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Established Education And Information in Cancer :

The Future of Telemedicine


Dr. Harjanto Prabowo
Gintoro, S. Kom, MM.
Agenda

• Definition of Telemedicine
• Telemedicine Implementation in Others Countries
• Why Indonesia Need Telemedicine - Problems
Identification
• Current Facts About Indonesia’s ICT and Health
• Step by Step Implementing Telemedicine in Indonesia and
RSKD
Definition of TELEMEDICINE

Telemedicine means, literally, 'medicine at a distance'. There are


several different definitions, but:
the definition of telemedicine adopted by an international consultation
group convened by the WHO in Geneva in December 1997 says:

“Telemedicine is the delivery of health-care services, where distance is


a critical factor, by health-care professionals using information and
communication technologies for the exchange of valid information
far diagnosis, treatment and prevention of disease and injuries, and for
the continuing education of health-care providers as well as research
and evaluation, all in the interests of advancing the health of individuals
and their communities.”

INTERNET

Sicurello, Telemedicine for Monitoring of Patients and Prevention


TELEMEDICINE Methods
Teleconsulting:

clinicians clinicians

Telediagnosis:

clinicians phisicians

Telemonitoring:

clinical centers patients

Telesurveillance:

health structure patients

Tele-emergency:

first aid health operators (ambulances)


patients

Sicurello, Telemedicine for Monitoring of Patients and Prevention


TELEMEDICINE Implementation
in Others Countries

Tele Monitoring (Europe)


TeleTele
Tele Observation
Cardiological
Observation (Hong
System
(Alaska Kong)
(Europe)
- US)
Why Indonesia Need Telemedicine -
Problems Identification

• Cost for medication in rural area is very high.


• Lack of specific experts in rural area.
• Lack of integrated knowledge base about specific
expertise in health for refrence, especially for less case
doctors in rural area.
• Lack of time for expert doctors in specific area to handle
consultation with the patient.
Current Facts About Indonesia’s ICT
and Health

• Distribution of Internet network and communcation in


most of the cities in Indonesia via cable or satelite
(Telkom).
• Most of expert doctors lives in Java’s big cities.
• The growth for the cancer patient in cities outside
Java’s big cities are increasing.
Year Subscribers Users
1998 134.000 512.000
1999 256.000 1.000.000
2000 400.000 1.900.000
2001 581.000 4.200.000
2002 667.002 4.500.000
2003 865.706 8.080.534
2004 1.087.428 11.226.143
2005 1.500.000 16.000.000
2006 1.700.000 20.000.000
2007* 2.000.000 25.000.000
Indonesia Internet Service Provider Association
(www.apjii.or.id) Dec 2007
Step by Step Implementing Telemedicine
in Indonesia and RSKD

1. Implementation of Case Based Knowledge Base for


cases all over Indonesia.
• Knowledge Base portal to search the case using enrich keywords.
WIKI for HEALTH/CANCER.
• Needs supports from the institution for supervise the contents.
• Social networking mechanism for doctors to put their case in the
form of text, voice, picture/image or video combine with the Blog
format sharing.
• Discussion and knowledge sharing.
1. Case Based Knowledge Base Model

Remote Area

Smaller Hospital
/Puskesmas

Medical Knowledge Base Portal

Hospital/Medical Center in
Remote Area

INTERNET

Center Hospital
Supervise the Content
[ RSKD ] Remote Area

Smaller Hospital
/Puskesmas

Hospital/Medical Center in
Physician as
Remote Area
Knowledge Contributor

Physician as
Knowledge Contributor
Step by Step Implementing Telemedicine in
Indonesia and RSKD (cont.)

2. Transformation the Case Based Knowledge Base into


Experts System or Inteligent Agents that works on case
based reasoning that can help patient answers several
questions and collecting preliminiary data.
• Dr. ELIZA, somekind of intelegent agents to collect the data and
giving some initial pointer for public/patient.
• Information center to answers tons of questions from patient,
public using inteligent agents.
2. Experts System / Inteligent Agents
Model

Medical Knowledge Base Portal

Experts System/Inteligent Agent

Pointer
INTERNET
Pointer

Question(s) Question(s)
Pointer
Question(s)
Remote Area
Smaller Hospital
/Puskesmas
Hospital/Medical Center in
Remote Area
Step by Step Implementing Telemedicine in
Indonesia and RSKD (contd.)

3. Educating public with learning contents portal to help


public understand all information about the diseases.
• Video campaign, case campaign, email campaign to gain
awareness from public for prevention or how to resolve their/their
family disesases.
3. Public Information Portal Model

Medical Knowledge Base Portal

Experts System/Inteligent Agent

INTERNET
Remote Area

Hospital/Medical Center in
Remote Area
WIKIPEDIA
MAYOCLINIC