Tele Diagnosis Project

Tele diagnosis Project.

“To harness the power of current and emerging Information technologies in providing second opinions for serious, complex and / or medico-legal (negligence) cases from the top super-specialists to patients through their local referring doctors anywhere the world.”

A diagnosis that is made at a remote location and is based on the evaluation of data transmitted from instruments that monitor the patient and a transfer link to a diagnostic center

The goal of this project is to evolve an infrastructure framework for strengthening the Community Health centers through an integrated solution covering Tele-diagnostics in the area of Cardiac care ,Radiology ,Pathology and Ophthalmology that can be scaled along with select Clinical Service providers and a referral hospital network.

The aim of this project is to manage the Community healthcare center requirements through a Community healthcare management solution in which Tele-diagnostics would initially be made available in 4 clinical areas, namely, cardiac care ,radiology,pathology and ophthalmology. The aim of this project is to ensure

The guiding principle for this project is to have a single infrastructure for multiple health services and the solution should be such that it could be expanded in scope to other clinical areas based on the disease disposition in that region.

By doing this, India will significantly strengthen the use of technology in administering health for its citizens.

SCOPE OF THE PROJECT

Scope of the Project is integrating 100 primary care Hospitals with 5 geographically well centralized Secondary care Hospitals as First referral Hospital and in turn connected with One Tertiary care Hospital in Mumbai for Telediagnosis of ECG, Radiology/PACS and Tele Pathology for the interpretation and Tele consultation services

The aim of our researchis to manage the Community healthcare center requirements through a Community healthcare management solution in which Tele-diagnostics would initially be made available in 2 clinical areas –

1.  Cardiac care

2.  Ophthalmology.

The aim of this project is to ensure

·  Ability to maintain basic longitudinal patient records

·  Patient identification through a photo – bar coded swipe card

·  Build transparency in the pharmaceutical requirements at Rural Hospitals

·  Automate the administrative aspects of the Rural hospital

·  Provide Tele-Diagnostics as a standard OPD feature at the desk of the doctors in Rural Hospitals

·  Generate select reports needed by the district health officials seamlessly.

·  Reduction in Infant Mortality Rate (IMR) and Maternal Mortality Ratio (MMR)

·  Improved access to public health services such as Women’s health, child health, water, sanitation & hygiene, immunization, and Nutrition.

·  Prevention and control of communicable and non-communicable diseases, including locally endemic diseases

·  Access to integrated comprehensive primary healthcare

·  Population stabilization, gender and demographic balance.

·  Revitalize local health traditions and Promotion of healthy life styles

Issues in Service System

Studies from developed countries demonstrate that an orientation towards a specialist-based system enforces inequity in access. Health systems in low income countries with a strong primary care orientation tend to be more pro-poor, equitable and accessible. At the operational level, the majority of studies comparing services that could be delivered as either primary health care or specialist services show that using primary care physicians reduces costs, and increases patient satisfaction with no adverse effects on quality of care or patient outcomes.

In India, Primary Health Centres (PHCs) are the cornerstone of rural healthcare; a first port of call for the sick and an effective referral system; in addition to being the main focus of social and economic development of the community. It forms the first level of contact and a link between individuals and the national health system; bringing healthcare delivery as close as possible to where people live and work.

The current PHC structure is extremely rigid, making it unable to respond effectively to local realities and needs. Moreover, political interference in the location of health facilities often results in an irrational distribution of PHCs and sub-centers. Government health departments are focused on implementing government norms, paying salaries, ensuring the minimum facilities are available rather than measuring health system performance or health outcomes. Further, the public health system is managed and overseen by District Health Officers. Although they are qualified doctors, they have barely any training in public health management; strengthening the capacity for public health management at the district and taluk level is crucial to improving public sector performance.

The lack of accountability stems from the fact that there is no formal feedback mechanism and incentive to treat citizens as clients. Patients often complain of rude and abrupt health workers that discriminate against women and minorities from scheduled castes or tribes. The lack of accountability leads to absentee doctors; as it is difficult to attract qualified doctors to rural areas, inconvenient opening times and little or no community participation.

The lack of resources, which is acute in some states, is certainly a contributing factor to the poor performance of the primary healthcare system. In poor states, spending levels are low while expectations for coverage remain high. The incongruence between resources and targets result in lack of medicines; the current budget for essential drugs is insufficient to cater to large number of patients, limited doctor salaries. In order to improve primary care services, a number of approaches are used in developing countries. Capacity building and encouraging community involvement are some of the main factors. Capacity building aims to improve the knowledge and skills of primary care professionals and community involvement improves governance and accountability of public primary health clinics, which lead to increase in drug supply and improved provider skills. A widely used mechanism to improve primary health services is contracting.

Methodology – What is e- Health?

e- Health is an ICT enabled solution to harness the power of current and emerging Information technologies in providing second opinions for serious, complex and / or medico-legal (negligence) cases from the top super-specialists to patients through their local referring doctors anywhere the world.

It is a diagnosis that is made at a remote location and is based on the evaluation of data transmitted from instruments that monitor the patient and a transfer link to a diagnostic center.

The goal of this concept is to evolve an infrastructure framework for strengthening the Community Health centers through an integrated solution covering Tele-diagnostics in the area of Cardiac care, Radiology, Pathology and Ophthalmology that can be scaled along with select Clinical Service providers and a referral hospital network. e-Health aims at managing the Community healthcare center requirements through a Community healthcare management solution in which Tele-diagnostics would initially be made available in four clinical areas, namely, cardiac care, radiology, pathology and ophthalmology.

Need Analysis

More than 70% of India’s billion plus population residing in rural areas across the country is prone to a host of illnesses. This state of physical health is mostly attributed to the poverty and lack of awareness on health and hygiene. Although an extensive rural public health system exists across all Indian states, the sheer magnitude of the health services required, coupled with a gross shortage of trained staff and equipment, renders the system with the gap.

It is generally agreed that there is a pressing need for a program that essentially facilitates access to quality healthcare services for rural populations, besides having the potential to be scaled up in a short time and a cost-effective manner.

The Indian healthcare sector is being transformed to avail improved services to larger populations. However, healthcare in rural areas still remains a significant challenge resulting in reduced life expectancy at birth (eight years below urban populations) and infant mortality rates almost twice as that in urban areas. The Baramati e-Health Initiative is a Partnership effort by VIIT to ensure uniformly accessible, affordable and equitable healthcare for rural populations by using Information and Communication Technology (ICT) enablers, along with pre-existing public health services.

In the current scenario, 75% of the qualified consulting doctors practice in urban, 23% in semi-urban (towns) and only 2% in rural areas where as the vast majority of population live in the rural areas. Hospital beds/1000 people are 0.10 in rural as compared to 2.2 in urban areas. Further, a vast proportion of north and north-eastern region of country lie in hilly terrain and some territory in remote islands making healthcare reach impossible to such far flung areas. E-Health concept is no longer new to the country. Both government and private agencies are venturing into it. Efforts are directed towards setting up standards and IT enabled healthcare infrastructure in the country. All those activities carried out by various agencies

Rural E-Health Benefits: With medical help easily accessible at short notice, the rural people saves on time, effort and money to arrange consultations, hospital admissions, and follow-ups with different specialists. This has in turn helps to increase awareness about health and hygiene within the community.

The health care centers have benefits in terms of better and organized utilization of existing infrastructure, enhanced revenues through better patient turnout and optimum utilization of available skills and time. The rural hospital provide an opportunity for online Telediagnosis and Tele consultations through District and Specialist Hospital

Medical professionals get easy access to information on the protocols of treatment, availability of various facilities, etc. Instant availability of patients’ medical history proves to be of crucial importance to the doctors, especially during emergencies.

Availability of standardized and reliable data for an entire region facilitates the formulation of health policies. The information also serves as a regional and national epidemiological database for designing population/disease specific health care delivery/monitoring systems and designing health care programs.

Current Status

Effective results from RUI Hospital (November 2nd to March 15th 2007

Tele-diagnosis cardiac care with Narayan Hrudayalaya

Ophthalmic with Aravind Eye Hospitals

Pilot Project -Objectives

The aim of this project is to manage the Community healthcare center requirements through a Community healthcare management solution in which Tele-diagnostics would initially be made available in 2 clinical areas, namely, cardiac care and ophthalmology. The aim of this project is to ensure

·  Ability to maintain basic longitudinal patient records

·  Patient identification through a photo – bar coded swipe card

·  Build transparency in the pharmaceutical requirements at Rural Hospitals

·  Automate the administrative aspects of the Rural hospital

·  Provide Tele-Diagnostics as a standard OPD feature at the desk of the doctors in Rural Hospitals

·  Generate select reports needed by the district health officials seamlessly

Funds Flow Analysis

Estimated Costs

Bill of Material for the Tele diagnosis connecting Primary care Secondary care and Tertiary care Hospitals

A. Hardware

B. Networking/Accessories

C. Medical Equipments

D. Software

Need based services