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An Introduction to Tele - medicine: where are we now?
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An Introduction to Tele - medicine: where are we now?

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  • 1. An introduction to Tele Medicine where are we now? Vijay Sardana MD,DM (neurology) Professor &Head Deptt of Neurology, Medical College, Kota
  • 2. Tele Medicine
    • Definition-Method-patient can be examined, monitored & treated with patient and doctor located at different place
    • Tele (Greek) –distance
    • Mederi(latin)-to heal
    • Healing by wire
    • Simplest e.g.-telephone
    • Advanced video conferencing between two continents
  • 3. Tele Medicine: History
    • 1876-Alexender graham bell
    • 1910- 1 st electrical stethoscope &telephone relay
    • 1959-1 st video communication for medical consultation
  • 4.
    • The Rapid changes that characterise medicine &computing give us the chance to be behind not one but two fast changing fields.
    • In the information age, knowledge is your best weapon
    • The problem the future is that it is always ahead of schedule
    Tele medicine
  • 5. Tele Medicine: Justification
    • Neurological care-450/1075 million
    • 1500 Neurologist
    • 100 Neurologist/year
    • 50% of medical college have Neurology/Neurosurgery deptt.
    • 15 centers of excellence
  • 6. Tele Medicine: Justification
    • City based specialists-unwilling for suburban/ Rural places
    • Lack of infrastructure
    • Quality of life
    • Professional isolation
    • Improper distribution
    • Delhi>North eastern India
  • 7.
    • Unpreceduted growth of information technology
    • -decreased Computer prices
    • -Internet through cables
    • -Fibro-optic cable
    • -Satellite transmission
    • -increase brand width
    • -Improvement in video+data compression licensing of private internet service providers
    • Telecommunication infrastructure in suburban/rural- easier specialist placement-difficult
    Tele medicine
  • 8. Tele Medicine: Advantages
    • Suburban/rural patient care
    • Max. utilization of suburban hospitals
    • Prim care physician doesn't loose patient
    • Up to 95% normal interaction can be established
    • Cost saving of unnecessary transfer
    • Continuing education for rural practitioners
    • Motivation for computer literacy
  • 9. Tele Medicine: problem
    • No hands on interaction with patient
    • Confidentiality of patient interaction
    • Reimbursement constraints
    • accuracy of diagnosis from remote place
    • who should take up? Time constraints
  • 10. Tele Medicine: Requirement
    • PC
    • Scanners
    • Digital cameras
    • Modified software
    • Appropriate networking system
    • Appropriate telecommunication technology
  • 11. Tele Medicine: technologies
    • Store and forward
    • Two way interaction television/Two way interactive video conferencing.
  • 12. Telemedicine- Technologies
    • ISDN lines
    • Internet protocol
    • Satellite
  • 13. Tele Medicine
    • Stroke
    • -</.5%acute stroke treated with Thrombolytic therapy
    • Tele-stroke management.
  • 14. Tele Medicine: Uses
    • Parkinson’s disease
    • Dementia
    • Epilepsy
  • 15. Tele Medicine: Uses
    • Neurotrauma
    • -decrease unnecessary transfer
    • -Early therapeutic interventions taken before transfer
  • 16. Tele Medicine:Telepathology
    • Intra-operative Pathology
    • Routine Surgical Pathology
    • 2 nd opinion
    • ?FNAC
    • ?Autopsy
  • 17. Tele Medicine: Indian scenario
    • 620 million- rural India
    • Bed populationratio-1:13330 (1991)
    • -ideal-1:1500
    • 2 million beds required. available 0.7 millions
  • 18. Tele Medicine: Indian scenario
    • ARAGONDA (population 5000)
    • First secondary care rural hospital using telemedicine-Apollo chennai
    • 40 bedded- physician, surgeon, pediatrician, 3 GDMOs
    • USG, Echo, ECG,Automated laboratory, CT scan, OT, Telemedicine unit
    • Web camera-ISDN lines
    • Digital camera-VSAT
    • D-microscope
  • 19. Tele Medicine: Indian scenario
    • ISRO- 200 hospitals
    • J&K, Karnataka, NE, Lakshadweep, Army,
    • Orrisa
    • Apollo hospital- chennai, Delhi, Hyderabad Tele medicine centers - Guwahati, Kolkata, Kohima, Portblair, Silcher, Mysore, Madurai, Military hospital Chennai, Dhaka
  • 20.  
  • 21.  
  • 22. Rajasthan
    • Population-56.5 million
    • Population growth rate-28.33(21.43)
    • Rural: Urban- 77:33
    • Large distances
  • 23.  
  • 24.  
  • 25.  
  • 26.  
  • 27.  
  • 28. Rajasthan Telemedicine programme
    • One of Biggest Tele medicine network in India
    • Population-56.5 m
    • Rural: urban- 77:23
    • Growth rate India:raj- 21.43:28.33
  • 29. Rajasthan Telemedicine programme
    • ISRO + Govt
    • 32 district hosp., 6 medical colleges, 6 mobile vans
    • VSAT at each location
    • INSAT
  • 30.  
  • 31.  
  • 32.  
  • 33. MBS Tele medicine unit
    • 2 PCs
    • TV
    • Video conferencing SONY camera with 360 degree tilt
    • Digital BP recorder, Digital ECG, Digital microscope, Digital PFT
    • Sitting capacity-30
    • 384 Kpbs
  • 34.  
  • 35.  
  • 36.  
  • 37. Tele Medicine: Learning Parts
    • Telemedicine here to stay despite advantages and disadvantages
    • Not a goal itself. should be used as a support to treat patients
    • Practical Problems-underutilized world over
    • Specialist consultation in sub urban and rural India & Rajasthan is now a mouse click away
  • 38. Thanks