Telemedicine

Outline of Presentation
 Objectives & Relevance  Benefits  Model  Telemedicine & PPP  Images & Graphics  Challenges

 Telemedicine has been defined as the use of telecommunications to provide medical information and services Provides healthcare services when distance separates the medical professional from the patient What is Telemedicine   Medicine at a distance(Medicine as we know it from practice. education e.c. using information -communication technology in all forms) .t.

To provide opportunities for continuing education of health care personnel.Objectives of Telemedicine Use of information and communication technologies:  To provide specialized health care consultation to patients in remote locations. .   To facilitate video-conferencing among health care experts for better treatment & care.

Relevance of Telemedicine (why)  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. .

Telemedicine : The Model  Patient under treatment  Physician treating the patient  A remote telemedicine console having audio visual and data conferencing facilities PO TS / I SD N Nodal Hospital / L EA SE D LI NE / V SA T Referral Hospital  An expert / specialised doctor  A central telemedicine server having audio visual and data conferencing facility .

System Schematic Referral Center Web Cam PSTN / Leased Line / ISDN / VSAT Digital Camera Scanner Doctor / Patient Electronics Microscope Web Cam Printer Specialist Doctor Scanner Digital camera ECG Machine Electronics Stethoscope Printer Nodal Center .

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•Tele health – Mainly consists of health education •Tele mentoring – Example is telesurgery.T Telemedicine ypes of service •Tele consultation – Helping the patient to reach a confirm diagnosis. •Tele monitoring – Example is monitoring a cardiac patient with an ECG. .

Telemedicine/Tele-diagnosis .

Telemedicine/Tele-monitoring .

Telemedicine/Tele-consultation .

data and images of test results. Operator enters patient record.Sequence of Tele-consultation (I) PATIENT IN Patient visits OPD Local Doctor checks up Patient receives treatment and is not referred to telemedicine system OUT Step One Patient referred to the Telemedicine system (some special investigations may be suggested) Patient visits Telemedicine data-entry console. appointment date is fixed for online telemedicine session Offline Data transfer from Nodal Centre OUT .

. . Online video conference & tele-consultation for patients between local doctors at the nodal hospital and specialist doctors at the referral hospital Step Two IN OUT Patient queue .Sequence of Tele-consultation (II) Patient 1 Patient 2 Patient 3 Patient 4 .

Telemedicine/Tele-consultation .

 Access to expertise of Medical Specialists to a larger population without physical referral. . semi-urban and remote areas.  Reduced visits to specialty hospitals for long term follow-up care for the aged and terminally ill patients.Benefits of Telemedicine (I) Benefits to Patients:  Access to specialized health care services to under-served rural.

) 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 . voice. comprehensive data (text. images etc.Benefits of Telemedicine (II) Benefits to Physicians:  Improved diagnosis and better treatment management  Access to computerized.

Benefits of Telemedicine (III) Hospital and Insurance Benefits:  Significant reduction in unnecessary visits & hospitalization for specialized care at tertiary hospitals.  Increase in the scope of services without creating physical infrastructure in remote hospitals .  Earlier discharge of patients leading to shorter length of stay in hospitals.

Kolkata : Habra State General Hospital. Coochbehar Connectivity: First with POTS.Leprosy . Project Completed: December 2003 DIT Sanction No. Disease Types: Skin Related and Blood Related Diseases. upgradation with ISDN. 150 lakhs . 24th Parganas (North) : MJN Hospital. lastly with 512 Kbps Leased Line using WBSWAN as backbone.01.Telemedicine in West Bengal (II) PROJECT . Project Cost : 2(5)/98-H&B Dated 21.I Referral Center Nodal Centers : School of Tropical Medicine.1999 : Rs.

 Treatment by “Thrombolysis”  Referral & Tele-consultation & video conferencing with RN Tagore International Institute of Cardiac Sciences.Services Provided  Treatment of Acute Heart Attack cases as evidenced by history and ECG. Kolkata .

VSAT and wireless media .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.

Text. ECG. Audio. Microscope fitted with digital camera  Support of medical standards . Graphics. USG.EEG.TelemediK Software (II)  Store & Forward Technical information  Online video conferencing and data transfer  Electronics Medical Record (EMR) Supported . CT SCAN. Video  Integration with different medical instrument . MRI. Image. Electronic stethoscope.

Live session using 512 Kbps Leased Line .

Ensuring trouble free & smooth connectivity through WAN (ISDN/Leased Line) . Identification of a Suitable site and preparation of site for Telemedicine facility. 6. 2. Technicians and Nurses. Synchronization of civil. Sensitization and repeated hands-on training of concerned Doctors. electrical and equipment related works.Challenges in Implementing Telemedicine 1. 5. Identification of a nodal officer (Other than Superintendent) for coordinating Telemedicine activities in the hospital. 3. Coordinating with referral centers to fix mutually convenient tele-consultation sessions on a regular basis. 4.

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