1. Long Distance WiFi for Telemedicine at Aravind Hospital, Tamil Nadu, India Sonesh Surana Tier Retreat, Oct 29, 2005 Tier, UC Berkeley

2. Outline Introduction to Aravind Eye Hospitals Need for Telemedicine Solution – Past and Current Link Usage Future Directions

3. Intro: Aravind’s Mission Eradication of Needless Blindness –45m globally –90% in developing world Sustainable Replicable

4. Intro: Patient Throughput 2003 –1.48m patients –200k surgeries –1.5k free eye camps Each day –4k patients –540 surgeries –3 camps/1000 ppl 1978-2003 –16m patients –1.8m surgeries –19k free eye camps Between 50% - 60% get free care. Yet sustainable and profitable

5. Need for Tele-Ophthalmology Shortage of Doctors 1 –No incentive to live in rural areas Low uptake of eye care services 2 –Transportation: Time, Cost, Company Intra-doctor/nurse consultation 1.Ref: http://aravind.org/Telemedicine_new/index.htmlhttp://aravind.org/Telemedicine_new/index.html 2.Ref: Low uptake of rural eye services in rural India: a challenge for programs of blindness prevention. Arch. Ophthalmology, 1999 Oct; 117(10):1393-9

6. Solutions: Existing Setup 1 Mobile Van –VSat N-logue for video conf. –35 Kbps –$50/month/center –Central Server –Served 3500 patients upto July 2005 1. More details at http://aravind.org/Telemedicine_new/index.htmlhttp://aravind.org/Telemedicine_new/index.html Theni Andipatti Ambasamudram N-logue

7. Solutions: Our setup 10.5km 802.11b link – setup July 2005 24dbi Directional Antennas Soekris routerboards (~15watt) Voltage Stabilizers UPS batteries No LOS – need relay

10. Link Usage Operational for 3 months now (since Aug05) 4.5 Mbps UDP (~1-2% loss) 4-5 patients/day (better perceived video quality) Remote desktop management (VNC) –Training Nurses/Operators –Sotware Installation & Troubleshooting Streaming Movies (VideoLan)

11. Future Directions Bodi Theni Hospital Ambasamudram Andipatti Kambam Complex Chimney House 33.3 Kms 10.2 Kms