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The telemedicine promise 23 May, 2008

In recent years, mobile telephony has dramatically changed access to healthcare. And the potential impact on rural communities is tremendous.

Dubbed telemedicine, the practice of extending clinical medicine through modern communication is a fast-expanding field.

For many, telemedicine is associated with advanced surgery performed over long distances with a videolink and remotely controlled surgical equipment. But it is much more than that.

Per definition, telemedicine is:

“…a rapidly developing application of clinical medicine where medical information is transferred via telephone, the Internet or other networks for the purpose of consulting, and sometimes remote medical procedures or examinations.”

So even two doctors discussing a case over the telephone counts as a valid example. But what we’re most interested in is of course how mobile telephony unlocks new possibilities and brings a new level of health and awareness to rural communities.

“In India, nearly 75% of the population lives in rural villages, and more than 75% of doctors are based in cities”

- Sanjit Baghi, “Telemedicine in Rural India“, 2006

The Indian government spends only 0.9% of the annual GDP on healthcare, and only a miniscule fraction of that reaches remote rural areas. And the poor infrastructure surrounding rural health centers makes if difficult to attract and retain good doctors in villages, since they become isolated and outdated because of lack of connectivity.

“89% of rural Indian patients have to travel about 8 km to access basic medical treatment, and the rest have to travel even farther”

- Rao R, “Taking health care to rural areas“, 2005

Many are hoping telemedicine can bridge this divide.

As a primer, and for further reading, we recommend taking a look at the research paper “Telemedicine: A new horizon in public health in India” by Dasgupta Aparajita and Deb Soumya.

To learn more, we’ve researched the emerging field of mobile-based telemedicine, primarily with a focus on India, and encountered a bunch of very promising initiatives and projects.

Apollo Telemedicine

The Apollo Hospitals Group is an Indian telemedicine pioneer. Apollo was started in the seventies, and is today the largest corporate entity in healthcare in India.

They have a large number of telemedicine centers across India, offer telehealth technology courses and are basing their telemedicine initiatives around their “Medintegra” software platform.

Read more about Apollo at telemedicineindia.com.

Dr. K. Ganapathy, neurosurgeon at Apollo in Chennai, has written a comprehensive and interesting article about telemedicine: Telemedicine in India – the Apollo experience

Telemedicine Society of India

TSI is an industry association, created to “promote and encourage development, advancement and research in the science of telemedicine and its associated fields”.

It aims to encourage application of telemedicine technology by working closely with the industry to develop and implement innovative telemedicine products & services.

More info can be found at tsi.org.in

Online Telemedicine Research Institute

OTRI aims to connect remote and rural areas with major hospitals.

Their speciality lies within software-based tools, ranging from the Medicon 9000 video conferencing tool to the Telecardio 3000 telecardiology system.

Learn more about OTRI: onlinetelemedicine.com

Narayana Hrudayalaya Foundation

The Narayana Hrudayalaya Foundation has a mission to make sophisticated healthcare available to the masses in India.

The NH Telemedicine Network is one of the largest telemedicine networks in the world. Sponsored by ISRO (Indian Space Research Organisation), it is available in 26 locations in India and abroad. Online 24/7, it mainly targets heart patients from remote areas.

Over 12,000 patients have been treated cost-free in the last two years.

Learn more at narayanahospitals.com

HealthCare Telebiomedical

India-based Telebiomedical develops technology for monitoring ECG, blood pressure values, blood glucose level, pulse oximeter, weight and other vital signs over the phone.

Their Heartline ECG monitoring product series is a full range of devices for remote diagnostic and emergency service applications.

SMS a doctor

Piramal Healthcare have started a rural healthcare pilot in Rajasthan. The idea is based around specially trained nurses that are locally stationed in villages and communicate back to doctors at a central hospital via SMS.

Read more in our previous post “A new model for rural healthcare

The mobile microscope

A research team at Unical has developed a device which turns mobile phones into microscopes.

Aptly named the “CellScope”, it has the potential to revolutionize telemedicine by giving much greater depth and detail to remote diagnosis and monitoring of illnesses.

The level of detail is so good that the CellScope can even show individual white and red blood cells – making it possible to identify the malaria parasite.

And the uses extend beyond traditional medicine. For example, farmers can send in images from diseased plant samples to be analysed by agricultural experts.

Learn more: “Doctor on call” (economist.com)

Project Tristan

The telemedicine experiment “Project Tristan” is a joint project managed by IBM. It centers around providing advanced telemedicine services to the isolated island of Tristan da Cunha – a small cluster of volcanic islands in the middle of the South Atlantic.

The Economist recently wrote about Project Tristan:

The islanders have access to some of the most advanced medical facilities in the world, thanks to IBM’s Project Tristan, an elaborate experiment in telemedicine.

This field, which combines telecommunications and medicine, is changing as technology improves. To start with, it sought to help doctors and medical staff exchange information, for example by sending X-rays in electronic form to a specialist. That sort of thing is becoming increasingly common.

What we are starting to see now is a patient-doctor model,” says Richard Bakalar, chief medical officer at IBM.”

The project allows worldwide medical experts to assist island clinicians with medical diagnoses and emergency support.

How VNL fits in

As you’ve probably learned by reading about VNL, our WorldGSM™ system makes it possible for mobile operators to extend their reach into previously un-connected areas.

It may sound like a small thing. But the truth is that billions of people still don’t have access to a mobile phone. In India alone, the numbers are measured in hundreds of millions.

We aim to change this fact by pioneering the microtelecom revolution.

Connectivity enables telemedicine. Needless to say, we’re excited about the opportunity!

What are your thoughts? Let us know!

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