ASIA-PACIFIC ADVANCED NETWORK 31 st MEETING. U Satyanarayana. Asian Institute of Gastroenterology Hyderabad, India.

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1 ASIA-PACIFIC ADVANCED NETWORK 31 st MEETING FEB HONG KONG Telemedical activity in India SGI 2010 and more U Satyanarayana Asian Institute of Gastroenterology Hyderabad, India.

2 India lives in its villages villages Mahatma Gandhi

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4 Health Scenario in India 620 million live in rural India (NCAER) Bed-Population ratio 1:1333 (1991) Vs. ideal of 1:500 2 million beds are required as against 0.7 million available. 700 hospitals of 250 beds each are required every year. only 9% of 1 billion people are covered health schemes. 5% of annual family income spent towards curative health care.

5 Need for Telemedicine in India A recent survey by the Indian Medical society has found 75% of qualified consulting doctors practice in urban areas and 23% in semi urban areas This leaves just 2 percent of the qualified doctors, who are attached to about 23,000 primary health and 3000 community health centers, to attend to 70 percent of the population living i in villages.

6 Need for Telemedicine dii in India This calls for innovative method of utilising science and technology for the benefit of Rural population in India. Adaptation oftelemedicine technology offers one of the best options for delivering healthcare for rural & geographically distant population p spread across India.

7 Telemedicine Telemedicine is practiced on the basis of two concepts: Store and forward (asynchronous) and Real time (synchronous) (y

8 Where do we use Telemedicine? Radiology Cardiology Orthopedics Dermatology Psychiatry Pathology Training of doctors & paramedics Continuing Medical Education (CME) between Medical Colleges & Post Graduate Medical Institutions/Hospitals.

9 Indian Space Research Organisation ISRO The telemedicine facility from ISRO connects the remote rural District Hospitals/Health Centre's with Super Specialty Hospitals in cities, through the INSAT Satellites for providing expert consultation to the needy and underserved population. About 1.5 Lakh patients are getting the benefits of Telemedicine every year.

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11 12 MBPS

12 Mobile Rural Health Care Telemedicine Programme from Asian Institute of Gastroenterology

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15 Fully Equipped Mobile Hospital Upper GI endoscopy Ultra sound Emergency resuscitation unit

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18 Village Panchayat Office Edurumondi Village, Krishna Dist

19 Details of Telemedicine camps No of Telemedicine Camps 529 No of Villages covered 4,837 No of Patients benefited 1,02,739 No of Endoscopy done 4,435 No of Ultrasound scans done 3,134

20 What Did We Learn Marked variation in Urban / Rural Incidence of Disease Urban Rural Diabetes 15% <4% H.Pylori Bacteria 20% 80% Nutrition 20% 70% Worms GI Cancers Same Incidence

21 Gastrointestinal Map of Andhra Pradesh Using Telemedicine as a tool

22 October 2010 Asian Institute of Gastroenterology is supposed to transmit Live NOTES procedure to Seoul as part of SGI 2010 and we were asked to transmit these procedures using DVTS technology?

23 Dr Shuji Shimizu

24 What we did DVTS software downloaded from the official website and checked it through our internal network. Got the required Bandwidth from the private operator Connected OT & other videos to the DVTS system using IEEE 1394 port

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27 The Digital Video Transport System (DVTS) is a simple and inexpensive method of transmitting high-quality video and audio over the Internet. Simple to operate Inexpensive (equipment)

28 Endoscopy Equipment OT - 1 OT - 2 Audio Mixer with Amplifier Microphone Microphone Endoscopy Equipment Speaker Return Audio Video Camcorder Speaker Return Audio Video Camcorder Receiving Audio DVTS PC (Transmit and Receive ) (IEEE 1394) Transmission Video and Audio Sony DV Recorder Audio and Video Transmit 30Mbps Presentation S-Video Panasonic MX70 Video Mixer Receiving Video Transmission Video Transmission Video

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30 Consultation Treatment C M E Live Operative Workshop s

31 Medicine WEDS Technology High-quality moving image on a broadband Internet

32 The Future has Just begun!! What next???

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34 Thank you