Telemedicine involves using telecommunications technologies to provide remote medical services. It allows specialists to consult with patients and healthcare providers in remote locations. The key benefits are improved access to specialized care for rural communities, reduced travel costs, and opportunities for continuing medical education. However, implementing telemedicine also faces challenges related to infrastructure, technology adoption, interoperability, and cost. Standards like DICOM help address some challenges by facilitating sharing of medical images between systems.
Survey on Mobile Based Telemedicine System for Patient Monitoring and Diagnos...IJERA Editor
Recently remote health care has been a key issue to look after. As Sikkim is a hilly area suffering from transportation and inadequate medical facilities. Therefore, this survey on telemedicine system provides sufficient ideas for remote health diagnosis and monitoring in remote of Sikkim. As per the health personalities the various chronic diseases are diagnosed and treated with the human parameters such as ECG, SpO2, temperature, and blood pressure. These psychological signs are diagnosed in remote hospitals and PHCs and all physiological signs will be immediately transmitted to remote medical server through both cellular networks and internet. Also data can be transmitted to a family member’s mobile phone or doctor’s phone 3G and 4G networks. As Sikkim has 7 major hospitals and 24 PHCs, so one major hospital such as CRH Manipal or STNM can be chosen as a remote server unit and all the information through advance wireless communication module is received in this unit and patient health status can be diagnosed. As this hilly place lacks in medical facilities in remote places due to in educate knowledge of telemedicine system. This paper discuss about the recent trends in telemedicine for a small state. This paper is discussed in order to give 24*7 medical facilities in every corner of Sikkim. This paper also discusses the telemedicine system for normal and emergency condition. As this telemedicine is not a new technology, it’s an existing technology this paper discuss the advancement in such technology to provide better medical service for remote places.
Survey on Mobile Based Telemedicine System for Patient Monitoring and Diagnos...IJERA Editor
Recently remote health care has been a key issue to look after. As Sikkim is a hilly area suffering from transportation and inadequate medical facilities. Therefore, this survey on telemedicine system provides sufficient ideas for remote health diagnosis and monitoring in remote of Sikkim. As per the health personalities the various chronic diseases are diagnosed and treated with the human parameters such as ECG, SpO2, temperature, and blood pressure. These psychological signs are diagnosed in remote hospitals and PHCs and all physiological signs will be immediately transmitted to remote medical server through both cellular networks and internet. Also data can be transmitted to a family member’s mobile phone or doctor’s phone 3G and 4G networks. As Sikkim has 7 major hospitals and 24 PHCs, so one major hospital such as CRH Manipal or STNM can be chosen as a remote server unit and all the information through advance wireless communication module is received in this unit and patient health status can be diagnosed. As this hilly place lacks in medical facilities in remote places due to in educate knowledge of telemedicine system. This paper discuss about the recent trends in telemedicine for a small state. This paper is discussed in order to give 24*7 medical facilities in every corner of Sikkim. This paper also discusses the telemedicine system for normal and emergency condition. As this telemedicine is not a new technology, it’s an existing technology this paper discuss the advancement in such technology to provide better medical service for remote places.
International Journal of Engineering Research and Applications (IJERA) is an open access online peer reviewed international journal that publishes research and review articles in the fields of Computer Science, Neural Networks, Electrical Engineering, Software Engineering, Information Technology, Mechanical Engineering, Chemical Engineering, Plastic Engineering, Food Technology, Textile Engineering, Nano Technology & science, Power Electronics, Electronics & Communication Engineering, Computational mathematics, Image processing, Civil Engineering, Structural Engineering, Environmental Engineering, VLSI Testing & Low Power VLSI Design etc.
Classification of cardiac vascular disease from ecg signals for enhancing mod...hiij
“Why to be in frustration we will do new creation f
or salvation”. Based on these words we grapes your
attention towards saving a life of a heart patient
with the use of ECG in Public Health Care Center by
transmitting ECG signals to nearby hospital server.
In this paper we analyze the abnormalities found i
n the
ECG signals by identifying the Normal, Bradycardia
Arrhythmia, Tachycardia Arrhythmia and Ischemia
signal using the method of Neuro Fuzzy Classifier.
Daubechies Wavelet Transforms is used for feature
extraction and Adaptive Neuro Fuzzy Inference Syste
m (ANFIS) is used for classification. The compressi
on
algorithm is performed by using Huffman coding.
Medical Care for Rural Populations
Shortening the distance between the patient & the physician
From eWave MD –
a web based Virtual Medical Consultation platform that delivers low-cost preventive
healthcare services to rural populations 24/7 medical advice, professional diagnostics, and the option to provide non-professional
staff with a wide variety of assistance
In this thesis the impact of digitisation on radiology is analysed based upon diverse initiatives and research projects that were conducted in the period between the early days and now. Various topics such as web-based sharing of radiological images, teleradiology, digital communication and advanced processing of medical data, are discussed. Based on these findings the author formulates his vision and advises about the future role of the radiologist.
In the dissertation The impact of information technology on radiology services the author describes the most important changes that took place in the field of information technology since the end of past century, and their impact on radiology.
A real revolution has been provoked in radiology by the complete digitisation of medical imaging and the deep integration of Internet in both society and healthcare. Digital archiving, processing and distribution of radiological images, as well as the development of various types of teleradiology, are an important part of this change.
Radiology is facing many new challenges and opportunities due to the on-going exchangeability, integration and automated analysis of medical data and images. Other major trends such as the increasing personalisation of medicine and growing engagement of patients in their healthcare process are also significantly influencing this turnaround in radiology.
Arduino Based Abnormal Heart Rate Detection and Wireless Communicationijcisjournal
The heart rate is to be monitored continuously for the heart patients. This paper proposed a system that
awakes to monitor the heart rate condition of the patient. This work includes two parts. 1) We developed an
application to monitor the patient’s heart beat and if the heart beat is abnormal, a message should be
transmitted to the doctor using 3G shield. Thus, doctors could monitor the patient’s heart rate condition
continuously and suggests few earlier precautions to the patient. The heart rate is detected by using
photoplethysmograph (PPG) technique. 2) The Arduino wireless communication is developed in such a
way that it performs voice calls, sends SMS by interfacing with 3G shield using AT commands. One of the
input given is a user specified number to be dial and the expected output is voice call should be successfully
performed. Here the program is written in such a way that there are many options available like dynamic
call, emergency call (police, ambulance, and fire), sending message, receiving call, Disconnect a call,
Redial, Forward message.
International Journal of Engineering Research and Applications (IJERA) is an open access online peer reviewed international journal that publishes research and review articles in the fields of Computer Science, Neural Networks, Electrical Engineering, Software Engineering, Information Technology, Mechanical Engineering, Chemical Engineering, Plastic Engineering, Food Technology, Textile Engineering, Nano Technology & science, Power Electronics, Electronics & Communication Engineering, Computational mathematics, Image processing, Civil Engineering, Structural Engineering, Environmental Engineering, VLSI Testing & Low Power VLSI Design etc.
Classification of cardiac vascular disease from ecg signals for enhancing mod...hiij
“Why to be in frustration we will do new creation f
or salvation”. Based on these words we grapes your
attention towards saving a life of a heart patient
with the use of ECG in Public Health Care Center by
transmitting ECG signals to nearby hospital server.
In this paper we analyze the abnormalities found i
n the
ECG signals by identifying the Normal, Bradycardia
Arrhythmia, Tachycardia Arrhythmia and Ischemia
signal using the method of Neuro Fuzzy Classifier.
Daubechies Wavelet Transforms is used for feature
extraction and Adaptive Neuro Fuzzy Inference Syste
m (ANFIS) is used for classification. The compressi
on
algorithm is performed by using Huffman coding.
Medical Care for Rural Populations
Shortening the distance between the patient & the physician
From eWave MD –
a web based Virtual Medical Consultation platform that delivers low-cost preventive
healthcare services to rural populations 24/7 medical advice, professional diagnostics, and the option to provide non-professional
staff with a wide variety of assistance
In this thesis the impact of digitisation on radiology is analysed based upon diverse initiatives and research projects that were conducted in the period between the early days and now. Various topics such as web-based sharing of radiological images, teleradiology, digital communication and advanced processing of medical data, are discussed. Based on these findings the author formulates his vision and advises about the future role of the radiologist.
In the dissertation The impact of information technology on radiology services the author describes the most important changes that took place in the field of information technology since the end of past century, and their impact on radiology.
A real revolution has been provoked in radiology by the complete digitisation of medical imaging and the deep integration of Internet in both society and healthcare. Digital archiving, processing and distribution of radiological images, as well as the development of various types of teleradiology, are an important part of this change.
Radiology is facing many new challenges and opportunities due to the on-going exchangeability, integration and automated analysis of medical data and images. Other major trends such as the increasing personalisation of medicine and growing engagement of patients in their healthcare process are also significantly influencing this turnaround in radiology.
Arduino Based Abnormal Heart Rate Detection and Wireless Communicationijcisjournal
The heart rate is to be monitored continuously for the heart patients. This paper proposed a system that
awakes to monitor the heart rate condition of the patient. This work includes two parts. 1) We developed an
application to monitor the patient’s heart beat and if the heart beat is abnormal, a message should be
transmitted to the doctor using 3G shield. Thus, doctors could monitor the patient’s heart rate condition
continuously and suggests few earlier precautions to the patient. The heart rate is detected by using
photoplethysmograph (PPG) technique. 2) The Arduino wireless communication is developed in such a
way that it performs voice calls, sends SMS by interfacing with 3G shield using AT commands. One of the
input given is a user specified number to be dial and the expected output is voice call should be successfully
performed. Here the program is written in such a way that there are many options available like dynamic
call, emergency call (police, ambulance, and fire), sending message, receiving call, Disconnect a call,
Redial, Forward message.
Telemedicine is an upcoming field in health science arising out of the effective fusion of Information and Communication Technologies (ICT) with Medical Science having enormous potential in meeting the challenges of healthcare delivery to rural and remote areas .
Telemedicine is an upcoming field in health science arising out of the effective fusion of Information and Communication Technologies (ICT) with Medical Science having enormous potential in meeting the challenges of healthcare delivery to rural and remote areas .
TELEMEDICINE IS A MOBILE HOSPITAL AND IS VERY HELPFUL IN REMOTE AREAS. THERE IS NO NEED OF DOCTOR TO BE PRESENT EVERYWHERE WHEN DOCTOR CAN BE CONNECTED WITH YOU AT YOUR PLACE THROUGH VIDEO CONFERENCING.
Telemedicine A BRIGHT FUTURE for hospitality.akriti singh
TELEMEDICINE is a kind of mobile hospital and is very helpful, especially in remote areas , like small towns and villages.
There is no need of Doctor to be present everywhere when u can connect with any doctor from your place only !!! TELEMEDICINE provides us this facility.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
1. telemedicine
narendra malhotra
jaideep malhotra
neharika malhotra bora
rishabh bora
www.rainbowhospitals.org
www.malhotrahospitals.com
2. What is Telemedicine
Telemedicine may be
defined as the use of
computers and
telecommunication
technologies to provide
medical information and
services from distant
locations
3. • Telemedicine comprises all medical actions which
extend the action space of health care professional
beyond the face-to-face relationship with the patient
in the direct surroundings.
• It is medicine at a distance.
This includes health care
delivery, diagnosis, consultation, treatment, educatio
n and the transfer of related data.
ITU-T Workshop on
Standardization in E-Health,
3
Geneva, 23-25 May 2003
4. Objectives of Telemedicine
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.
5. 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.
6. 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.
7. Benefits of Telemedicine (II)
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
8. Benefits of Telemedicine (III)
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
10. Telemedicine : The Model
Patient under treatment
Physician treating the patient
A remote telemedicine console having
audio visual and data conferencing
Nodal Hospital facilities
Referral Hospital
An expert / specialised doctor
A central telemedicine server having
audio visual and data conferencing
facility
11. Different types of services
Telecardiology
Teleradiology
Telepathology
Telepsychiatry
Early Warning System
[ Prevention and control of endemic and infectious diseases ]
12. Benefits of E-Health
• Support for diagnostic (primary
diagnostic, collaboration, 2nd opinion)
• Triage for evacuation of patients
• Distant education
• Enhancement of collaboration spirit
• Diminution of isolation
• Use of personal computers for health care.
ITU-T Workshop on
Standardization in E-
Health, Geneva, 23-25 May
2003
13. Telemedicine in India
•Existing system limited only to private hospital
•CORPORATE Group of Hospitals.
•RN Tagore Cardiac Hospital, Calcutta. (Asia Heart Foundation)
• No Telemedicine system for public health care
•Corporate Sectors Offering Telemedicine Systems
•APPOLO & OTHER CORPORATE Groups
•Online Telemedicine System, Ahmedabad.
•WIPRO GE
•SIEMENS
14. Aim of the Telemedik System
• Information management
– Patient information
– Medical data (signs, symptoms, test reports, etc..)
– Appointment scheduling
– Archival and retrieval of patient records
• Low cost solution
– Using ordinary telephone line
• Service to large population
– Through public health care delivery systems
• Development of knowledge-based system
– For decision support
– For training and education
15. Why it is relevant to our society
Poor infrastructure
Non-availability of experts (disparate distribution)
Low doctor-patient ratio (large population)
Lack of proper medical education
Special attention required for Public Health Care System
16. Medical constraints and challenges
• Need and will of cooperation
between medical sites;
• Complementary function of
involved institutions and
organizations;
• Acceptance of technology and
change of working environment;
• Interoperability issues ignored.
ITU-T Workshop on Standardization in E-Health, Geneva, 23-25 May 2003
17. Major Challenges
•Poor Data Communication Infrastructure.
•A Large Population Catered by
Government Hospitals.
•System Features should be scalable.
•Cost of the system should be scalable.
18. Telecommunication constraints
• Minimum requirement is
reliable telephone line at
19.2KBit/s
• Simultaneous Internet
access recommended
• ISDN permits more
advanced solutions like
video-conferencing
• xDSL for the future.
ITU-T Workshop on Standardization in E-Health, Geneva, 23-25 May 2003
19. Few E-Health Standards applicable
• DICOM (Digital Communication Medicine) for
medical imaging
• ITU H320/H120 for video-conferencing
• Proprietary systems for “Store-And-Forward”
• Proprietary interactive and collaborative systems
ITU-T Workshop on Standardization in E-Health, Geneva, 23-25 May 2003 19
20. Digital Imaging Communications in Medicine
(DICOM )
originally the ACR-NEMA
developed by American College of Radiology (ACR) and
the National Electrical Manufacturer's Association (NEMA)
provides standardised formats for image capture and storage
coupled with a common information model specifying service
definitions and protocols for communication
21. System Schematic
Referral Center
Digital Camera Web Cam
PSTN /
Leased Line Doctor / Web Cam
Scanner Patient Electronics
/ ISDN /
Microscope
VSAT
Printer
Specialist Doctor
Scanner
Digital camera
ECG Machine
Printer
Electronics
Stethoscope
Nodal Center
22. Requirement Specification
• A patient getting treated
Nodal Hospital • A Doctor
• A remote telemedicine console having audio visual
and data conferencing facilities
POTS / ISDN
• An expert/ specialized doctor
Referral Hospital • A central telemedicine server having
audio visual and data conferencing facility
23. Sequence of Operation
PATIENT IN
Patient visits OPD Patient receives local treatment
OUT
Local Doctor checks up and not referred to telemedicine
system
Patient referred to the Telemedicine system (some special
investigations may be suggested)
Patient visits Telemedicine data-entry console.
Operator entries patient record, data and images of test OUT
results, appointment date is fixed for online telemedicine
session
Offline Data transfer
from Nodal Centre
24. Sequence of Operation
Patient 1
Patient 2
Patient 3 Online conference for the patient.
Patient 4
. IN Patient, local doctors at the nodal hospital OUT
. and specialist doctors at the referral
. hospital
Patient queue
25. Concept of “Store and Forward”
Radiograph PC
Scanner
Document
Scanner
ITU-T Workshop on
Standardization in E-
Health, Geneva, 23-25 May 25
2003
26. Hardware Configuration
Video Conference
Modem Telephone
Referral Hospital Microscope and other
medical instruments
Video Conference
PSTN/ISDN/VSAT link
Digital camera
Scanner
Telephone Modem Printer
Nodal Hospital
28. Videoconferencing
• Interactive
• Well suited for seminars or special case discussion
• Less adapted and expensive for routine work
• Requires ISDN
ITU-T Workshop on Standardization in E-Health, Geneva, 23-25 May 2003
29. Second opinion telemedicine concept
Internet/ISDN/Phone
Digitalisation Digitalisation
Radiologist
Telemedicine Center Pathologist
Other
Patient Record and Store & Forward
Medical Images Medical supervision Telemedicine
Private doctor
Small clinic
ITU-T Workshop on
Standardization in E-Health,
29
Geneva, 23-25 May 2003
30. The Data
• Data related to a patient’s personal information
• Data related to a patients medical information
• Data for patient management in Telemedicine
• Data related to the doctors
• Data for system management
36. Data related to the doctors
• Doctor’s personal
information
• Unique Identification
key
37. Medical information on Internet
• Gives valuable on-line access to
huge medical knowledge &
databases.
• Lack of quality control
-> www.hon.ch
• Language barrier.
-> www.etho.org
ITU-T Workshop on Standardization in E-Health, Geneva, 23-25 May 2003 38
38. Schematic Diagram for Proposed Telemedicine using WBSWAN
Writers Bldg.
State
Referral Centre
Switching Centre
DM OFFICE
District
Switch Centre
Nodal Hospital
40. …. 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.
42. At raibbow hospitals Agra , we are in the process of establishing a tele med deptt
for second opinions and for reportings
THANK YOU FOR HEARING ME OUT