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Dr Modem

Telemedicine is saving thousands of lives in remote India

Priyanka Srivastava | August 22, 2003 12:59 IST

Reaching medical services to remote parts of India is a daunting task. But rushing specialist advice and care in an emergency is next to impossible.

That is now beginning to change because of the Internet. Medical specialists are fast becoming available for consultation through videoconferencing, Web cameras, online sharing of reports and 'telemedicine' software.

A pioneer in this business is the Apollo Hospitals Group. This year alone, the Apollo Telemedicine Network has given consultation to over 6,000 patients in remote areas through the Internet from telemedicine facilities in its 39 centers. Another 277 telemedicine centres are being planned.

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Pendra is a remote village in Chattisgarh. Dr Amar Singh Thakur, chief medical officer at the Pendra District Hospital was challenged by the condition of an 18-month-old baby suffering from a congenital heart anomaly. He was not sure if little Poornima really needed to make the journey to a big hospital in a far away city. He needed specialist advice.

So Dr Thakur simply used a telemedicine facility to present Poornima and her case to senior doctors in Bilaspur. At the other end were cardiologists Dr Jairam Iyer and Dr Rathi and cardio thoracic surgeon Dr Sanjay Jain. They were shown x-ray plates and ECG reports through teleconferencing. Dr Iyer decided that the baby need not travel right away and the surgery could be postponed for a few years.

Kanta Chatterjee, IT manager at the Bilaspur Apollo Hospital, told Rediff Guide to the Net that the videoconferencing facility at Pendra used ISDN lines to connect with Apollo hospitals in Bilaspur and Chennai.

Now there are plans to hook up 16 district hospitals with the main hospital either through ISDN lines provided by BSNL or by using VSAT with dedicated bandwidth.

The telemedicine gear usually comprises a computer with a Web camera, frame grabber, Ethernet card, terminal adapter, printer, scanner, videoconferencing equipment and some telemedicine software.

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In another case, the ocean between Port Blair and Chennai was spanned easily. A 35-year-old labourer met with a road accident in the island of Andaman and Nicobar. He was brought unconscious to the GB Pant Hospital in Port Blair, which had no neurosurgeon or doctor familiar with treatment of serious head injuries.

Dr K Ganapathy, senior consultant neurosurgeon and secretary, Asian Australian Society of Neurological Surgery, Chennai, was sent the CT scan images and other relevant photographs as JPEG images by email.

Local doctors, with the aid of teleconsultants, carried out treatment. The patient recovered completely and was discharged in 15 days! "The poor man took a ship to come all the way to Chennai with a dozen apples to express his gratitude," says Dr Ganapathy.

A serious head injury was treated in a remote place only because Dr Ganapathy had already delivered a lecture to the local doctors in Port Blair on using telemedicine techniques for accessing specialists on the mainland.

Telemedicine facility is becoming common in India and several doctors, or 'teleconsultants', if you will, have become a 'familiar face' in remote villages, claims Dr D Lavanian, who heads delivery of telemedicine at the Apollo Telemedicine Network Foundation, Hyderabad.

Some very serious cases have also been handled through telemedicine like in the case of a patient from Aragonda village in Andhra Pradesh. The man suffered from 'ventricular septal defect', a congenital defect where a hole is present in the heart between the walls of the ventricles. Local doctors could manage the case only because of timely instructions from remote specialists.

Dr Lavanian points out another critical case where a patient from Guwahati suffered from hydronephrosis, or a swelling of the kidney leading to blockage of the urinary tract. Again local doctors saved the day by turning to telemedicine to overcome the emergency.

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But the medical fraternity is not unanimous on the efficacy of telemedicine. Dr R Deshmukh of Nagpur talks about survey reports that show how several patients, despite taking teleconsultation, have gone ahead to seek face-to-face consultation, believing that minute details are not observable through this technique.

However, Dr Lavanian believes that details are captured through high-resolution digital images. "Besides, a qualified doctor is present at the patients' end to visually observe, palpate, note details and inform the teleconsultant," he says.

Dr Uday Bodhankar agrees. The paediatrician from Nagpur feels telemedicine is greatly needed in Vidarbha, central India, "to reach out to the children in the villages ailing from serious problems like diarrhoea and ARI (acute respiratory infection). They require immediate medical aid. And contacting a medical expert from this remote area is not always feasible. If only all district hospitals were connected to a main hospital in a city nearby things would change."

More Links
Telemedicine Glossary
List of Indian hospitals with telemedicine facility



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