIA
27 RCCs & 108 Peripheral27 RCCs & 108 Peripheral Cancer Centers (PCC) in India(Under implementation)
Dept. of Information Technology Ministry of Health & FW
Update on 32nd APAN Meeting in New Delhi, India; 22-27 August 2011
p gyGovt. of India
Ministry of Health & FWGovt. of India
ONCONET IndiaONCONET India
U d N ti l C C t l• Under National Cancer Control Programme Nationwide Tele-oncology Network in India
• Department of Medical Education,G t f U P t U P M di lGovt. of U.P. setup U.P. MedicalColleges Telemedicine Network.
• School of Telemedicine &Bi di l I f ti SGPGIMSBiomedical Informatics, SGPGIMS,Lucknow entrusted the job ofdesigning the technical architectureand System requirementand System requirement
• National Co-operative ConsumerFederation of India Ltd. (NCCF)
id tifi d t i l t thwas identified to implement theproject.
• The pilot phase has beenl t d ith d l t fcompleted with deployment of
telemedicine infrastructure inMedical Colleges at Allahabad,Kanpur and Meerut
Update on 32nd APAN Meeting in New Delhi, India; 22-27 August 2011
Kanpur and Meerut.
Design of UP Medical College Network WAN & LAN & Digital Library NetworkWAN & LAN & Digital Library Network
Update on 32nd APAN Meeting in New Delhi, India; 22-27 August 2011
Proposed National Medical College TelemedicineNational Medical College Telemedicine Network Architecture
Update on 32nd APAN Meeting in New Delhi, India; 22-27 August 201120
Design of National Medical College Network WAN & LAN N t kWAN & LAN Network
National Resource Center
Apex Medical Institutions
Medical Colleges
Update on 32nd APAN Meeting in New Delhi, India; 22-27 August 2011
National HUB at SGPGI, Lucknowat o a U at SG G , uc o
Update on 32nd APAN Meeting in New Delhi, India; 22-27 August 2011
Network Monitoring & Data Storageet o o to g & ata Sto age
Update on 32nd APAN Meeting in New Delhi, India; 22-27 August 2011
International Telemedicine Networks
Update on 32nd APAN Meeting in New Delhi, India; 22-27 August 2011
Update on 32nd APAN Meeting in New Delhi, India; 22-27 August 2011http://www.jdwnrh.gov.bt/?page_id=69
SAARC Telemedicine Network
• Ministry of External Affairs, Govt. of IndiaIndia
• Implementing Agency: Telecommunications Consultants India Ltd (TCIL)Ltd. (TCIL)
• Connectivity: Satellite & fiber optic network N t ki f /t h it l i• Networking of one/two hospitals in each of the SAARC countries with 3-4 Super Specialty hospitals in IndiaC S• Current Status: JDWNRH, Bhutan , Indira Gandhi Child Hospital, Kabul, Afghanistan & Patan Hospital, K th d N l ith SGPGIMSKathmandu, Nepal with SGPGIMS, Lucknow & PGIMER, Chandigarh with academic activities
Update on 32nd APAN Meeting in New Delhi, India; 22-27 August 2011
Update on 32nd APAN Meeting in New Delhi, India; 22-27 August 2011www.panafricanenetwork.com
PAN Africa Network
Ministry of External Affairs, Govt. of India
• Implementing Agency: TCIL• 53 countries of the African Union • Connectivity: Satellite & fibre optic
• Collaboration between MDRF, World Diabetes ,Foundation and ISRO.
• Serves 42 villages (in and round Chunmpetvillage) in Kancheepuram District, Tamilnadu, I diIndia.
• The experts testing, diagnosis, medicines and even laser surgery are at door step
Update on 32nd APAN Meeting in New Delhi, India; 22-27 August 2011
Tele-Oncology UnitM l b C C S i t KMalabar Cancer Care Society, Kannur
Comprehensive Disease Control Activities Through EarlyDetection Treatment & Awareness Building for CancerDetection, Treatment & Awareness Building for CancerCancer, AIDS, TB, Cardiac diseases & Pre and post natalrequirements.‘Sanjeevani’ is a Mobile Tele Oncology unit with satelliteSanjeevani is a Mobile Tele Oncology unit with satellitecommunication link, advanced diagnostic and treatmentequipments, telemedicine infrastructure, software forElectronic Health Record e-Health Card for patients etcElectronic Health Record, e Health Card for patients etc.aimed to provide telemedicine services for early cancerdetection, follow up consultation, treatment of cervicalcancers and awareness building to rural masses at fiveca ce s a d a a e ess bu d g to u a asses at enorthern districts of Kerala.
Update on 32nd APAN Meeting in New Delhi, India; 22-27 August 2011
http://cancercaremccskannur.org/
Interior view of Tele-Oncology Unitgy
Laboratory
Update on 32nd APAN Meeting in New Delhi, India; 22-27 August 2011
Videoconference Station Operation Table for Colposcopy and cauterization for early
cervical cancer
Equipment installed inside mobile van, Patient Access Door and Satellite External Unit HousingDoor and Satellite External Unit Housing
M bil Ul d d X U i Colposcopy Unit used for earlyMobile Ultrasound and X-ray Unit Colposcopy Unit used for early detection
of Cervical Cancer & intervention
Update on 32nd APAN Meeting in New Delhi, India; 22-27 August 2011
Patient Access DoorSatellite external Unit housing
Regional Institute of Ophthalmology“Sunayanam” A Tele ophthalmology UnitSunayanam – A Tele-ophthalmology Unit
• Regional Institute of Ophthalmology• Regional Institute of Ophthalmology(RIO), Trivendrum
• Designed and implemented by C-DAC
• Well-equipped to carry out completeophthalmic examinationophthalmic examination.
• Further assistance are met with bycontacting the specialists at RIO by
f id f iway of videoconferencing• Equipped with photo slit lamps.
http://www yentha com/news/view/1/2724
Update on 32nd APAN Meeting in New Delhi, India; 22-27 August 2011
http://www.yentha.com/news/view/1/2724
General PurposeGeneral Purpose Mobile Telemedicine Unit
Update on 32nd APAN Meeting in New Delhi, India; 22-27 August 2011
General Purpose Mobile Telemedicine Unite
Sri Ram Medical College, Amrita Institute of Medical Sciences, C hi
Sri Ram Medical College, Chennai & Amrita Institute of Medical Sciences
g ,Chennai
General Purpose Rural Tele-health Clinic with ISRO Antenna & VSAT
i i
Cochin AIMS Hospital’s Mobile Telemedicine Unit isthe size of a city bus and includes X-rayfacilities ECG scanner pathology lab workconnectivity facilities, ECG scanner, pathology-lab-workfacility, specialty cardiac services and atelemedicine satellite link with AIMS Hospital.
Update on 32nd APAN Meeting in New Delhi, India; 22-27 August 2011
Application of AIMS Telemedicine Van Tele health service in Koshi flood affected AreaTele-health service in Koshi flood affected Area
First used in tsunami-relief work in Kerala and Tamil Nadu. Direct Relief International ( a U.Sbased NGO) has supported in setting up of this van while Indian Space Research Organization
Update on 32nd APAN Meeting in New Delhi, India; 22-27 August 2011
based NGO) has supported in setting up of this van while Indian Space Research Organization( ISRO) provides the satellite-technology and connectivity
Apollo Telemedicine Network Foundationp
• Jointly undertaken by ISRO, Philips India, y y , p ,Apollo Telemedicine Networking Foundation (ATNF) and the Madurai based NGO, Development of Human Action (DHAN)
• A tele clinical van equipped with diagnostic• A tele-clinical van, equipped with diagnostic equipment provided by Philips India. The van has an ultrasound machine, an X-ray, a defibrillator and an ECG machine
Update on 32nd APAN Meeting in New Delhi, India; 22-27 August 2011
Wireless Mobile Health System
Update on 32nd APAN Meeting in New Delhi, India; 22-27 August 2011
Wireless Mobile Health Systemy
• Evolution of wireless communication• Evolution of wireless communicationtechnologies have enabled telemedicinesystems to operate in the remotest place forsystems to operate in the remotest place forrural health practices hence expandingtelemedicine benefits applications andtelemedicine benefits, applications, andservices.
• In India majority of the people are living in therural and remote locations where even the basicfacilities are not available for the society.
Update on 32nd APAN Meeting in New Delhi, India; 22-27 August 2011
3G enabled mHealthApollo Telemedicine Network FoundationApollo Telemedicine Network Foundation
Update on 32nd APAN Meeting in New Delhi, India; 22-27 August 2011
Mobile Tele-Ophthalmology Van is equipped with various equipments like Slit lamp, auto-refractometer,tonometer, ophthalmoscope, retinoscope and a wireless internet enabled computer with which theuser can connect to internet at anytime and anywhere in the field to transfer the captured images ofpatient’s eyes and other related data through the software e-Sanjeevani
Update on 32nd APAN Meeting in New Delhi, India; 22-27 August 2011
patient s eyes and other related data through the software e-Sanjeevanihttp://www.cdacmohali.in
mHealth4u Suitcase and backpack modelSchool of Telemedicine & Biomedical Informatics SGPGIMSSchool of Telemedicine & Biomedical Informatics, SGPGIMS
Update on 32nd APAN Meeting in New Delhi, India; 22-27 August 2011
Integrated Medical Equipments
PC Interface:USB & Bluetooth
Blood Pressure
Digital Glucometer
Common Interface
Spirometer
Wrist ClinicWrist Clinic
Weighing Machine
SPO2
Atom based Low Cost Laptop with Integrated Telemedicine Software
ECG
Update on 32nd APAN Meeting in New Delhi, India; 22-27 August 2011
Connectivity via High Speed Broadband (HSB)
Opportunities and ChallengesOpportunities and Challenges
Update on 32nd APAN Meeting in New Delhi, India; 22-27 August 2011
OpportunitiesOpportunities
• Vast and diverse geography with dominantrural population
• Disparity in healthcare infrastructure• Low cost local technical solution & ICT• Low cost local technical solution & ICT
expertiseFast adoption of Mobile technology• Fast adoption of Mobile technology
• Successful pilot projects• Policy on adoption of ICT in service delivery
Update on 32nd APAN Meeting in New Delhi, India; 22-27 August 2011
Challenges 1g
N ti l H lth P li• National e Health Policy
• Evaluation & Identification of Best Telemedicine
Practices
• Confidentiality & Security of Personal Health Record
• Credentials and competence of the remote physicianCredentials and competence of the remote physician
• Legal, ethical and social issues yet to be addressed
• Broadband internet yet to reach rural areas
NGN lik Wi M d 3G t t b l h d
Update on 32nd APAN Meeting in New Delhi, India; 22-27 August 2011
• NGN like Wi Max and 3G yet to be launched
Challenges 2Challenges 2
• E-health adoption by stake holdersp y
• e-Health Program sustainability Models
• Inter-operability of e Health system
• Integration into prevailing Health System• Integration into prevailing Health System
• Development of National e-Health Observatory
• Capacity Building in e-health System
• Research & Development in e-health technology and
system appropriate for local situation with global impact
Update on 32nd APAN Meeting in New Delhi, India; 22-27 August 2011
y pp p g p
School of Telemedicine & Biomedical Informatics
Thank you
Update on 32nd APAN Meeting in New Delhi, India; 22-27 August 2011www.nrct.in | www.telemedindia.org | www.stbmi.ac.in | www.sgpgi-telemedicine.org