Telemedicine can make healthcare available, accesible and affordable. This presentation addresses some of the myths around Telemedicne in India and discusses why Tele-followup as an achievable paradigm.
2. The uses of Telemedicine
are limited
only by
our imagination.
*Pathni RK. Telemedicine in emergency medical care. Indo-US Emergency Medicine
Summit. 2005
7. < 1Dr / 1700
population
28 mn babies born
every year
Only ~40 Paed
Cardiologists in the
entire country
India is the Diabetes
capital of the world –
more renal / cardio
problems
Indians are 3 times more
vulnerable to heart attack
than Europeans
<80 Cardiologists / year
<60 Nephrologists /year
Where are the specialist to treat this huge
case load?
10. “The two monsters of rural communities
are time and distance. Spending money to
conquer either is simply making an
investment in our children.”
-Dr. John Hall
11. Telemedicine helped in saving about 81% of
treatment costs for patients (ISRO).
Upto 90% financial and man work-hours savings*
Level of satisfaction withTele-follow-up ranged
from very good to excellent.*
* Mishra A, Pradeep PV, Kapoor L, Basnet R, Satpathy C, Mishra SK. Tele follow-up of thyroidectomy
and parathyroidectomy patients: preliminary experience.
12.
13. • We need PHC, not fancyTM
Need
• Indian public is traditional
Acceptability
• Indian doctors are traditional
Acceptability
• We can’t do such hi-tech things
Ability
• What we have is no good
Availability
14. 95% doctors use telephone, e-mail, letters frequently.
Faculty in higher age group were found to be more likely
to have used telemedicine (p<0.05)
Most users expressed apprehensions regarding physical
examinations through TM.
Surgical disciplines were found to be more likely to use
telemedicine.
* Pathni RK, Satpathy S, Chaubey PC, Kailash S. Patterns of Practice Of TM at AIIMS. JAHA.
15. Acceptable
Very beneficial
Usage increased during the study period with 96%
users wishing to continue the service
* Bali S, Singh AJ. Mobile phone consultation for community healthcare in rural north India. J
Telemed Telecare 2007; 13: 421-24
16. “The necessary infrastructure in the form of satellite or
broadband connectivity is already in place in the
country.
Telemedicine in India is generally seen as
technologically on a par with the developed
countries.
Internationally, the Indian Telemedicine pilot projects are
also largely being viewed as successful.”
Solberg KE. Telemedicine set to grow in India over the next 5 years. Lancet. 2008 Jan; 371:17-18
17. *Pathni RK, Satpathy S, Kailash S. Need for tele-follow-up. J Telemed & Telecare. 2009
18.
19. AIIMS OPD : 25 lakh patients p.a.
14 lakh were old cases
OLD CASES AS PERCENTAGE OF OPD WORKLOAD
(SPECIALITY-WISE)
0% 50% 100%
Medicine
Haematology
Gastroenterology
Paediatrics
Dermatology
Psychiatry & NDDTC
General Surgery
Urology
Anaesthesia (Pain clinic)
Paediatric Surgery
Orthopaedics
ENT
Obstetrics & Gynaecology
Dental Surgery
Cardiology & CTVS
Neurology & Neurosurgery
Oncology & Oncosurgery
Ophthalmology
Old New
Pathni RK, Satpathy S, Kailash S. Need for tele-follow-up. J Telemed & Telecare. 2009
20. *Pathni RK, Satpathy S, Kailash S. Need for tele-follow-up. J Telemed & Telecare. 2009
Tele-Follow-up*
Essential
encounter
21.
22. Infrastructure costs
Equipment – Capital costs, Imports, Maintenance
Building, staff, training,
Connectivity costs
Acceptability ofTelemedicine
Patient – No touch, no confidence (GP can provide that)
Doctor – No trg
Logistics of bringing Consultant –Patient-Connectivity
together at the same time
23. Standards, Guidelines
Legal Issues – Licensing, Liability
Ethics – Confidentiality, consent, doctor-patient
relationship
Virtually no exposure to the applications of medical
ICT in curriculum of medical colleges.
Lack of health infrastructure and services
24.
25. MCIT – Development ofTelemedicineTechnology
NRHM
11th 5yr Plan (2007-12) – Rs 200 cr
NeGP Rs22,600cr
NationalTelemedicine Grid
Development of Standards
EMR - Guidelines
28. Tele-obstetrics*
78% of the patients avoided referral
All major anomalies and diagnoses confirmed
Tele – ultrasonography
*Prenatal Telemedicine. Andrea Di Lieto, et al. www.intechopen.com
31. The uses of Telemedicine
are limited
only by
our imagination.
*Pathni RK. Telemedicine in emergency medical care. Indo-US Emergency Medicine Summit. 2005