Use of Telemedicine for reforms in newer medical colleges of India Telemedicon-2015 "The AIIMS RRC Workshop Dr. Nidhi Bhatnagar Assistant Professor, ACMS Department of Community Medicine
Plan of Presentation Current status of Medical Colleges in India Medical Colleges - Role in Society Need for technological reforms Potential use of Telemedicine in newer medical colleges Challenges
Medical Colleges-Current Status Number of Medical Colleges (Teaching MBBS courses)-398 55% - Private (Trust owned) in 2014 compared to 33% in 1990 (Medical Council of India) New Medical Colleges in Pipeline; [Public + Private] 15- Orissa, 5-Telangana 6 new AIIMS at Jodhpur, Bhopal, Patna, Rishikesh, Bhubaneswar & Raipur (Pradhan Mantri Swasthya Suraksha Yojana)-FUNCTIONAL 4 new AIIMS in Andhra Pradesh, West Bengal, Vidarbha in Maharashtra & Poorvanchal in Uttar Pradesh. [Health Budget 2014-15]
ROME (1977) appears realistic in 2015 Re-orientation of Medical Education (ROME) Objectives; (i) introducing community bias in training of undergraduate medical students with emphasis on preventive and promotive services (ii) reorientation of medical colleges, to make them an integral part of health-care system and not function in isolation. (iii) reorientation of faculty members from hospital-based and diseaseoriented training to community-based and health-oriented training. (iv) development of effective referral linkages between PHCs, District Hospitals and Medical Colleges. ROME CAN BE UTILIZED THROUGH TELEMEDICINE, INFORMATION TECHNOLOGY AND OPENING OF SEVERAL NEWER MEDICAL COLLEGES IN REMOTE AND UNDERSERVED AREAS OF INDIA.
Role of Medical Colleges MEDICAL EDUCATION AND TRAINING RESEARCH EXPERT TREATMENT AND MEDICAL CONSULTATIONS
Medical Education [e Health] Information Technology critical in practice of evidence based medicine. Continuing medical education through online modules to health practitioners in distant locations. Distance education courses delivered through academic medical centers of excellence to provide on job training. Virtual classroom lectures by experts disseminated to several educational institutes. Online journal clubs for developing critical thinking and problem based learning.
Expert treatment and consultations [Tele-medicine] Expert consultations and diagnosis from distant locations. e.g. Tele-pathology, Tele-radiology, Tele-ophthalmology, Tele-dermatology Early diagnosis and treatment Cost and time effective Delivery of quality health care services Research [Tele-health and mhealth] Paperless Data collection through tablets, PDAs and mobile phones Real time data transfer for action Multi-stakeholder involvement and availability of experts simultaneously on the same platform-biomedical Research Implementation research; Facilitate implementation or scale up of interventions. Use of evidence in decision making by experts e.g. policies and programs. Operational research; Guide policy and programs
Need For Technological Reforms I. Large and diverse country with 69% of rural population II. III. IV. Reach and cost effectiveness of Information technology Focus on evidence based medicine Status of rural health care infrastructure in India V. Extreme shortage of skilled health care providers VI. Inequitable distribution of health manpower across urban & rural areas VII. Increasing costs of skilled manpower VIII. Rapid changing medical practice
Potential use of Telemedicine in newer medical colleges Fill gaps in faculty across several disciplines. Mentor young faculty by senior faculty from established colleges. Provide diverse clinical exposure to students. Collaboration for research. Facilitate Community orientation in medical education and practice.
Challenges! Rigid structured medical curriculum leaves little scope for application of newer techniques Technology unfriendly attitude of health care staff. Poor uplink and bandwidth availability in remote areas of India.
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Technology and Medicine E health Transfer of health resources and health care by electronic means. It encompasses three main areas: Delivery of health information, for health professionals and health consumers, through Internet and telecommunications. Using the power of IT and e-commerce to improve public health services, e.g. through the education and training of health workers. Use of e-commerce and e-business practices in health systems management. [ World Health Organization] Mhealth A recent term for medical and public health practices supported by mobile devices, such as mobile phones, patient monitoring devices, personal digital assistants (PDAs), and other wireless devices.
Telemedicine is the use of telecommunications to diagnose and treat disease and ill-health. Tele-health includes surveillance, health promotion and public health functions. It is broader in definition than tele-medicine and includes computer-assisted telecommunications to support management, surveillance, literature and access to medical knowledge Telematics for health is a WHO composite term for both telemedicine and tele-health, or any health-related activities carried out over distance by means of information communication technologies.