Department of

Biomedical Physics & Technology

Dhaka University

<www.bmpt.du.ac.bd>

Telemedicine for Rural Areas(PC and Smartphone based)

Abdullah-Al Amin

Ahamad Imtiaz Khan

AKM Bodiuzzaman

Zihad tarafdar

Ahmed Raihan Abir

M Obaidur Rahman

Kamrul Hussain

Papia Chowdhury

Nazimul Kadir

K Siddique-e Rabbani

Bangladesh

> 70% live in rural areas

3.6 doctors for 10,000 people

70% people consult village doctors or quacks

No access to qualified (MBBS/Specialist) Doctors

What is telemedicine?

• Telemedicine healing at a distance (first used in 1970s )

• Telephone allowed earliest tele-consultation by doctors

• ICTs can make a revolution in Telemedicine

• Huge potential in Bangladesh and throughout the globe

Rural Healthcare in Bangladesh

• Semi-rural Health Complexes: 400 (hospitals with X-ray, Pathology and other facilities)

• Very difficult to retain qualified specialist doctors there.

• Rural Community Clinics: 15,000 with short-trained personnel, to provide very primary healthcare and referral of patients 

Possibility of telemedicine in Bangladesh

Need: Good communication

link providing consultation

with doctors in towns or cities

Internet and mobile phone

networks cover almost the

whole of Bangladesh.

Telemedicine can be used

effectively in Bangladesh

using both these media.

Telemedicine efforts in Bangladesh

• Several groups mostly video

conferencing only no diagnostic

equipment

• Telemedicine enabled diagnostic

equipment imported costs

prohibitively high.

• Foreign equipment cannot provide

prolonged service hot and humid

climate abnormal electricity

supply

Our efforts at Dhaka University

At Department of Biomedical Physics & Technology [BMPT-DU]

• PC based system with integrated diagnostic equipment greater capability of data capture

• Uses internet, Rural centres with PC, Doctors at Expert centres

A2I funding for Field Trial Recent fund from ISIF-Asia to develop a

mobile phone based system

• Health workers at rural homes doctors directly

Background work at BMPT-DU

Primary target: Upazilla Health Complexes (have X-ray, Pathology

facilities but no specialists)

We developed the following:

• ECG (12 lead, diagnostic quality)

• Stethoscope (Real time, needed for primary diagnosis)

• Respiration Monitor (Electrical Impedance based)

• X-ray viewer (for sending image to Radiologists)

• Microscope (for sending image of prepared specimen to

Pathologists)

• Colposcope (for viewing the cervix, to diagnose cervical cancer)

Temperature, Blood Pressure, Blood Glucose, Weight, Height measured and data typed in manually

Digital ECG, PC based12 lead, Graphical User Interface for data acquisition, display, storage and transfer.

BMPT-DU DEVICES FOR TELEMEDICINE Indigenous design

Certification for ECG equipment

Given by DMCH,

Obtained through DG Health, Bangladesh Govt.

ECG, 12 lead, with live internet transmissionFor telemedicine

Graphical User Interface for ECG

Instructions available on screen – both English and Bangla versions.User clicks using a mouse to interact – lead selection, data acquisition, transmission, etc.

ECG Report

Patient Name : null Sex: FemaleAge: 0 Wednesday 01 July 2015

Patient ID :

1

I

II

III

aVR

aVL

aVF

V1

V2

V3

V4

V5

V6

25 mm/sec 10 mm/mV

II

0s 1s 4s2s 3s 2s 3s1s 4s0s

2s0s 4s1s 3s

5 mm/mV

ECG REPORTSent to Cardiologist through own server or email

14

Improvised Digital Stethoscope

A microphone insert is fixed at a cut end of the rubber tube of a commercial stethoscope

Variable delays through internet distorts quality of sound and its time sequence

We are now using store and forward of short recordings

Improvised Digital MicroscopeSoftware zoom

A good webcam attached to a Chinese microscope.We are trying alternative methods using USB camera modules and improvised optics.

16

Digital X-Ray View Boxsoftware zoom

17

Digital Colposcopefor detection of Cervical Cancer

Improvised from a binocular

Software filtering done to get effects similar to that obtained using Red,

Green and Blue filters

 

INTERNET 

Helath Center

 

Helath Center

Rural/Semi rural Centers

 

Expert Center

 

Expert Center

Expert Centers

 

Helath Center

.

.

.

.

.

.

Basic scheme of our telemedicine system

Outputs of our devices

Scheme at Rural/Semi-rural Telemedicine Center

 

Digital Stethoscope

Digital X-ray Viewer

Digital Microscope

Digital Colposcope

Digital ECG, 12 Lead

Typed data entry

through PC keyboard

Sound input jack of PC

USB port of PC

USB port of PC

USB port of PC

USB port of PC

Local PC

 

Telemedicine Software 

Display 

Report and Prescription Generation

 Archiving and

Printing    

INTERNET

Video Conferencing

Software for TELEMEDICINE, Web based

• Address: www.bmpt.du.ac.bd/telemedbd

• Registration and ID to health operator and doctor by admin

• Log in by remote operator

• Log in by doctor

• Patient registration, vital information entry and uploading

• Doctor sees uploaded data

• Patient consults doctor through video consultation.

• Real time (almost) stethoscope

• Real time (almost) respiration monitor

• Real time (almost) ECG

• Uploading of images of Ultrasound, X-ray, previous prescriptions A Prescription - preliminary and final

• All records archived for future reference

<www.bmpt.du.ac.bd/telemedicine> Software for TELEMEDICINE

Prescription Generation

• Mixed Bangla and

English

• User friendly

generation, use of data

bases of symptoms,

advices and drugs.

• Keyword linked for

fast prescription

generation

Future:

Implementation in Bangladesh leading to a mature technology

through feedback and further R&D (both hardware and software)

Development in other languages (for other countries)

As a philosophy, we are not patenting our innovations

We plan for an open source movement in healthcare technology

Ready to share, collaborate with others from any country

Please contact us if you are interested

<rabbani@du.ac.bd>

See our activities at: <www.bmpt.du.ac.bd>

Acknowledgements

1. Farm Fresh brand of Akij group, Bangladesh

2. ISP of Uppsala University, Bangladesh

3. Access to Information (A2I) programme of Govt of Bangladesh (partners: UNDP, USAID)

4. Information Society Innovation Fund (ISIF)-Asia

5. All post graduate students and staff at the department who provided encouragement and support to this project

Thank You

Thank You