Your SlideShare is downloading. ×
Nyaya Health Ultrasound Program: Implications for Teleradiology in Resource-Denied Areas
Upcoming SlideShare
Loading in...5
×

Thanks for flagging this SlideShare!

Oops! An error has occurred.

×

Saving this for later?

Get the SlideShare app to save on your phone or tablet. Read anywhere, anytime - even offline.

Text the download link to your phone

Standard text messaging rates apply

Nyaya Health Ultrasound Program: Implications for Teleradiology in Resource-Denied Areas

1,219
views

Published on

April 24, 2009 …

April 24, 2009
Telemedicine Conference
Bryn Mawr College, Philadelphia, PA

Published in: Health & Medicine, Business

0 Comments
2 Likes
Statistics
Notes
  • Be the first to comment

No Downloads
Views
Total Views
1,219
On Slideshare
0
From Embeds
0
Number of Embeds
3
Actions
Shares
0
Downloads
20
Comments
0
Likes
2
Embeds 0
No embeds

Report content
Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
No notes for slide

Transcript

  • 1. April 24, 2009 Telemedicine Symposium, Bryn Mawr College Nyaya Health's Ultrasound Program in Rural Nepal Implications for Teleradiology in Resource-Denied Areas Duncan Maru, PHD
  • 2. Overview
    • About Nyaya Health and Achham
    • Global Need for Radiology Services
    • Nyaya's Program
    • Ultrasound Design Specs
    • Human Resources
    • Quality Assurance and Teleradiology
    • Implications for X-Ray and Beyond
  • 3. Achham, Nepal
    • Number of citizens: 250,000
    • Number of doctors: 1
    • 99.5% of babies are delivered outside a health center
    • 1 in 125 deliveries result in death of the mother
    • 60% of children are chronically malnourished
    • Average person makes $150 a year
    • Nearest functioning airport and hospital: 10 hour bus ride away, costs 1-2 months' average income
    • 80% households have one male migrating to India
  • 4. Mission 1: Facilitate resource distribution to resource-denied areas
  • 5. Mission 2:
    • Foster local human capacity and grassroots collective action
  • 6. Mission 3: Apply evidence-based medicine principles and data monitoring
  • 7. Mission 4: Involve the central government in pro-poor health infrastructure
  • 8. Mission 5: Achieve transparency and collaboration in global health delivery
  • 9. Global Need for Radiology
    • over 50% of the world's population lack access to X-Ray and ultrasound
    • effective technology exists
    • what is lacking: financial support, training, evaluation, monitoring
  • 10. Ultrasound: Uses in Rural Areas
    • Referral to higher level facilities
    • Assistance in guiding procedures
    • Point of care diagnostics
  • 11. Ultrasound: Uses in Rural Areas
  • 12. Nyaya’s Ultrasound Program
    • started August 2008
    • from donation of GE Logicbook E through International Aid
    • with assistance from Yale Emergency Medicine faculty
  • 13. Ultrasound Design Specs
    • small, portable
    • power needs of a small laptop
    • robust; used in extreme environments
    • produces high-quality images
  • 14. Human Resources
    • Focus on physician initially
    • Gradually building up capacity of midwives
    • Need to improve overall computer literacy
    • Can improve job satisfaction, retention, cost-effectiveness
    • Oversight is critical
  • 15. Quality Assurance
    • store-and-forward
    • review of static images by Yale faculty
    • Simple data collection and review
    • Open-access to data
    • wiki.nyayahealth.org/UltrasoundProgram
  • 16. First 6 Months: Snapshot
    • primarily physician-conducted
    • Training of midwives ongoing
    • 70 Obstetric, 99 Non-Obstetric
    • 23% of OB and 40% of non-OB significantly changed management
  • 17. Selected Diagnoses and Procedures
    • Hepatic mass
    • Hydronephrosis
    • Cholecystitis
    • Enlarged abdominal lymph nodes
    • Retained placenta
    • Fetal demise
    • Normal pregnancy
    • Tuberculosis
    • IV access
    • Abscess drainage
  • 18. Implications: Teleradiology
    • Effective teleradiology can be quite “simple” technology-wise
    • Key is regular oversight and data review
    • Investments in telecommunications can be well worth the expense
  • 19. Implications: X-Ray
    • Similar issues in technology, staffing, evaluation, monitoring
    • Again: need financing and collaboration
    • Simple store-and-forward teleradiology can be highly effective
    • Open-access standards to improve transparency
  • 20. What you can do…
    • Join the social movement. Donate, spread the word, fundraise.
    • Volunteer. Need for dynamic, financially and tech saavy global health leaders
    • More info at www.nyayahealth.org