RLN Murthy Indian Space Research organisation (ISRO) Bangalore, India

Transcription

1 From Initiatives to Implementation Indian Telemedicine Programme Spearheaded by Indian Space Research Organisation (ISRO) APT PSC Conference Okinawa June 15, 2007 RLN Murthy Indian Space Research organisation (ISRO) Bangalore, India 1

2 INDIA THE LAND OF DIVERSITY Population of billion, 28 States & 5 union territories Vast Population (80%) spread in inaccessible & remote areas (border areas) & remote islands in around 627,000 villages 8O % of superspecialty live in big cities 2

3 The Indian healthcare system Predominantly government managed Threetier hierarchical system of Primary, Secondary and tertiary healthcare ~ Primary Healthcare Centres (PHCs), 3000 Community Healthcare Centres (CHCs) and 670 District Hospitals (DHs) as the major governmental healthcare delivery system + Private institutions serving the population. 3

4 Telemedicine in India ISRO Dept of IT Railways State governments Private network by Apollo, AHF, AIMS, ESCORTS etc Biggest NW by ISRO 4

5 INDIAN SPACE SYSTEMS LAUNCH VEHICLE INSAT IRS 5

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

7 TM ISRO Initiatives ISRO initiated Telemedicine in 2001 as a special programme Telemedicine Facilities in distant and rural of India to supplement the general healthcare infrastructure. 7

8 Advantages of Satellite Communication Easy reach, quick installation Not affected by environment Flexible network Bandwidth can be shared by number of users Highquality network Extensive and Consistent geographic coverage Efficient support to broadcast and multipoint communications for medical education and consultation sessions Network capacity flexibility, reliability and security 8

9 ISRO s s Telemedicine Program Thrust Areas Providing Technology and Connectivity Remote/rural hospitals and specialty hospital Continuing Medical education (CME) Mobile telemedicine units Disaster Management Support (DMS) Integrating with Village Resource Centres (VRC) / information kiosks for multiple services 9

10 Telemedicine Technology Evolution in India: Point to point Point to multipoint Multipoint to multipoint Teleeducation Patient end 10

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

13 PointtoMultipoint System Configuration Super Specialty Hospital Rural/District Hospital Server PatientEnd DoctorEnd DoctorEnd DoctorEnd

14 Continuing Medical Education (CME) Configuration TV Monitor LCD Projector Mixer/Switcher Antenna & ODU Video Camera DVBRCS InDoor Unit Microphone Hub/Switch Document Camera Server(s) Scanner Work Station (s)

15 MOBILE TELEMEDICINE To overcome the prohibitive costs of large number of terminals and reaching out to the rural areas Sankara Nethralaya Aravind Eye Hospital More than 200,000 patients in 3 years TeleOphthalmic Van Shankara Nethralaya TeleOphthalmic Van Aravind Eye Hospital 15

16 Telemedicine STANDARDS in India Guidelines and Standards for Telemedicine System Network / Connectivity Interoperation of Telemedicine Systems Standards for Security & Process guidelines Efforts to standardize healthcare data interchange using DICOM Digital Imaging and Communication in Medicine HL7 Health Level Seven and ITU standards for Video conferencing 16

17 Approach followed by ISRO 1. Technology Demonstration thru Pilot Projects 2. Development of national standards and guidelines 3. Technology evolution and adaptation for the rural need 4. Developing and nurturing of industries for meeting the technocommercial needs and standards 5. Efforts to customise the software and hardware 6. Efforts to optimise the clinical requirements for evolving a suitable eheath technology 7. Minimise the costs and maximise the reach 8. New models & efforts like innovative insurance schemes 9. Bringing Stake holders to a common platform healthcare administrators, planners, technologists, entrepreneurs

18 Approach followed by ISRO 10. Training and handholding to the users (doctors and technicians) 11.Workshops and seminars for creating awareness among the users as well as nonusers Initiating policy guidelines 12. Brining in speciality hospitals to provide teleconsultation as a social service 13.Developing Mobile system doorsteps of rural population 14.Mobiles in Areas of Teleophthalmology, community health and diabatology 15.Sensitising the health care administrators for adopting the innovative technology at the national level (NTF)

19 Maximising the reach Pilot project in 2001, connecting : Aragonda Apollo, Chennai & Chamaraj Nagar Narayana Hrudayalaya ISRO TELEMEDICINE Network Remote Remote 2 2 Speciality Speciality Remote Remote 10 Speciality 10 Speciality Remote Remote Speciality Speciality Remote Remote Speciality Speciality Remote Remote Speciality Speciality ( ( target target ) ) Remote Remote Remote Remote Speciality Speciality Speciality Speciality 19

20 Minimising the Costs for Growth SYSTEM COST ( PATIENT END per Node) $ $ 43,000 43,000 VSAT VSAT TM TM system system $ $ 34,000 34,000 33% $ $ 20,000 20,000 40% 40% ,000 12,000 40% 40% $ $ 9,700 9,700 20% 20% 20

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22 National Task Force Constituted by Federal Ministry of Health & Family Welfare To make TM to enter the mainstream of Healthcare delivery To Define a National TM Grid and consider its standards and operational aspects To identify & Evaluate all players and projects currently involved in TM in India To prepare National Cancer TM Network To define standards & structures of EMR and patient data base To draft a National Policy on TM and CME to prepare a Central Scheme for the 11 th FYP 22

23 Awareness Programme & International Cooperation INTELEMEDINDIA 2005 attended by various Intl specialists Joint working group with Canadian Space Agency ISRO CNES interaction on Technology Asia Pacific Telemedicine Collaboration under ITU Interaction with WHO, ISfT, APT and other agencies UN OOSA Workshop in China, India Training Programme for Afghanistan

24 Road Map for the Future ISRO to continue leading Telemedicine efforts in India Enhancing awareness and interest among the stake holders Independent evaluation of the utilisation and scope for improvement Introducing Telemedicine in an operational mode Integrating SatCom and complementing technologies (wireless and Terrestrial) for seamless connectivity Creation of web portal as a repository and knowledge base Continue thrust in RuralMobile Telehealth programme Steps towards National ehealth policy formulation Movie

25 Acknowledgements Dr. G. Madhavan Nair, Chairman, ISRO Mr. A. Bhaskaranarayana, Director, SCP Mr. L.S.Satyamurthy, Coordinator, Telemedicine Prof Isao Nakajima Mr. Koredianto USMAN Prof. S.K. Mishra APT & PSC team members 25

26 Thank you for Your Attention 26