Prof. S. K. Mishra, MS, FACS

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1 Evolution of Mobile ehealth Technology, Tools, Practices in India Prof. S. K. Mishra, MS, FACS Head, Dept. of Endocrine Surgery & Faculty I/C, SGPGI Telemedicine Programme Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGIMS), Lucknow, India

2 Agenda Origin of the Concept Telemedicine Application in Festival with large gathering First Prototype of Mobile ehealth System & Disaster Telemedicine Mobile ehealth units for specific health conditions Satcom Based Shankar Nethralaya Tele-Opthalmology Unit Aravind Mobile Eye Screening VAN Madras Diabetic Research Foundation (MDRF) A Tele-Diabetic Unit Malabar Cancer Care Society, Kannur Tele Oncology Unit Terrestrial / Wireless Based C-DAC Mohali : Tele-Ophthalmology Van Regional Institute of Ophthalmology, A Tele-ophthalmology Unit General Purpose Mobile Telemedicine Unit Sri Ram Medical College, Chennai Amrita Institute of Medical Sciences, Cochin Apollo Telemedicine Network Foundation 3G enabled mhealth- Apollo Telemedicine Network Foundation mhealth4u Portable Tool Kit Case Study: Telemedicine enabled specialty healthcare access for health emergencies Conclusion

3 Application of Telemedicine Technology to provide Tele-health care during mela/ festival and disaster Maha Kumbh Mela (Indian festival) DIT Project Jan-Feb 2011

4 Telecommunication Development Bureau ITU-D Study Groups RAPPORTEUR'S GROUP MEETING ON QUESTION 14- / - TOKYO, MARCH 2011

5 Location of Telemedicine work station in Kumbh Mela

6 1st Mobile ehealth System 2001 Prototype of First Mobile ehealth System developed. Suitcase and Mobile Van were developed and demonstrated. ISDN as Communication Media

7 Disaster Telemedicine Kit 2002 Designed and Developed in Year 2002 as P.O.C. used in Gujarat Earthquake

8 Mobile ehealth units for specific health conditions

9 Shankar Nethralaya Tele-Opthalmology Unit WDF Mobile Unit in Karnataka ISRO Mobile Unit at Maharastra Vidarbha Mobile Unit at Maharastra

10 Design of Mobile Unit

11 Mobile Refraction Unit

12 Aravind Mobile Eye Screening VAN ISRO Connectivity Known Diabetic Pts are collected by Physician Recorded in a specialized software EyeTalk & transmitted to the reading grading center at Base Hospital

13 Satellite Based Mobile Telemedicine Unit Asia Heart Foundation, Kolkata Gangaram Hospital, New Delhi Chitrakoot, MP

14 Tele-Ophthalmology Unit under ISRO Network Location No. of Unit Sankara Nethralaya, Chennai 02 Aravind Eye Hospital, Madurai 01 Agarwal Eye Hospital, Chennai 01 Chaitinaya Hospital, Cochin 01 Prabha Eye Clinic, Bangalore 01

15 Madras Diabetes Research Foundation (MDRF) Collaboration between MDRF, World Diabetes Foundation and ISRO. Serves 42 villages (in and round Chunmpet village) in Kancheepuram District, Tamilnadu, India. The experts testing, diagnosis, medicines and even laser surgery are at door step

16 Internal view of MDRF Mobile System

17 Tele-Oncology Unit Malabar Cancer Care Society, Kannur Comprehensive Disease Control Activities Through Early Detection, Treatment & Awareness Building for Cancer Cancer, AIDS, TB, Cardiac diseases & Pre and post natal requirements. Sanjeevani is a Mobile Tele Oncology unit with satellite communication link, advanced diagnostic and treatment equipments, telemedicine infrastructure, software for Electronic Health Record, e-health Card for patients etc. aimed to provide telemedicine services for early cancer detection, follow up consultation, treatment of cervical cancers and awareness building to rural masses at five northern districts of Kerala.

18 Exterior View

19 Interior View: Documentation & Videoconference Station, Satellite Indoor unit

20 Interior view: Laboratory workstation

21 Interior view: Videoconference Station (close up view during operation)

22 Interior view: Operation Table for Colposcopy and cauterization for early cervical cancer

23 Equipment installed inside mobile van Mobile Ultrasound and X-ray Unit Colposcopy Unit used for early detection of Cervical Cancer & intervention

24 Patient Access Door and Satellite External Unit Housing Satellite external Unit housing Patient Access Door

25 C-DAC Mohali : Tele-Ophthalmology Van Mobile Tele-Ophthalmology Van is equipped with various equipments like Slit lamp, auto-refractometer, tonometer, ophthalmoscope, retinoscope and a wireless internet enabled computer with which the user can connect to internet at anytime and anywhere in the field to transfer the captured images of patient s eyes and other related data through the software e-sanjeevani

26 Regional Institute of Ophthalmology Sunayanam A Tele-ophthalmology Unit Regional Institute of Ophthalmology (RIO), Trivendrum Designed and implemented by C-DAC Well-equipped to carry out complete ophthalmic examination. Further assistance are met with by contacting the specialists at RIO by way of videoconferencing Equipped with photo slit lamps.

27 General Purpose Mobile Telemedicine Unit

28 Sri Ram Medical College, Chennai ISRO Antenna & VSAT connectivity. General Purpose Rural Tele-health Clinic

29 Amrita Institute of Medical Sciences, Cochin AIMS Hospital s Mobile Telemedicine Unit is the size of a city bus and includes X-ray facilities, ECG scanner, pathology-lab-work facility, specialty cardiac services and a telemedicine satellite link with AIMS Hospital. First used in tsunami-relief work in Kerala and Tamil Nadu. Direct Relief International ( a U.S based NGO) has supported in setting up of this van while Indian Space Research Organization ( ISRO) provides the satellitetechnology and connectivity

30 Application of AIMS Telemedicine Van Tele-health service in Koshi flood affected Area

31 Apollo Telemedicine Network Foundation Jointly undertaken by ISRO, Philips India, Apollo Telemedicine Networking Foundation (ATNF) and the Madurai based NGO, Development of Human Action (DHAN) A tele-clinical van, equipped with diagnostic equipment provided by Philips India. The van has an ultrasound machine, an X-ray, a defibrillator and an ECG machine ISRO is providing the connectivity through VSAT

32 Outside view and Internal view of Telemedicine on Wheel

33 Tele-consultation from VAN

34 Wireless Mobile Health System Evolution of wireless communication technologies have enabled telemedicine systems to operate in the remotest place for rural health practices hence expanding telemedicine benefits, applications, and services. In India majority of the people are living in the rural and remote locations where even the basic facilities are not available for the society.

35 3G enabled mhealth Apollo Telemedicine Network Foundation

36 Telemedicine enabled Kit Apollo Telemedicine Network Foundation Vital Parameters (12Lead ECG, BP, Stethoscope,PO2, Meter, Temperature Probe, and Glucometer) 3G Broadband

37 mhealth4u Suitcase and backpack model School of Telemedicine & Biomedical Informatics, SGPGIMS

38 Integrated Medical Equipments PC Interface: USB & Bluetooth Spirometer Common Interface Digital Glucometer Blood Pressure Wrist Clinic Weighing Machine SPO 2 ECG Atom based Low Cost Laptop with Integrated Telemedicine Software Connectivity via High Speed Broadband (HSB)

39 Screen Shot of Software based Video Conferencing

40 Screen Shot of Cure-Soft Software

41 Case Study: Telemedicine enabled specialty healthcare access for health emergencies

42 2009 Puri Rath Orissa

43 Video Clip

44 Conclusion Several prototypes and Mobile e-health tools in India Innovative applications general & theme based Indigenous satellite technology and support of ISRO Very much relevant in health system in low resource countries Current generation wireless broadband holds promise to develop low cost sustenance model of operation Lack of healthcare infrastructure in village level and last mile connectivity problems are addressed in Indian model High level of illiteracy in population is a barrier in developing mhealth applications on handsets Empowering rural healthcare providers with suitcase / backpack model m-health tool kit may be considered by health policy makers

45 Thank You website Mail School of Telemedicine & Biomedical Informatics, SGPGI, Lucknow

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