Indian Telemedicine Program: Marching Toward Transforming National Healthcare Delivery System

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2. Populace of just 1.1 billion, 28 States

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Indian Telemedicine Program: Marching Toward Transforming National Healthcare Delivery System June 12, 2007 Presented by: Shabbir Syed Abdul Authors: R.L.N. Murthy & L.S. Satyamurthy Telemedicine Program Indian Space Research Organization (ISRO) Bangalore, India

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INDIA – THE LAND OF DIVERSITY Population of just 1.1 + billion, 28 States & 5 union regions Vast Population (80%) spread in out of reach & remote territories (fringe regions) & remote islands in around 627,000 towns 8O % of super-claim to fame live in huge urban areas

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The Indian human services framework Predominantly government oversaw Three-level various leveled arrangement of Primary, Secondary and tertiary social insurance ~ 23000 Primary Healthcare Centers (PHCs), 3000 Community Healthcare Centers (CHCs) and 670 District Hospitals (DHs) as the major administrative medicinal services conveyance framework + Private establishments serving the populace.

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TeleMedicine in India Agencies like ISRO, Dept of IT, Railways, Few State governments, Private system by Apollo, AHF, AIMS, ESCORTS and so on and are likewise some portion of this development in their own particular limit Efforts by ISRO: Space based Rural Development Programs since 1990s Major push for TM as an extraordinary program since 2001 Spearheading the Telemedicine Movement in India with the biggest system and contineous change

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" … . SECOND TO NONE IN THE APPLICATION OF ADVANCED TECHNOLOGIES TO THE REAL PROBLEMS OF MAN AND SOCIETY " SPACE FOR THE SOCIETY THE MAN AND THE VISION .... Satellites Launch Services Ground Systems Operational Services THUMBA FIRST ROCKET LAUNCH ON 21st NOVEMBER 1963

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ISRO's Initiative in Telemedicine ISRO started Telemedicine program in 2001 as an exceptional program, for giving Telehealth to the un-served and the under-served Set up Telemedicine Facilities in removed and provincial of India to supplement the general medicinal services framework.

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Advantages of Satellite Communication Easy achieve, brisk establishment No geological and ecological hindrances Flexible, brilliant system Extensive and Consistent geographic scope Efficient support to communicate and multipoint correspondences for restorative instruction and conference sessions Network limit adaptability, unwavering quality and security

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ISRO's Telemedicine Program - Thrust Areas Providing Technology and Connectivity Remote/provincial doctor's facilities and claim to fame doctor's facility Continuing Medical training (CME) Mobile telemedicine units Disaster Management Support (DMS) Integrating with Village Resource Centers (VRC)/data booths for various administrations

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Growth of TM Applications 2001 : Tele-radiology –still pictures 2002 : Tele-cardiology – Moving pictures, CME 2003 : Tele-pathology, Tele-ophthalmology 2004 : Tele-oncology, Tele-surgery 2005 : Mobile TeleHealth - enlargement 2006 : Telemedicine for Primary human services - VRC … the excursion proceeds …

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Growth by Maximizing the achieve Pilot extend in 2001, interfacing : Aragonda Apollo, Chennai & Chamaraj Nagar Narayana Hrudayalaya ISRO TELEMEDICINE Network 2007 220 + hubs ( target 280 hubs) 181 - Remote 40 - Speciality 2006 184 + hubs 148 - Remote 36 - Speciality 2005 140 + hubs 109 - Remote 31 - Speciality 2004 100 hubs 78 – Remote 22 - Speciality 2003 58 hubs 36 – Remote 22 - Speciality 2002 27 hubs 17 – Remote 10 - Speciality 2001 5 hubs 3 – Remote 2 - Speciality

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2003 14 Lakhs VSAT-8 L TM framework 6 L ( S/W : 1.6 L) 33% Minimizing the Costs for Growth SYSTEM COST ( PATIENT END per Node) 2002 18 Lakhs VSAT-10 L TM framework 8 L ( S/W : 3 L) 2004 8.2 Lakhs VSAT-5 L TM framework - 3.2 L ( S/W : 0 .65 L) 40% 2005 5 Lakhs VSAT-2 L TM framework – 3 L ( S/W : 0.25 L) 40% 2006 4 Lakhs VSAT-1.2 L TM framework – 2.8 L ( S/W : 0.25 L) 20%

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Satcom Based Telemedicine Connectivity

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Approach took after by ISRO Proof of Concept - Technology Demonstration through' Pilot Projects in a few states Development of national measures and rules Efforts to upgrade the clinical necessities for advancing an appropriate e-heath innovation Efforts to limit the expenses to get reasonableness and augment the range

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Approach took after by ISRO Encouraging new models and endeavors like creative protection plans Integrating the social insurance executives, organizers, technologists and business visionaries and conveying all the partners to a typical stage. Preparing and instructing clients (specialists and patients) to make enthusiasm for using Telemed and eHealth devices Developing Mobile social insurance framework for achieving the doorsteps of the provincial populace

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Telemedicine Technology Evolution in India: Point to direct Point toward Multipoint to multipoint Tele-training Patient end

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Point to point System Patient end Doctor end 12 Lead ECG A3 Scanner SkyIp Terminal Video Conferencing Camera SkyIp or FlexiDama Terminal OR Digital Camera Switch Video Conferencing Camera Hub/Switch Doctor-End Station TV Monitor TV Monitor District Client Station

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Point-to-Multipoint System Configuration Super Specialty Hospital Rural/District Hospital Patient-End Server Doctor-End Doctor-End Doctor-End

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Continuing Medical Education (CME) Configuration TV Monitor Antenna & ODU LCD Projector Mixer/Switcher Video Camera DVB-RCS In-Door Unit Hub/Switch Microphone Document Camera Server(s) Scanner Work Station (s)

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MOBILE TELEMEDICINE Tele-Ophthalmic Van – Shankara Nethralaya Tele-Ophthalmic Van – Aravind Eye Hospital To defeat the restrictive expenses of expansive number of terminals and contacting the rustic zones Sankara Nethralaya Aravind Eye Hospital

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Telemedicine STANDARDS in India Guidelines and Standards for Telemedicine System Network/Connectivity Interoperation of Telemedicine Systems Standards for Security & Process rules Efforts to institutionalize human services information exchange utilizing DICOM - Digital Imaging and Communication in Medicine HL7 - Health Level Seven and ITU models for Video conferencing

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ISRO TELEMEDICINE Program All states spoke to including the far-flung regions like – J&K, Andaman & Nicobar islands, Lakshadweep, Uttaranchal and North East and so forth. Unique systems for Army, Navy & Air Force 221 hubs 181 remote doctor's facilities 40 Specilaity doctor's facilities

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National Task Force Constituted by Federal Ministry of Health & Family Welfare To make TM to enter the standard of Healthcare conveyance To Define a National TM Grid and consider its models and operational angles To recognize & Evaluate all players and activities as of now required in TM in India To get ready National Cancer TM Network To characterize measures & structures of EMR and patient information base To draft a National Policy on TM and CME to set up a Central Scheme for the 11 th FYP

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Awareness Program & International Cooperation INTELEMEDINDIA 2005 – went to by different Intl' masters Joint working gathering with Canadian Space Agency ISRO CNES communication on Technology Asia Pacific Telemedicine Collaboration under ITU Interaction with WHO, ISfT and different offices UN OOSA Workshop in China, India Training Program for Afghanistan UN workshop in India

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Road Map for the Future ISRO to keep driving Telemedicine endeavors in India Enhancing mindfulness and enthusiasm among the partners Introducing Telemedicine in an operational mode the nation over Integrating SatCom and supplementing advances (remote and Terrestrial) for consistent availability Creation of web-based interface as a storehouse and learning base Steps towards National eHealth approach plan Efforts to create and empower Telemedicine extend in SAARC area

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We esteem your input and Suggestions ! Be open… ., to close the crevice between sick wellbeing & wellbeing !! Much thanks to you for Your Attention For Details: murthy@antrix.gov.in

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