Abstract

Telemedicine Overview

Design Concept

Jose K Joy, Manisha Iyer, Nikhil DevInformation & Interface Design, 2010Guide: Dr. Bibhudatta BaralTelemedicine in India

Telemedicine is the use of Information and Communi-cation Technology for the delivery of Health Care Serv-ices to areas where health services are below the re-quired levels. It can be as simple as a telephone con-versation between medical professionals disussing the condition of a patient or as complicated as performing a surgery.

Objective of the research was to analyze the current Telemedicine scenario and identify areas where Design Intervension was required. Our research showed us that though the main idea behind Telemedicne was to increase the acessibility of Health Care to Rural India, it has not been implemented. The major cause were identified as Technology, Connectivity, initial invest-ment and absence of standards and guidelines. Keeping these issues in mind a model has been proposed which focuses on increasing the reach & accessibility of Telemedicine in Rural Areas.

Problem Identification

Research Methodology

Population Distribution Doctor Distribution

Rural Areas

Urban Areas

Analysis of literature

Technological issues Technology is not accessible averywhere Inefficient use of existing technology Software interoperability issues Primary level is not equiped Cost of implementation

Cultural issues of people Not effective as face to face consultation Confidentiality and Security issues

Implementaion Experts

Equipment manufacturers

Service Providers

Technicians

End users

General Public

User Experience

Latest service delivery models

Issues in Implemenation

Narayana Hrudayalaya

Apollo Hospitals

Manipal Hospital

Neurosynaptics

Patients

Telemedicine in India Web-sites.

Research papers on Tele-medicine Initiatives in India Papers onTechnology

Presentations on Rural telemedicine

Identify the sources Field work

Anganwadi is set of nation wide government sponsored child-care and mother-care centers in India, Managed by Aganwadi workers. Each Anganwadi covers a population of 1000. There are an estimated 1.053 million anganwadi centers in India. The duties of anganwadi worker are Regular health check-up. Immunization. Health education. Non-formal pre-school education.

Gaps in Literature

BenefitsSince the anganwadi workers are already trained in conducting health check ups, they can efficiently pro-vide assistance.More anganwadi workers can be trained for this and becomes an employment opportunity for women in rural areas.Kiosk occupies minimum space- just requires a closed space. No additional building costCare giver to patient ratio: not less than 1: 1000Automatic Routing mechanism allows the PHC to quickly avail connection to any of the available special-ity hospitals/ doctors and makes Urgent consultation possibleMedical training Awareness of telemedicine at grass root level.

Maintenance issuesPublic awarenessGovernment policies and political influencesAbsence of proper standards & rulesAbsence in Home based tele-health care

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7 8 9

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2 3Patient goes to Anganwadi

Staff connects to the TM network

Doctor prescribes medicines Anganwadi has a mini-pharma Satisfied patient

Sets up the equipment Does remote consultation

Meets Anganwadi staff Leads to telemedicine room

ANGANWADI

In case the request is rejected, the routing mechanism routes the call to next Doctor in the priority order.Error free, reliable and secure transmission has to be ensured. (The Hippa standards for transmission of medical information could be used, but it should be al-tered according to the Indian context).

Medical report and prescription can be obtained if scan-ner and printer is available (optional).

A stock of regular medicines are maintained in the an-ganwadi centres. On prescription, the anganwadi worker gives the medicine to the patient.

In case Tests are required only then the patient needs to travel to the PHC/CHS.

The telemedicine facility can be used to provide training to the anganwadi staff.

Telemedicine Kiosk at Anganwadi centres:

By making use of the existing facilities of Anganwadi and ex-pertise of the Anganwadi workers, telemedicine can be made more accessible. A simple Telemedicine Kiosk can be in-stalled in the Anganwadi Centre.

Recommended Specifications:

Location: Small enclosed area, with minimum noise distur-bance, within Anganwadi

Operated by: Anganwadi worker, who already has basic health care training.

Basic Equipments: Web Cam, Thermometer, Pulse, ECG, Stethoscope ideally integrated with the Telemedicine inter-face.

The equipments can be handled by the anganwadi worker with minimum training.

Connectivity: Router,Telephone line,ISDN, VSAT, GRAMSAT

Tele-Consultation: Video Conferencing with the PHC.

If the officer at PHC is busy then, The Request will be routed to the nearby Community Health Centre or District Hospital.