1. Prakhar Kasar Harish Thimmappa Team 9
Telemedicine
Prakhar Kasar Harish Thimmappa
Team 9
Team 9

2. 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

3. 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

4. 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.
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5. 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% * 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
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6. Pioneers: ISRO’s initiative in Telemedicine
Apollo Hospital’s initiative in Telemedicine
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7. 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
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8. The components of the proposed structure
Networks
Network Equipment
Tele-health Equipment
Room Evaluation
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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

10. 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
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11. FEATURES Compatibility 2. Interoperability 3. Scalability
Compatibility 
2. Interoperability 
3. Scalability 
4. Reliability 
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12. Equipment procurement Installation Training Testing Implementation
Milestones
Equipment procurement
Installation
Training
Testing
Implementation
Phase 1
Phase 2
Maintenance
Security
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13. 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
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14. These will be the machines that will serve SHCs 1,46,026 PHCs 23,236
CHCs ,346
Total No. of Centers: ,72,608
Total Cost: Rs. 258,91,20,000 (1,72,608 * 15,000)
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15. 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: ,80,000 (117 * 40,000)
Total project costs: Rs.268,18,00,000
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16. 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.
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17. 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.
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18. 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.
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19. 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