1. TELEMEDICINE PROJECTS
in
West Bengal
A Presentation by
Dr. Rajendra S. Shukla, Special Secretary,
H & FW Dep’t, Government of West Bengal
&
Dr. J. N. Maity, Director,
WEBEL ECS Ltd.
29th September 2006, Vigyan Bhawan, New Delhi
2. Outline of Presentation
• Objectives & Relevance
• Benefits
• Model
• Telemedicine Projects in West Bengal
• Telemedicine & PPP
• Images & Graphics
• Awards
• Challenges & Way Forward
3. Use of information and communication
technologies:
i) To provide specialized health care
consultation to patients in remote
locations,
ii) To facilitate video-conferencing among
health care experts for better treatment
& care,
iii) To provide opportunities for continuing
education of health care personnel.
Objectives of Telemedicine
4. Relevance of Telemedicine
Inadequate infrastructure in rural/district
hospitals
Large number of indoor/outdoor patients
requiring referral for specialized care
Low-availability of Health Experts in
district/remote hospitals
Dearth of adequate opportunities for training or
continuing Medical Education for Doctors in
Rural/Remote Health facilities.
5. Benefits of Telemedicine (I)
Benefits to Patients:
Access to specialized health care services to
under-served rural, semi-urban and remote
areas,
Access to expertise of Medical Specialists to a
larger population without physical referral,
Reduced visits to specialty hospitals for long
term follow-up care for the aged and terminally
ill patients.
6. Benefits to Physicians:
Improved diagnosis and better treatment
management
Access to computerized, comprehensive data
(text, voice, images etc.) of patients – offline
as well as real time
Quick and timely follow-up of patients
discharged after palliative care
Continuing education or training through
video conferencing periodically
Benefits of Telemedicine (II)
7. Hospital and Insurance Benefits:
Significant reduction in unnecessary visits &
hospitalization for specialized care at tertiary
hospitals,
Earlier discharge of patients leading to shorter
length of stay in hospitals,
Increase in the scope of services without
creating physical infrastructure in remote
hospitals
Benefits of Telemedicine (III)
8. Telemedicine : The Model
Patient under treatment
Physician treating the patient
A remote telemedicine console having
audio visual and data conferencing
facilities
Nodal Hospital
Referral Hospital
An expert / specialised doctor
A central telemedicine server having
audio visual and data conferencing
facility
10. Sequence of Tele-consultation (I)
PATIENT IN
Patient visits OPD
Local Doctor checks up
Patient receives treatment
and is not referred to
telemedicine system
Patient referred to the Telemedicine system (some
special investigations may be suggested)
Patient visits Telemedicine data-entry console.
Operator enters patient record, data and images of
test results, appointment date is fixed for online
telemedicine session
OUT
OUT
Offline Data
transfer
from Nodal
Centre
11. Patient 1
Patient 2
Patient 3
Patient 4
.
.
.
Online video conference &
tele-consultation for patients
between local doctors at the
nodal hospital and specialist
doctors at the referral
hospital
Patient queue
IN OUT
Sequence of Tele-consultation (II)
12. Health Infrastructure in West Bengal
(Government)
Medical College Hospitals 9
Dental College Hospitals 2
School of Tropical Medicine 1
District Hospitals 15
Sub-Divisional & State General Hospitals 70
Rural Hospitals 95
Block Primary Health Centres 251
Primary Health Centres 922
Sub-Centres 10,356
** Health on the March 2004-05 Gov. WB
13. Telemedicine in West Bengal (I)
Project Implementation by Webel ECS Ltd,
Kolkata (Dep’t of IT, Govt. West Bengal)
Software development by CS & E Dept. IIT,
Kharagpur
Project sponsored & funded by the Dep’t of IT,
Min. of Communications & IT, Govt. of India
Implementation and usage of facilities by the
Dept. of Health & FW, Govt. of West Bengal
14. PROJECT - I
DIT Sanction No. : 2(5)/98-H&B Dated 21.01.1999
Project Cost : Rs. 150 lakhs
Referral Center : School of Tropical Medicine, Kolkata
Nodal Centers : Habra State General Hospital, 24th
Parganas (North)
: MJN Hospital, Coochbehar
Telemedicine in West Bengal (II)
Connectivity: First with POTS, upgradation with ISDN, lastly
with 512 Kbps Leased Line using WBSWAN as backbone.
Disease Types: Skin Related and Blood Related
Diseases,Leprosy .
Project Completed: December 2003
15. 128 KBPS ISDN Link
Koochbehar MJN
Habra SGH
STM
Location of Centers
0f Project I
LEGEND
16. PROJECT - II
DIT Sanction No. : 2(11)/2001-HBT, dated 31.03.2002
DIT, GOI Contribution : Rs. 147 lakhs
Referral Center : NRS Medical College & Hospital, Kolkata
: Burdwan Medical College & Hospital, Burdwan
Nodal Centers : Purulia District Hospital, Purulia
: Suri District Hospital, Birbhum
: Baharampur District Hospital, Murshidabad
: Midnapur Medical College & Hospital, Midnapur
Connectivity: 512 Kbps Leased Line using WBSWAN as
backbone.
Disciplines: Cardiology, Radiology, Medicine, Pediatrics,
Pathology, Neurology, Dermatology etc.
Project Completed: December 2004
17. 512 KBPS Leased Line
Behrampur DH
Suri DH
MidnapurMC&H
Burdwan MC&H
NRS MC&H
Purulia DH
Location of Centers
Of Project II
LEGEND`
18. PROJECT - III
DIT Sanction No. : 2(20)/2003-Telemed Dt. 08.03.04
DIT, GOI Contribution : Rs. 287 lakhs 0
Referral Center : Calcutta Medical College, North Bengal Medical
College, Chittaranjan National Cancer Institute,
Kolkata
Nodal Centers : Darjeeling, Raigunj & Tamluk District Hospitals
: Arambag Sub. Div. Hospital, Hoogly
Connectivity: ISDN for Arambag Nodal center and 512
Kbps Leased Line using WBSWAN as backbone for other
centers.
Disciplines: Cardiology, Radiology, Medicine, Pediatrics,
Pathology, Neurology, Dermatology, Oncology etc.
19. 512 KBPS Leased Line
128 KBPS ISDN Link
NBMCH
Darjeeling DH
Tamluk DH
Arambag SDH
CMC&H
Raiganj DH
CNCI
Location of Centers
Of Project III
LEGEND
20. Koochbehar MJN
Habra SGH
Behrampur DH
Suri DH
MidnapurMC&H
Purulia DH
Darjeeling DH
Tamluk DH
Arambag SDH
Raiganj DH
CMC&H
CNCI
STM
NRS MC&H
NBMCH
Burdwan MCH
KOLKATA
LEGEND
Total Mapping of
The Nodal and
Referral Centers
21. TelemediK Software (I)
Is a point-to-point telemedicine system
Symmetric
No distinction between nodal and referral centers
Any hospital can communicate to other hospitals
2nd level referral is allowed
Multi nodal, multi referral environment
Operates over a spectrum of low to high
bandwidth communication channels - POTS,
ISDN, leased line, VSAT and wireless media
22. Store & Forward Technical information
Online video conferencing and data transfer
Electronics Medical Record (EMR) Supported
- Text, Image, Graphics, Audio, Video
Integration with different medical instrument
- EEG, ECG, USG, MRI, CT SCAN, Electronic
stethoscope, Microscope fitted with digital camera
Support of medical standards
TelemediK Software (II)
23. Training Provided
Training Provided
Tele-medicine Centers Doctors Paramedics
Habra SDH 03 12
Coochbehar DH 08 12
Midnapur MC & H 12 03
Behrampur DH 05 02
Purulia DH 18 08
Suri DH 15 02
NRS MC & H 03 01
Burdwan MC & H 15 07
STM, Kolkata 05 01
Total 84 48
24. Discipline wise Patient Consultation
Pediatrics 75
Orthopedics 96
Neurology 34
Cardiovascular Medicine 27
Psychiatry 12
ENT 31
Urosurgery 11
Hematology, Dermatology, General Medicine,
OBG, Leprosy, etc
3300
25. Public-Private Partnership in Tele-
medicine
Integrated Tele-Cardiology & Tele-health Project
Govt. facilities covered - BSMCH & Siliguri SDH
Partnership with Asia Heart Foundation & RN
Tagore International Institute of Cardiac Sciences,
Kolkata
Connectivity through POTS & ISDN
26. Services Provided
Treatment of Acute Heart Attack cases as
evidenced by history and ECG,
Treatment by “Thrombolysis”
Referral & Tele-consultation & video
conferencing with RN Tagore International
Institute of Cardiac Sciences, Kolkata
27. Bankura Sammilani
Medical College
Siliguri SD
Hospital
Patients Admitted 1493 2418
Thrombolysed 296 197
Tele-consultation 915 458
Utilization of Tele-cardiology
Facilities
36. Awards Received
National e-Governance Award, 2004 – from
Govt. of India under Category “ Outstanding
Performance in Service Delivery”
Skoch Challenger Award, 2005
Manthan – American India Foundation
Award, 2006 under “e- Health” Category
37. Challenges in Implementing Telemedicine
1. Identification of a Suitable site and preparation of site
for Telemedicine facility.
2. Synchronization of civil, electrical and equipment
related works.
3. Identification of a nodal officer (Other than
Superintendent) for coordinating Telemedicine activities
in the hospital.
4. Sensitization and repeated hands-on training of
concerned Doctors, Technicians and Nurses.
5. Coordinating with referral centers to fix mutually
convenient tele-consultation sessions on a regular
basis.
6. Ensuring trouble free & smooth connectivity through
WAN (ISDN/Leased Line)
38. …. way forward
1. Hand-holding support to Hospital administration for 3-4
years for stabilization of telemedicine services.
2. Integration of Telemedicine activities with Health
Management Information System for regular reporting
(preferably web-based)
3. Including Telemedicine activities in the performance
appraisal of individuals and institutions.
4. Introducing Telemedicine (concept, technical aspects
and implementation arrangements) as part of medical
education & continuing medical education.
