Prakhar Kasar Harish Thimmappa Team 9 Telemedicine Prakhar Kasar Harish Thimmappa Team 9 Team 9

Healthcare Scenario in India Limited networking among doctors or hospitals Private providers are fragmented and unregulated 117 tertiary medical colleges and hospitals 4,400 Districts and Taluk hospitals 3,300 CHCs 23,000 PHCs 1,50,000 SHCs Health infrastructure is concentrated in urban areas Team 9

Purpose of the Telemedicine Project Level 1: District Hospitals Level 2: Community Hospitals Level 3: Primary Health Centers Level 4: Sub Health Centers People that are catered to by the level 4 sub health centers are the most under privileged lot. Team 9

Reasons of inability to provide quality healthcare in rural region Four factors: High cost of health care Problem of retaining doctors Inadequate medical facilities and inaccessible terrain. Lack of investment in health care. Team 9

Major Diseases that can be tackled with telemedicine About 60% of all diseases can be tackled with telemedicine and 70% of the rest need physical examination by a health worker. That’s 60% + .7 * 40% = [88%] Communicable diseases like Malaria, Filaria, Diarrhea, Acute respiratory diseases etc. Nutritional diseases : Protein energy malnutrition like Kwashiorkor and Marasmus etc. Non Communicable diseases - Hypertension, Diabetes etc. Pregnancy complications Team 9

Pioneers: ISRO’s initiative in Telemedicine Apollo Hospital’s initiative in Telemedicine Team 9

Focus will be on SHCs (the lowest level) What we propose to do? Provide the health centers at all four levels with required hardware and software to equip them with telemedical facilities. Focus will be on SHCs (the lowest level) Overview of functioning of the system Team 9

The components of the proposed structure Networks Network Equipment Tele-health Equipment Room Evaluation Team 9

How it will work Every Govt. medical college will act as a nodal centre for the operation. Every health center will have a computer with an attached web-cam, audio speakers, internet facility. A website will be established to which every health center can log on using a unique username and password. The web-site will be divided into two sections: the demand side and the supply side. Team 9

Daily availability updates Unexpected availability and emergency needs The supply side: Manned system Daily availability updates Unexpected availability and emergency needs The demand side: Basic diagnosis and specialist location Request updating Channel establishment Medication disbursement Team 9

FEATURES Compatibility 2. Interoperability 3. Scalability   Compatibility  2. Interoperability  3. Scalability  4. Reliability  Team 9

Equipment procurement Installation Training Testing Implementation Milestones Equipment procurement Installation Training Testing Implementation Phase 1 Phase 2 Maintenance Security Team 9

Initial cost per village: System + modem cost Rs 11,000 Finances Initial cost Initial cost per village: System + modem cost Rs 11,000 Webcam Rs 1,000 UPS Rs 1,000 Initial telephone and internet cost Rs 1,000 Training and installation cost Rs 1,000 Total [approx] per Health Centre Rs 15,000 Team 9

These will be the machines that will serve SHCs 1,46,026 PHCs 23,236 CHCs 3,346 Total No. of Centers: 1,72,608 Total Cost: Rs. 258,91,20,000 (1,72,608 * 15,000) Team 9

Total project costs: Rs.268,18,00,000 The 4400 District and Taluk hospitals will have computers of higher capacity Cost :20,000 per computer. Total Cost: Rs8,80,00,000 (4400 * 20000) At 117 medical hospitals, a server will have to be set up. Because of higher configuration the cost per computer will be Rs 40,000 Total Cost: 46,80,000 (117 * 40,000) Total project costs: Rs.268,18,00,000 Team 9

Periodic/Running costs: For each center Medicine ,will be per hospital basis Personnel salary: Power cost( approx Rs.200) Internet cost (approx Rs.300) Nominal charges per patient. Team 9

Good quality service to people at even remote villages SWOT Analysis Strengths Cost Good quality service to people at even remote villages System is upgradeable and almost maintenance free Interoperability is feasible and scaling is possible due to the atomic structure Weaknesses (and their remedies) The system at present will not be able to treat complex cases. We are going to depend on an external network (internet) which is not fully reliable. The use of ‘sense of touch and feel’ is very important for both doctors and patients and will be lacking in telemedicine. Team 9

The whole system is very easy to operate once it is established Opportunities Leveraging existing network at low costs to provide a diversified service and integrating add on benefits. The whole system is very easy to operate once it is established Pooling of medical expertise for service and growth Link up with foreign hospitals Threats (and their counter measures) Patients may not trust the system. Resistance to changes inside the organization. Misuse of systems at the nodes. Interruptions in power supply. Team 9

Foreign collaboration for medical hospital Telemedicine to homes Further Improvements Foreign collaboration for medical hospital Telemedicine to homes Mobile and connected ambulances, and highway patrol ambulances Rural Prisons Extension of the service to charity, missionary, NGOs, and corporate hospitals, factory hospitals, ESI dispensaries, CGHS etc Training of personnel at various health centers using the existing network Team 9