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The uses of Telemedicine
are limited
only by
our imagination.
*Pathni RK. Telemedicine in emergency medical care. Indo-US Emergency Medicine
Summit. 2005
http://www.informationweek.com/mobile/10-medical-robots-that-could-change-healthcare/d/d-id/1107696?
Whereas the world is moving …
< 1Dr / 1700 population
28 mn babies born every year
Only ~40 PaedCardiologists in the entire country
India is the Diabetes capital of the world –more renal / cardio problems
Indians are 3 times more vulnerable to heart attack than Europeans
<80 Cardiologists / year<60 Nephrologists /year
Where are the specialist to treat this huge case load?
“Healthcare should be available
affordableaccessible
&acceptable”
“The two monsters of rural communities
are time and distance. Spending money to
conquer either is simply making an
investment in our children.”
-Dr. John Hall
Telemedicine helped in saving about 81% of treatment costs for patients (ISRO).
Upto 90% financial and man work-hours savings*
Level of satisfaction with Tele-follow-up ranged from very good to excellent.*
* Mishra A, Pradeep PV, Kapoor L, Basnet R, Satpathy C, Mishra SK. Tele follow-up of thyroidectomy
and parathyroidectomy patients: preliminary experience.
• We need PHC, not fancy TMNeed
• Indian public is traditionalAcceptability
• Indian doctors are traditionalAcceptability
• We can’t do such hi-tech thingsAbility
• What we have is no goodAvailability
95% doctors use telephone, e-mail, letters frequently.
Faculty in higher age group were found to be more likely
to have used telemedicine (p<0.05)
Most users expressed apprehensions regarding physical
examinations through TM.
Surgical disciplines were found to be more likely to use
telemedicine.
* Pathni RK, Satpathy S, Chaubey PC, Kailash S. Patterns of Practice Of TM at AIIMS. JAHA.
Acceptable
Very beneficial
Usage increased during the study period with 96% users wishing to continue the service
* Bali S, Singh AJ. Mobile phone consultation for community healthcare in rural north India. J
Telemed Telecare 2007; 13: 421-24
“The necessary infrastructure in the form of satellite or
broadband connectivity is already in place in the
country.
Telemedicine in India is generally seen as
technologically on a par with the developed
countries.
Internationally, the Indian Telemedicine pilot projects are
also largely being viewed as successful.”
Solberg KE. Telemedicine set to grow in India over the next 5 years. Lancet. 2008 Jan; 371:17-18
*Pathni RK, Satpathy S, Kailash S. Need for tele-follow-up. J Telemed & Telecare. 2009
AIIMS OPD : 25 lakh patients p.a.
14 lakh were old cases
OLD CASES AS PERCENTAGE OF OPD WORKLOAD
(SPECIALITY-WISE)
0% 50% 100%
Medicine
Haematology
Gastroenterology
Paediatrics
Dermatology
Psychiatry & NDDTC
General Surgery
Urology
Anaesthesia (Pain clinic)
Paediatric Surgery
Orthopaedics
ENT
Obstetrics & Gynaecology
Dental Surgery
Cardiology & CTVS
Neurology & Neurosurgery
Oncology & Oncosurgery
Ophthalmology
Old New
Pathni RK, Satpathy S, Kailash S. Need for tele-follow-up. J Telemed & Telecare. 2009
*Pathni RK, Satpathy S, Kailash S. Need for tele-follow-up. J Telemed & Telecare. 2009
Tele-Follow-up*
Essential
encounter
Infrastructure costs
Equipment – Capital costs, Imports, Maintenance Building, staff, training, Connectivity costs
Acceptability of Telemedicine
Patient – No touch, no confidence (GP can provide that)
Doctor – No trg
Logistics of bringing Consultant –Patient-Connectivitytogether at the same time
Standards, Guidelines
Legal Issues – Licensing, Liability
Ethics – Confidentiality, consent, doctor-patient relationship
Virtually no exposure to the applications of medical ICT in curriculum of medical colleges.
Lack of health infrastructure and services
MCIT – Development of Telemedicine Technology NRHM 11th 5yr Plan (2007-12) – Rs 200 cr NeGP Rs22,600cr National Telemedicine Grid Development of Standards EMR - Guidelines
Buy – Install - Operate Buy “Know-how” “Plug-in” (Apollo-RWW) Rent Mobile TM Telemedicine-in-a-suitcase Railways TM Homes mHealth Teladoc Recharge Coupons
Tele – ANYTHING
Tele-presence
Tele-surgery
Tele-Diagnostics
Tele- ICU
Tele-Homecare
Tele Home- Dialysis
Tele-obstetrics*
78% of the patients avoided referral
All major anomalies and diagnoses confirmed
Tele – ultrasonography
*Prenatal Telemedicine. Andrea Di Lieto, et al. www.intechopen.com
Tele- Robotic Surgery
1992 - experimental demonstrations
1997 – Lapcholecystectomy
1998 - Beating heart surgeries
Tele Hypnosis
The uses of Telemedicine
are limited
only by
our imagination.
*Pathni RK. Telemedicine in emergency medical care. Indo-US Emergency Medicine Summit. 2005
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