148 Journal of Today s Biological Sciences : Research & Review (JTBSRR) Vol.1,Issue 1,page 148-152,December 30,2012 ISSN 2320-1444 (Online) JTBSRR Available on : www.jtbsrr.in APPLICATION OF TELEMEDICINE IN INDIA -- AN OVERVIEW SUBHASIS BANDYOPADHYAY, LECTURER OF INSTITUTE OF COMPUTER AND INFORMATION SCIENCE, BANKURA,WEST BENGAL, INDIA E-MAIL: subhasis_ban83@yahoo.co.in ABSTRACT India got an opportunity to make its health infrastructure better with its faster growing information and communication technology. With implementation of Telemedicine, it can serve weakly served or un served parts of country. Telemedicine uses some modern information and communication techniques to connect distant part of world. By application of it countries like India can make drastic change in their health structure by milking its advantages. They can serve cheap but world class medical facilities and education to rural parts of country (as most ill served part of India is villages).but to implement it India may face some challenges. It have to overcome those challenges and implement it with help of Government bodies (like Indian Space Research Organization), Govt. executives and private players working together. Key Words: Telemedicine, Health, Medical facility, INTRODUCTION Telemedicine is a boon of modern information and communication system. It is a process of connecting healthcare system of one part of world with other parts for exchanging consultancies, education some other healthcare facilities with a view of betterment of worlds health infrastructure. Here Tele is a Greek word which means Distance and Mederi is a Latin word which means to heal. So Times magazine has described this system as Healing by wire. World health organization has defined Telemedicine as--- The delivery of healthcare services, where distance is a critical factor, by all healthcare professionals using
149 information and communication technologies for the exchange of valid information for diagnosis, treatment and prevention of disease and injuries, research and evaluation, and for continuing education of healthcare providers, all in the interest of advancing the health of individuals and their communities. India also has come up with Telemedicine technology with a plane of connecting excellent healthcare facilities of specialty hospitals with rural hospitals. There are several types of Telemedicine facilities. They are 1. Telenpathology: Images and videos can be transmitted as a computerized file and thus job of pathologist can be made easy. 2. Telesurgery: by use of multiple high resolution video camera doctors can get three dimensional views. Medical students also can do dissection using visuals on internet. 3. Telecardiology: In telecardiology, Electrocardiographs (EGCs0 can be transmitted using information and communication technologies. METHODOLOGY Application of Telemedicine in India to cover its under developed rural healthcare facilities is discussed here with some case studies. Reliable secondary data and some case studies are used to analyze the applications of Telemedicine with giving a trace on Indian villages. Technologies used in Telemedicine. Growth of Information and communication technologies is the reason of boom of Telemedicine world wide. There are several technologies used to transmit image and video files from one place to other. They are 1. Stored and forward method:- in this process digital image is taken and stored. Then the image is forwarded to another location. Diagnosis and / or consultation information are sent back. 2. Video Conferencing: - two way interactive communications is made through televisions. 3. Integrated services digital Network (ISDN), a high-speed international communication standard for transmitting video, audio and data over digital or normal telephone wires. 4. T-1 is another technology used to transmit voice and digital data at 1.554 megabyte per second(mbps) 5. Plain old telephone service also used for audio conferencing, storing and forwarding data and low bandwidth video conferencing. 6. Internet is also used for telemedicine services. Several hospitals have their own website providing information and consultancies.
150 Application of telemedicine in India Out of total 1210.2 million populations in India, 833.1(68.84%) million population resides in rural India. This 68.84% of rural population lack the basic medical facilities. According to a report of rural health statistics (RHS), 2010, there is a shortage of 19,590 sub centers, 4252 primary health centers and 2115 community health centers in India. Beside this crude birth rate (defined as the number of live births per 1000 persons over a period of one year.) in rural India has also declined from 38.9 per thousand in 1971 to 23.7 per thousand in 2010. According to Indian Institute of public opinion, that 89% of rural Indian patients have to travel near about 8 km for accessing basic medical facilities. In another report of Indian medical society has informed that 75% of qualified doctors are practicing in urban areas, 23% in semi urban areas and only 2% in rural health centers. This all shows the poor infrastructure of rural India and the need of introduction of Information and communication technologies like Telemedicine in India. Telemedicine can provide world class medical facilities of specialty hospital to the hospitals of remote areas and thus can reduce the cost of treatment there. Telemedicine can make medical facilities accessible to all rural Indian families. In Indian telemedicine reform, Indian space research organization (ISRO) has played a vital role. It has come up with satellite bandwidth, soft wares and hard wares. ISRO has set up Health SAT, a satellite, to provide telemedicine facilities to rural people of India. According to L.S. Sathyamurthy, Program director of Telemedicine at ISRO There are 650 district hospitals, 3000 taluk(sub district)hospitals and more than 23000 primary health centers in the country, we must aim to connect all these phases. First district hospitals connected to specialty hospitals in major cities, then taluk level hospitals, and finally primary health centers, so that nobody, irrespective of his location, is deprived of lifesaving specialty consultation. In the goal of doing that, ISRO has run a pilot project in 2001 and connected 60 remote hospitals with 20 super specialty hospitals. India has efficiently applied Telemedicine in several hospitals of it and has got a good result. Till now Indian Telemedicine network has done efficiently well by treating more than 25000 patient and proving Telemedicine facilities to 100 of hospitals(isro has connected 78 rural/remote/district health centers with 22 specialty hospitals of major cities. In an telemedicine project, G.B.Pant hospital at port blair has connected with shri Ramchandra medical college and research institute, Chennai. In another project, Narayana Hrudayalaya of Karnataka is linked with Chamaraynagar and Vivekananda memorial hospital,d district hospital of Sagar by Telemedicine facilities. According to Amrita Telemedicine Programme s report, 13 th January 2003, they has performed first remote Telesurgery to save a pilgrim using local Telemedicine facility. Besides them Apollo group also has successfully implemented Telemedicine facilities in India. A CASESTUDY OF APOLLO GROUP Apollo hospital has introduced Telemedicine with a mission of spreading standard healthcare facilities in the reach of every individual of India and world. In voice of Dr. Prathap C. Reddy (Founder and Chairman, Apollo Hospitals Group), Our mission is to bring healthcare of international standards within the reach of every individual. We are
151 committed to the achievement and maintenance of excellence in education, research and healthcare for the benefit of humanity". In the aim of introducing Telemedicine in India, Apollo group has introduced Apollo Telemedicine Networking foundation (ATNF), non profit organization. Today ATNF has 125 peripheral centers including 10 overseas. Besides, ATNF providing telemedicine facilities in the distance ranging 200 to 75000 km with its 75000 teleconsultation in 25 different disciplines. Ministry of external affair had selected ATNF for providing teleconsultation and tele education to 53 countries of African union. In the 12 year journey of ATNF, It has done remarkably well to cover several parts of country and 29 African countries. World healthcare congress, Washington, usa has awarded ATNF with the BEST POSTER AWARD in april, 2011. CHALLENGES FACED BY INDIA IN INTRODUCTION OF TELEMEDICINE Poor infrastructure and lack of knowledge of computer in rural India has made task of implementation of Telemedicine very challenging. Several type of problems faced in implementation of Telemedicine in India. They are 1. There are lack of infrastructure in rural india.several villages still have no electricity. Though Rajiv Gandhi Gramin Vidyutikaran Yojana (RGGVY) has introduced as a remedy of that problem by providing connection to all villages and free connection to BPL families. 2. There is a fear of losing job if this technology is introduced. 3. Due to lack of knowledge and expertise in handling information technology and other equipments, people hesitate to use Telemedicine. 4. Some people think that setting up of telemedicine facilities will incur high initial investment. So it is not financially viable. 5. Doctors even sometimes are not fully convinced or familiar with this technology. 6. There is only few people who know English. So, Language barrier is a big challenge in India. BENEFITS OF USING TELEMEDICINE Telemedicine is like a magic to Indian healthcare infrastructure which can make drastic change in rural healthcare practice by bringing world class medical facilities to remote and rural villages. People who are suffer of poor rural healthcare facilities in India, will be able to access those facilities at their door step. Besides this, Telemedicine also possesses several other benefits. They are --- 1..Telemedicine provides cost effective medical services. 2. Telemedicine is used in optimization of resources. 3. It can provide specialist advice and counseling via use of information and communication technologies at patient s home or nearest possible site eliminating need of unnecessary travelling.
152 4. Telemedicine helps in providing healthcare facilities at remote villages. 5. Telemedicine is very helpful for medical professional in exchanging information and consultation. 6. Telemedicine can be used to save life of injured people at war or disaster effected areas. 7. Telemedicine is also help in the education of medical healthcare professionals. CONCLUSION With a bird eye view of improving healthcare system in India, Telemedicine emerging in this subcontinent in jet speed. Govt. body (like ISRO, department of information technology of ministry of communication and information technology etc.) and private players have come up with efforts in implementation of telemedicine. Now India is able to milk their opportunity to cover its weak health infrastructure with the boon of faster growing information technology dream of Healthy India will come in reality. REFERENCE 1.APOLLO GROUP: ATNF website:-- http://www.telemedicineindia.com/ 2.Bachi S. (2006) Telemedicine in rural India, PLoS Med 3(3): e82 doi : 101371/ Journal pmed -0030082, march 2006 3.Berdusis K., Tele echocardiography and Tele cardiology, Telemedicine Today, June 1999. 4.Deb Soumya, 2008, Telemedicine a new horizon in public health in India, Indian J community Med, January,2008, 33(1):3-8 doi 10.4103/0970-218.39234 5.http://www.isro.org/publications/pdf/Telemedicine.pdf 6.Hazra Anupam,2012, Development Demography of rural India, Kurukshetra, Vol. 60 No. 9, July 2012 7.Kohil Seema, 2012, Telemedicine an overview, Pharmatimes, Vol. 36, No.7, July 2004. 8.Mundrey K. Telemedicine : The new frontier, Information systems computer world, June 1998 9.Report of technical working group for telemedicine standardization, department of information technology(dit),ministry of communication and information technology(mcit),2003, http://telemed.esanjeevani.in/telemedicine/report.pdf