Transcript Document

TELEMEDICINE PROJECTS
in
West Bengal
A Presentation by
Dr. Rajendra S. Shukla, Special Secretary,
H & FW Dep’t, Government of West Bengal
&
Dr. J. N. Maity, Director,
WEBEL ECS Ltd.
29th September 2006, Vigyan Bhawan, New Delhi
Outline of Presentation
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Objectives & Relevance
Benefits
Model
Telemedicine Projects in West Bengal
Telemedicine & PPP
Images & Graphics
Awards
Challenges & Way Forward
Objectives of Telemedicine
Use of information and communication
technologies:
i) To provide specialized health care
consultation to patients in remote
locations,
ii) To facilitate video-conferencing among
health care experts for better treatment
& care,
iii) To provide opportunities for continuing
education of health care personnel.
Relevance of Telemedicine
 Inadequate infrastructure in rural/district
hospitals
 Large number of indoor/outdoor patients
requiring referral for specialized care
 Low-availability of Health Experts in
district/remote hospitals
 Dearth of adequate opportunities for training or
continuing Medical Education for Doctors in
Rural/Remote Health facilities.
Benefits of Telemedicine (I)
Benefits to Patients:
 Access to specialized health care services to
under-served rural, semi-urban and remote
areas,
 Access to expertise of Medical Specialists to a
larger population without physical referral,
 Reduced visits to specialty hospitals for long
term follow-up care for the aged and terminally
ill patients.
Benefits of Telemedicine (II)
Benefits to Physicians:
 Improved diagnosis and better treatment
management
 Access to computerized, comprehensive data
(text, voice, images etc.) of patients – offline
as well as real time
 Quick and timely follow-up of patients
discharged after palliative care
 Continuing education or training through
video conferencing periodically
Benefits of Telemedicine (III)
Hospital and Insurance Benefits:
 Significant reduction in unnecessary visits &
hospitalization for specialized care at tertiary
hospitals,
 Earlier discharge of patients leading to shorter
length of stay in hospitals,
 Increase in the scope of services without
creating physical infrastructure in remote
hospitals
Telemedicine : The Model
Nodal Hospital
 Patient under treatment
 Physician treating the patient
 A remote telemedicine console having
audio visual and data conferencing
facilities
Referral Hospital
 An expert / specialised doctor
 A central telemedicine server having
audio visual and data conferencing
facility
System Schematic
Referral Center
Digital Camera
Web Cam
PSTN /
Leased Line
/ ISDN /
VSAT
Scanner
Printer
Specialist Doctor
Doctor /
Patient Electronics
Microscope
Web Cam
Scanner
Digital camera
ECG Machine
Electronics
Stethoscope
Printer
Nodal Center
Sequence of Tele-consultation (I)
PATIENT IN
Patient visits OPD
Local Doctor checks up
Patient receives treatment
and is not referred to
telemedicine system
OUT
Patient referred to the Telemedicine system (some
special investigations may be suggested)
Patient visits Telemedicine data-entry console.
Operator enters patient record, data and images of
test results, appointment date is fixed for online
telemedicine session
Offline Data
transfer
from Nodal
Centre
OUT
Sequence of Tele-consultation (II)
Patient 1
Patient 2
Patient 3
Patient 4
.
.
.
IN
Patient queue
Online video conference &
tele-consultation for patients
between local doctors at the
nodal hospital and specialist
doctors at the referral
hospital
OUT
Health Infrastructure in West Bengal
(Government)
Medical College Hospitals
Dental College Hospitals
School of Tropical Medicine
District Hospitals
Sub-Divisional & State General Hospitals
Rural Hospitals
Block Primary Health Centres
Primary Health Centres
Sub-Centres
9
2
1
15
70
95
251
922
10,356
** Health on the March 2004-05 Gov. WB
Telemedicine in West Bengal (I)
 Project Implementation by Webel ECS Ltd,
Kolkata (Dep’t of IT, Govt. West Bengal)
 Software development by CS & E Dept. IIT,
Kharagpur
 Project sponsored & funded by the Dep’t of IT,
Min. of Communications & IT, Govt. of India
 Implementation and usage of facilities by the
Dept. of Health & FW, Govt. of West Bengal
Telemedicine in West Bengal (II)
PROJECT - I
Referral Center
: School of Tropical Medicine, Kolkata
Nodal Centers
: Habra State General Hospital, 24th
Parganas (North)
: MJN Hospital, Coochbehar
Connectivity: First with POTS, upgradation with ISDN, lastly
with 512 Kbps Leased Line using WBSWAN as backbone.
Disease Types: Skin Related and Blood Related
Diseases,Leprosy .
Project Completed: December 2003
DIT Sanction No.
Project Cost
: 2(5)/98-H&B Dated 21.01.1999
: Rs. 150 lakhs
Location of Centers
0f Project I
Koochbehar MJN
LEGEND
Habra SGH
128 KBPS ISDN Link
STM
PROJECT - II
Referral Center : NRS Medical College & Hospital, Kolkata
: Burdwan Medical College & Hospital, Burdwan
Nodal Centers : Purulia District Hospital, Purulia
: Suri District Hospital, Birbhum
: Baharampur District Hospital, Murshidabad
: Midnapur Medical College & Hospital, Midnapur
Connectivity: 512 Kbps Leased Line using WBSWAN as
backbone.
Disciplines: Cardiology, Radiology, Medicine, Pediatrics,
Pathology, Neurology, Dermatology etc.
Project Completed: December 2004
DIT Sanction No.
DIT, GOI Contribution
: 2(11)/2001-HBT, dated 31.03.2002
: Rs. 147 lakhs
Location of Centers
Of Project II
Behrampur DH
Suri DH
LEGEND`
Burdwan MC&H
Purulia DH
NRS MC&H
512 KBPS Leased Line
MidnapurMC&H
PROJECT - III
Referral Center : Calcutta Medical College, North Bengal Medical
College, Chittaranjan National Cancer Institute,
Kolkata
Nodal Centers : Darjeeling, Raigunj & Tamluk District Hospitals
: Arambag Sub. Div. Hospital, Hoogly
Connectivity: ISDN for Arambag Nodal center and 512
Kbps Leased Line using WBSWAN as backbone for other
centers.
Disciplines: Cardiology, Radiology, Medicine, Pediatrics,
Pathology, Neurology, Dermatology, Oncology etc.
DIT Sanction No.
DIT, GOI Contribution
: 2(20)/2003-Telemed Dt. 08.03.04
: Rs. 287 lakhs 0
Location of Centers
Of Project III
Darjeeling DH
NBMCH
Raiganj DH
LEGEND
Arambag SDH
512 KBPS Leased Line
CMC&H
128 KBPS ISDN Link
CNCI
Tamluk DH
Total Mapping of
The Nodal and
Referral Centers
Darjeeling DH
NBMCH
Koochbehar MJN
Raiganj DH
KOLKATA
NRS MC&H
Burdwan MCH
Behrampur DH
CMC&H
Suri DH
CNCI
Arambag SDH
STM
Habra SGH
LEGEND
Purulia DH
MidnapurMC&H
Tamluk DH
TelemediK Software (I)
 Is a point-to-point telemedicine system
 Symmetric
 No distinction between nodal and referral centers
 Any hospital can communicate to other hospitals
 2nd level referral is allowed
 Multi nodal, multi referral environment
 Operates over a spectrum of low to high
bandwidth communication channels - POTS,
ISDN, leased line, VSAT and wireless media
TelemediK Software (II)
 Store & Forward Technical information
 Online video conferencing and data transfer
 Electronics Medical Record (EMR) Supported
- Text, Image, Graphics, Audio, Video
 Integration with different medical instrument
- EEG, ECG, USG, MRI, CT SCAN, Electronic
stethoscope, Microscope fitted with digital camera
 Support of medical standards
Training Provided
Tele-medicine Centers
Habra SDH
Coochbehar DH
Midnapur MC & H
Behrampur DH
Purulia DH
Suri DH
NRS MC & H
Burdwan MC & H
STM, Kolkata
Total
Doctors
03
08
12
05
18
15
03
15
05
84
Paramedics
12
12
03
02
08
02
01
07
01
48
Discipline wise Patient Consultation
Pediatrics
Orthopedics
Neurology
75
96
34
Cardiovascular Medicine
Psychiatry
ENT
27
12
31
Urosurgery
Hematology, Dermatology, General Medicine,
OBG, Leprosy, etc
11
3300
Public-Private Partnership in Telemedicine
Integrated Tele-Cardiology & Tele-health Project
 Govt. facilities covered - BSMCH & Siliguri SDH
 Partnership with Asia Heart Foundation & RN
Tagore International Institute of Cardiac Sciences,
Kolkata
 Connectivity through POTS & ISDN
Services Provided
 Treatment of Acute Heart Attack cases as
evidenced by history and ECG,
 Treatment by “Thrombolysis”
 Referral & Tele-consultation & video
conferencing with RN Tagore International
Institute of Cardiac Sciences, Kolkata
Utilization of Tele-cardiology
Facilities
Patients Admitted
Thrombolysed
Tele-consultation
Bankura Sammilani
Medical College
1493
296
915
Siliguri SD
Hospital
2418
197
458
Live session using 512 Kbps
Leased Line
Images
Video Clip
Vector Data
Awards Received
 National e-Governance Award, 2004 – from
Govt. of India under Category “ Outstanding
Performance in Service Delivery”
 Skoch Challenger Award, 2005
 Manthan – American India Foundation
Award, 2006 under “e- Health” Category
Challenges in Implementing Telemedicine
1. Identification of a Suitable site and preparation of site
for Telemedicine facility.
2. Synchronization of civil, electrical and equipment
related works.
3. Identification of a nodal officer (Other than
Superintendent) for coordinating Telemedicine activities
in the hospital.
4. Sensitization and repeated hands-on training of
concerned Doctors, Technicians and Nurses.
5. Coordinating with referral centers to fix mutually
convenient tele-consultation sessions on a regular
basis.
6. Ensuring trouble free & smooth connectivity through
WAN (ISDN/Leased Line)
…. way forward
1. Hand-holding support to Hospital administration for 3-4
years for stabilization of telemedicine services.
2. Integration of Telemedicine activities with Health
Management Information System for regular reporting
(preferably web-based)
3. Including Telemedicine activities in the performance
appraisal of individuals and institutions.
4. Introducing Telemedicine (concept, technical aspects
and implementation arrangements) as part of medical
education & continuing medical education.