Telehealth Roadmap: South Asia Feasibility Study

March 9, 2009Taiwan

Telehealth Roadmap: South Asia Feasibility Study

March 9, 2009Taiwan

Parvati Dev

A TEIN3 South Asia Project

Parvati Dev

A TEIN3 South Asia Project

Goal for RoadmapGoal for Roadmap

Current status of telehealth in South Asian countries

Gaps, barriers and opportunities Proposed 5 year roadmap Proposed high-impact initial projects

Current status of telehealth in South Asian countries

Gaps, barriers and opportunities Proposed 5 year roadmap Proposed high-impact initial projects

South Asian countriesSouth Asian countries

Afghanistan Bangladesh Bhutan India Maldives Nepal Pakistan Sri Lanka

Afghanistan Bangladesh Bhutan India Maldives Nepal Pakistan Sri Lanka

Method for document development

Method for document development

Web survey of existing projects, sent to members of SAFS project and colleagues

Web research for telehealth documents pertinent to South Asia

Drafts of document reviewed by contributors and survey participants

Web survey of existing projects, sent to members of SAFS project and colleagues

Web research for telehealth documents pertinent to South Asia

Drafts of document reviewed by contributors and survey participants

Document structureDocument structure

Introduction to telehealth concepts Summary of telehealth projects and ICT infrastructure in South Asia, by country

Proposed roadmap of projects for 5 years

Selected projects highlighted as possible high-impact projects

Appendix with results of web survey

Introduction to telehealth concepts Summary of telehealth projects and ICT infrastructure in South Asia, by country

Proposed roadmap of projects for 5 years

Selected projects highlighted as possible high-impact projects

Appendix with results of web survey

Telehealth: Many implementationsTelehealth: Many implementations

Applications Technology Feature

Telemedicine Point to point High bandwidth and low latency (for real-time consultation); High reliability (for store-and-forward)

Region-wide or local classroom

Multicast; Streaming Real-time interaction

Physician, drug and service directories; eLibraries

Web services Scalability and reach

Personal health records Privacy and security; Storage technology

High availability and high reliability

Advice and alerts, typically through SMS text messages or email

Context-based advice

High availability and high reliability

Informatics Compute clusters; Grid technology

High performance

Telemedicine platformTelemedicine platform

Equipment computer, scanner, videoconferencing

Software Data acquisition, storage, display, transmission

Clinical devices Electronic stethoscope, microscope, ECG, camera

Communications media Internet, ISN, VSAT, dial-up

Equipment computer, scanner, videoconferencing

Software Data acquisition, storage, display, transmission

Clinical devices Electronic stethoscope, microscope, ECG, camera

Communications media Internet, ISN, VSAT, dial-up

Telemedicine by countryTelemedicine by country

Highlights only (I may have missed some significant projects)

Highlights only (I may have missed some significant projects)

AfghanistanAfghanistan

National telemedicine projects are being planned

Aga Khan Foundation piloting a Pakistan-Afghanistan tele-radiology project

National telemedicine projects are being planned

Aga Khan Foundation piloting a Pakistan-Afghanistan tele-radiology project

BangladeshBangladesh

Plan to bring high bandwidth NREN to public and private universities.

Connectivity to hospitals is not mentioned.

The Diabetic Association has hub-and-spoke real-time telemedicine from Dhaka to Faridpur

Plan to bring high bandwidth NREN to public and private universities.

Connectivity to hospitals is not mentioned.

The Diabetic Association has hub-and-spoke real-time telemedicine from Dhaka to Faridpur

BhutanBhutan

Building on its 176 Basic Health Units (BHU)

Equip with dial-up Internet, computer, printer

Add portable electrocardiograph equipment at 15 BHUs

Collaborate with India, under SAARC (South Asia Association for Regional Cooperation) for digital teleradiology

Building on its 176 Basic Health Units (BHU)

Equip with dial-up Internet, computer, printer

Add portable electrocardiograph equipment at 15 BHUs

Collaborate with India, under SAARC (South Asia Association for Regional Cooperation) for digital teleradiology

IndiaIndia

Building National Knowledge Network VSAT and ISDN used for telemedicine Numerous separate projects

ISRO, SGPGI, Apollo, SAARC, Amrita, others

Numerous different telemedicine platforms

Pushing for international projects Professional association:

Society for Telemedicine in India

Building National Knowledge Network VSAT and ISDN used for telemedicine Numerous separate projects

ISRO, SGPGI, Apollo, SAARC, Amrita, others

Numerous different telemedicine platforms

Pushing for international projects Professional association:

Society for Telemedicine in India

MaldiveMaldive

No information on telemedicine initiatives

No information on telemedicine initiatives

NepalNepal

Pilot project between Kathmandu (specialty hospital) and Dolkha (in mountainous region)

Wireless link used for H.323 videoconference

Medical consultation Includes tele-education

Pilot project between Kathmandu (specialty hospital) and Dolkha (in mountainous region)

Wireless link used for H.323 videoconference

Medical consultation Includes tele-education

PakistanPakistan

Numerous telehealth initiatives PAKSAT, Aga Khan, UM Jaroka, IBM, others

Using VSAT, ISDN, dial-up PAKSAT is biggest project Aga Khan has teleradiology with Afghanistan

Jaroka uses diaspora; text messaging IBM has public-private partnership

Numerous telehealth initiatives PAKSAT, Aga Khan, UM Jaroka, IBM, others

Using VSAT, ISDN, dial-up PAKSAT is biggest project Aga Khan has teleradiology with Afghanistan

Jaroka uses diaspora; text messaging IBM has public-private partnership

SrilankaSrilanka

Telehealth projects planned Broadband, low-bandwidth Internet, VSAT

Multi-purpose videoconferencing units with HD resolution at 15 universities planned

Tele-teaching agreements with UK and Sweden

Telehealth projects planned Broadband, low-bandwidth Internet, VSAT

Multi-purpose videoconferencing units with HD resolution at 15 universities planned

Tele-teaching agreements with UK and Sweden

Regional / InternationalRegional / International

Afghanistan-Pakistan: Aga Khan Teleradiology project.

Afghanistan-USA: NASA Virtual SILK project Pakistan-US: Jaroka project with Pakistani medical diaspora in USA.

Pakistan-US: Public-private partnership with IBM and the Pakistan government.

India-Bhutan: SAARC teleradiology project. India-Africa: Pan- Africa e-health project India - South Asia – Europe: SGPGI telemedicine project

Srilanka-Europe: Tele-education project.

Afghanistan-Pakistan: Aga Khan Teleradiology project.

Afghanistan-USA: NASA Virtual SILK project Pakistan-US: Jaroka project with Pakistani medical diaspora in USA.

Pakistan-US: Public-private partnership with IBM and the Pakistan government.

India-Bhutan: SAARC teleradiology project. India-Africa: Pan- Africa e-health project India - South Asia – Europe: SGPGI telemedicine project

Srilanka-Europe: Tele-education project.

Telehealth trendsTelehealth trends

Existing base of telemedicine projects or pilots in most SAFS countries.

Significant activity in hub-and-spoke projects linking remote and rural sites to a specialist center.

Existing annual meeting in India for telemedicine, with participation by some South Asian countries, and with internationally recognized keynote speakers.

Increasing support of telemedicine and telehealth by national governments.

Recognition by national governments of the strategic importance of high bandwidth networks for education, research and telehealth.

Existing base of telemedicine projects or pilots in most SAFS countries.

Significant activity in hub-and-spoke projects linking remote and rural sites to a specialist center.

Existing annual meeting in India for telemedicine, with participation by some South Asian countries, and with internationally recognized keynote speakers.

Increasing support of telemedicine and telehealth by national governments.

Recognition by national governments of the strategic importance of high bandwidth networks for education, research and telehealth.

BarriersBarriers

Internet access not available universally and reaches very few

Bandwidth is low and access is expensive, making telemedicine deployment expensive.

Telemedicine and telehealth are not routine services in any hospital in the SAFS countries.

Physicians at specialist hospitals are not available for consulting on telemedicine patients.

Not much activity linking one specialist center to another either for telemedicine or for tele-education.

Telemedicine platforms are numerous and not interoperable. Telemedicine is still a fragmented “cottage industry”

Real-time interaction requires significant bandwidth. Other modes (store-and-forward, text messaging) less used

Internet access not available universally and reaches very few

Bandwidth is low and access is expensive, making telemedicine deployment expensive.

Telemedicine and telehealth are not routine services in any hospital in the SAFS countries.

Physicians at specialist hospitals are not available for consulting on telemedicine patients.

Not much activity linking one specialist center to another either for telemedicine or for tele-education.

Telemedicine platforms are numerous and not interoperable. Telemedicine is still a fragmented “cottage industry”

Real-time interaction requires significant bandwidth. Other modes (store-and-forward, text messaging) less used

ACTI VITY ONE YEAR TARGETS TWO YEAR TARGETS FIVE YEAR TARGETS

Build community of telehealth experts

South Asia meeting at th e annual meetin g of the Teleme dicine Society of India

South Asia Telehealth Society

Annual Society meet ing, with techn ical a nd app lication tracks

Tele -educati on and tele-communit y for remote health personnel

Weekly meetings, presentations, Vi rtual Gran d Roun ds

Always-on chat mee tings, video confe rence kiosks, virtual mee tings

Build on existing hub -and-spoke projects

Worksho p to review projects an d discuss scale -up

Cross-border demonstr ations Policies for sustainable practice

Expand selecte d telehealth projects to regional scale

Specialty -based regional workshop – Cancer, Radiology

Expand tele -radiolog y or Onconet pr ojects

Develo p stan dards for intero perability of systems

Collaborate with ATA and other grou ps

Certification Selecte d subjects A basic curricul um Multiple cur ricula

Suggested projectsSuggested projects

Project 1: Expand Onconet-like project to other South Asian countries

Project 2: Expand Pakistan-Afghanistan or Bhutan-India TeleRadiology project

Project 3: Organize a one-day South Asia Telemedicine workshop

Project 4: Initiate Virtual Grand Rounds between countries

Project 1: Expand Onconet-like project to other South Asian countries

Project 2: Expand Pakistan-Afghanistan or Bhutan-India TeleRadiology project

Project 3: Organize a one-day South Asia Telemedicine workshop

Project 4: Initiate Virtual Grand Rounds between countries

Thank youThank you

parvati@parvatidev.orgparvati@parvatidev.org