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  1. 2. <ul><li>Last year Doctors used the latest technology in medical education which shocked the country </li></ul><ul><li>By using ICT tools </li></ul><ul><li>Pen Scanners, Email, GPRS, MMS, SMS, Bluetooth. </li></ul><ul><li>In leaking Question papers in All India PG entrance </li></ul><ul><li>Where are we? </li></ul>
  2. 4. Present scenario-INDIA
  3. 6. Relation between Health and ICT ? <ul><li>Why both to be related & Why now? </li></ul><ul><li>Deals with computers or patients ? </li></ul><ul><li>Public or Private? </li></ul><ul><li>Which part of Health is useful? </li></ul><ul><li>Where is the challenge? </li></ul><ul><li>How for its useful? </li></ul><ul><li>Costlier ? </li></ul><ul><li>Future – telemedicine? </li></ul>
  4. 15. eHealth <ul><li>eHealth is the use, in the health sector, of digital data transmitted, stored and retrieved electronically in support of health care both at the local site and at a distance. </li></ul><ul><li>A global consultation meeting on eHealth for countries was held on 12-13 February 2004, at WHO headquarters in Geneva </li></ul><ul><li>The recommendations are…. </li></ul>
  5. 16. RECOMMENDATIONS <ul><li>1. Information for health promotion and awareness, medical education, health and biomedical research, evidence-based medicine and e-learning. </li></ul><ul><li>2. Information for HIS(disease surveillance, health statistics, MIS, financial, logistical, and GIS), monitoring and evaluation. </li></ul><ul><li>3. Information for HCD: diagnostics, treatment, consultation (telemedicine applications) and EPR. </li></ul>
  7. 20. Key challenges <ul><li>1. Lack of financial support and sustainability </li></ul><ul><li>2. Poor quality of technology and infrastructure </li></ul><ul><li>3. Lack of technically competent staff at all levels </li></ul><ul><li>4. Lack of awareness, access and attitudinal problems among users </li></ul><ul><li>5. Legal and policy issues </li></ul>
  8. 21. Initiatives taken in India Public Sector <ul><li>Disease surveillance systems under IDSP in Andhra Pradesh and Tamil Nadu. </li></ul><ul><li>ICDS surveillance system in Orissa </li></ul><ul><li>Jiva's teledoc initiative, the use of PDAs by ANMs in Nalgonda (sponsored by World Bank), </li></ul><ul><li>The Electronic Resource Centre for capacity building in HIV/AIDS set up by SAATHI </li></ul>
  9. 22. <ul><li>CDAC, an autonomous government IT organization, was a pioneer in developing First HIS in India. </li></ul><ul><li>First total HIS software in collaboration with Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow in 1997. </li></ul><ul><li>This has been implemented at SGPGI and GTB hospital, New Delhi </li></ul>
  10. 23. NGOs <ul><li>eHealth-Care foundation was conceptualized in 2001 as </li></ul><ul><li>e-Swasthya (eHealth in Hindi) with a goal to implement it across 21 health centres in the Madhubani district of Bihar. </li></ul><ul><li>eHealth-Care Foundation, (eHCF) a New Delhi based Not for Profit Organization- Digital Partners, a USA and India based Non-Profit Organization </li></ul>
  11. 24. M/s. eHealth-Care - Authorize Channel Partner of France Telecom’s RBGAN Terminal (Mobile Satellite Communication) <ul><li>National Thermal Power Corp. Ltd (NTPC) , New Delhi & Noida (Medical Card & Referral Slip Software) </li></ul><ul><li>NTPC-SAIL Power Corp. Ltd (NSPCL), New Delhi (Medical Card & Referral Slip Software) </li></ul><ul><li>NTPC-NCR, Noida (Medical Card & Referral Slip Software) </li></ul><ul><li>General Hospital, Sirsa, Haryana (Medical Cards & Online Prescription writing Software) </li></ul><ul><li>Sirsa District Administration, Haryana (Birth & Death Registration Software) </li></ul>
  12. 29. Initiatives telemedicine- Govt <ul><li>Indian Space Research Organisation (ISRO)- GRAMSAT (rural satellite) programme. </li></ul><ul><li>Presently ISRO’s Telemedicine Network consists of 75 Hospitals </li></ul><ul><li> 61 Remote/Rural/District Hospital/Health Centre connected </li></ul><ul><li>14 Super Specialty </li></ul><ul><li>Hospital located in the major cities. </li></ul><ul><li>More than 12,500 patients have been provided with Teleconsultation & treatment under ISRO </li></ul><ul><li>DIT </li></ul><ul><li>For telemedicine software systems - C-DAC </li></ul><ul><li>Started its pilot projects in HP,AP,TN,TRIPURA,WB,PUNJAB,KERALA </li></ul><ul><li>National Resource Centre for Telemedicine and Biomedical Informatics </li></ul><ul><li>at SGPGI, Lucknow. </li></ul><ul><li>DIT grant-in-aid Rs. 515 Lakhs for the presentation. </li></ul>
  13. 30. Private sector <ul><li>Apollo </li></ul><ul><li>set up over 45 Telemedicine Centres across different locations in the country </li></ul><ul><li>Asia Heart Foundation </li></ul><ul><li>more than 2000 tele- cardiology consultation through an enterprise based network </li></ul><ul><li>Escort Heart Institute & Research Center </li></ul><ul><li>involved in telecardiology service </li></ul><ul><li>Shankar Nethralaya , Chennai and Meenakshi Eye mission , Madurai </li></ul><ul><li>Mobile Tele-Ophthalmology service </li></ul><ul><li>Online Telemedicine Research Institute,Ahmedabad </li></ul><ul><li>R&D activities in telemedicine </li></ul>
  14. 32. Objectives of Telemedicine <ul><li>Enable the medical experts to take control of a remote medical emergency when required </li></ul><ul><li>The telemedicine system and sub-system especially at the remote location should be designed for use by non-medical but trained personnel </li></ul><ul><li>The remote telemedicine system should be designed for easy portability </li></ul><ul><li>The telemedicine solution should be cost effective requiring minimal training, installation and maintenance </li></ul><ul><li>The telemedicine equipment used should use a optimum bandwidth for data communication </li></ul><ul><li>Benefits </li></ul><ul><li>Patient - Improved access to quality care </li></ul><ul><li>Doctor - improved Disease management </li></ul><ul><li>Hospital - Substantial cost reduction in short term and long term health care </li></ul>
  15. 33. A model of eHealth- Canada <ul><li>COST </li></ul><ul><li>$142 Billion business </li></ul><ul><li>10.4% of GDP </li></ul><ul><li>60% of costs for hospitals, physicians and drugs </li></ul><ul><li>FINANCING </li></ul><ul><li>70% public and 30% private funded </li></ul><ul><li>SHARED GOVERNANCE </li></ul><ul><li>Federal Govt coordinates healthcare via the Canada Health Act </li></ul><ul><li>Provinces & territories have primary responsibility for healthcare </li></ul><ul><li>100+ health regions deliver care </li></ul>
  16. 34. Courtesy: eHealth India 2007
  17. 35. Courtesy: eHealth India 2007
  18. 36. Challenges in future <ul><li>Human factors </li></ul><ul><li>Individuals </li></ul><ul><li>Address concerns about training, liability, patient security and </li></ul><ul><li>increased workload among providers </li></ul><ul><li>Organizations </li></ul><ul><li>Demonstrate the value of eHealth to the health payer, provider and advocacy organizations </li></ul><ul><li>Align telemedicine with the increasing emphasis on self-care and multidisciplinary care models </li></ul><ul><li>Continue clinical trials at academic institutions to demonstrate that eHealth is effective and efficient </li></ul><ul><li>Governance </li></ul><ul><li>Promote acceptance of a patient-centred and technology-enabled method of health-care delivery </li></ul><ul><li>Create practice environments that reduce defensive medicine practices, which in turn limit the adoption of new clinical interventions such as telemedicine (e.g. malpractice reform) </li></ul><ul><li>Create a compelling case for lifting licensure restrictions that inhibit telemedicine activities across borders </li></ul>
  19. 37. <ul><li>Economics </li></ul><ul><li>Pilot new third-party reimbursement mechanisms to attract greater patient and provider participation, particularly in health systems that are not supported publicly </li></ul><ul><li>Explore global markets for eHealth that allow the export of medical expertise </li></ul><ul><li>Seek sustainable economic models that support telemedicine in the developing world to address the growing burden of chronic disease </li></ul><ul><li>Technology </li></ul><ul><li>Improve usability for patients with limited function, but who aim to benefit from eHealth. </li></ul><ul><li>Implement methods that verify and authorize access to health information such as fingerprint and voice recognition </li></ul><ul><li>Create communications devices that are smaller, less expensive and more powerful, which will be available at the point of care </li></ul><ul><li>Create sensors that are more sensitive, less expensive, passive and less obtrusive </li></ul><ul><li>Introduce methods of bridging the ‘digital divide’ faced by developing countries </li></ul>
  20. 38. FUTURE- A VISION <ul><li>A patient in mondola will be diagnosed as Peptic ulcer and not MI by the GTB cardiologist by telecardiology. </li></ul><ul><li>Ectopic pregnancy will be diagnosed in dhallupura by teleradiology. </li></ul><ul><li>From the health card ,it will be known that a person </li></ul><ul><li>is diabetic under 10years of listed treatment </li></ul><ul><li>hypertensive under 5 years of treatment </li></ul><ul><li>Sulpha drug allergy </li></ul><ul><li>TT Immunization 2 years back </li></ul><ul><li>Lipid profile done 1 week back with details </li></ul>
  21. 39. Professor of Harvard public health school will elaborate his views to the Health care professionals in rural part of india.