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 skmishra@sgpgi.ac.in
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
Application of Telemedicine Technology to provide Tele-health care during mela/ festival and disaster Maha Kumbh Mela (Indian festival) DIT Project Jan-Feb 2011
Telecommunication Development Bureau ITU-D Study Groups RAPPORTEUR'S GROUP MEETING ON QUESTION 14- / - TOKYO, 10-11 MARCH 2011
Location of Telemedicine work station in Kumbh Mela
1st Mobile ehealth System 2001 Prototype of First Mobile ehealth System developed. Suitcase and Mobile Van were developed and demonstrated. ISDN as Communication Media
Disaster Telemedicine Kit 2002 Designed and Developed in Year 2002 as P.O.C. used in Gujarat Earthquake
Mobile ehealth units for specific health conditions
Shankar Nethralaya Tele-Opthalmology Unit WDF Mobile Unit in Karnataka ISRO Mobile Unit at Maharastra http://www.sankaranethralaya.org/ Vidarbha Mobile Unit at Maharastra
Design of Mobile Unit
Mobile Refraction Unit
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 http://www.aravind.org/telemedicine/va.htm
Satellite Based Mobile Telemedicine Unit Asia Heart Foundation, Kolkata Gangaram Hospital, New Delhi Chitrakoot, MP http://laico.org/v2020resource/files/remote_rural_population.htm
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
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
Internal view of MDRF Mobile System
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. http://cancercaremccskannur.org/
Exterior View
Interior View: Documentation & Videoconference Station, Satellite Indoor unit
Interior view: Laboratory workstation
Interior view: Videoconference Station (close up view during operation)
Interior view: Operation Table for Colposcopy and cauterization for early cervical cancer
Equipment installed inside mobile van Mobile Ultrasound and X-ray Unit Colposcopy Unit used for early detection of Cervical Cancer & intervention
Patient Access Door and Satellite External Unit Housing Satellite external Unit housing Patient Access Door
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 http://www.cdacmohali.in
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. http://www.yentha.com/news/view/1/2724
General Purpose Mobile Telemedicine Unit
Sri Ram Medical College, Chennai ISRO Antenna & VSAT connectivity. General Purpose Rural Tele-health Clinic http://www.srmc.edu/telemedicine.htm
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 http://www.aimshospital.org/hospital/cdh/facilities_telemedicine.php#8
Application of AIMS Telemedicine Van Tele-health service in Koshi flood affected Area
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 www.medetel.lu/download/2010/.../growth_and_development.pdf
Outside view and Internal view of Telemedicine on Wheel
Tele-consultation from VAN
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.
3G enabled mhealth Apollo Telemedicine Network Foundation http://www.medetel.lu/download/2010/parallel_sessions/presentation/day1/mhealth_bridging.pdf
Telemedicine enabled Kit Apollo Telemedicine Network Foundation Vital Parameters (12Lead ECG, BP, Stethoscope,PO2, Meter, Temperature Probe, and Glucometer) 3G Broadband
mhealth4u Suitcase and backpack model School of Telemedicine & Biomedical Informatics, SGPGIMS
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)
Screen Shot of Software based Video Conferencing
Screen Shot of Cure-Soft Software
Case Study: Telemedicine enabled specialty healthcare access for health emergencies
2009 Puri Rath Yatra @ Orissa
Video Clip
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
Thank You website www.stbmi.ac.in www.nrct.in www.sgpgi-telemedicine.org Mail telemedicine@sgpgi.ac.in School of Telemedicine & Biomedical Informatics, SGPGI, Lucknow