TELEMEDICINE PROJECTS

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TELEMEDICINE PROJECTS in West Bengal
A Presentation by Dr. Rajendra S. Shukla,
Special Secretary, H FW Dept, Government of
West Bengal Dr. J. N. Maity, Director, WEBEL
ECS Ltd. 29th September 2006, Vigyan Bhawan, New
Delhi
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Outline of Presentation

• Objectives Relevance
• Benefits
• Model
• Telemedicine Projects in West Bengal
• Telemedicine PPP
• Images Graphics
• Awards
• Challenges Way Forward

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Objectives of Telemedicine

• Use of information and communication
  technologies
• 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.

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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.

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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.

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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

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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

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Telemedicine The Model

• Patient under treatment
• Physician treating the patient
• A remote telemedicine console having audio
  visual and data conferencing facilities

Nodal Hospital
POTS / ISDN / LEASED LINE / VSAT
Referral Hospital

• An expert / specialised doctor
• A central telemedicine server having audio
  visual and data conferencing facility

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System Schematic
Referral Center
Web Cam
Digital Camera
PSTN / Leased Line / ISDN / VSAT
Doctor / Patient
Web Cam
Scanner
Electronics Microscope
Printer
Specialist Doctor
Scanner
Digital camera
ECG Machine
Printer
Electronics Stethoscope
Nodal Center
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Sequence of Tele-consultation (I)
PATIENT IN
Patient receives treatment and is not referred to
telemedicine system
Patient visits OPD Local Doctor checks up
OUT
Patient referred to the Telemedicine system (some
special investigations may be suggested)
Step One
Patient visits Telemedicine data-entry
console. Operator enters patient record, data and
images of test results, appointment date is fixed
for online telemedicine session
OUT
Offline Data transfer from Nodal Centre
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Sequence of Tele-consultation (II)
Patient 1 Patient 2 Patient 3 Patient 4 . . .
Online video conference tele-consultation for
patients between local doctors at the nodal
hospital and specialist doctors at the referral
hospital
Step Two
OUT
IN
Patient queue
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Health Infrastructure in West Bengal (Government)
Health on the March 2004-05 Gov. WB
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Telemedicine in West Bengal (I)

• Project Implementation by Webel ECS Ltd, Kolkata
  (Dept of IT, Govt. West Bengal)
• Software development by CS E Dept. IIT,
  Kharagpur
• Project sponsored funded by the Dept of IT,
  Min. of Communications IT, Govt. of India
• Implementation and usage of facilities by the
  Dept. of Health FW, Govt. of West Bengal

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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. 2(5)/98-HB Dated
21.01.1999 Project Cost Rs. 150
lakhs
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Location of Centers 0f Project I
Koochbehar MJN
LEGEND
Habra SGH
STM
128 KBPS ISDN Link
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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. 2(11)/2001-HBT, dated
31.03.2002 DIT, GOI Contribution Rs. 147
lakhs
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Location of Centers Of Project II
Behrampur DH
Suri DH
LEGEND
Burdwan MCH
Purulia DH
NRS MCH
512 KBPS Leased Line
MidnapurMCH
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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. 2(20)/2003-Telemed Dt.
08.03.04 DIT, GOI Contribution Rs. 287
lakhs 0
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Location of Centers Of Project III
Darjeeling DH
NBMCH
Raiganj DH
LEGEND
Arambag SDH
512 KBPS Leased Line
CMCH
128 KBPS ISDN Link
CNCI
Tamluk DH
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Total Mapping of The Nodal and Referral Centers
Darjeeling DH
NBMCH
Koochbehar MJN
Raiganj DH
KOLKATA
NRS MCH
Burdwan MCH
Behrampur DH
CMCH
Suri DH
Arambag SDH
STM
CNCI
Habra SGH
LEGEND
Purulia DH
MidnapurMCH
Tamluk DH
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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

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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

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Training Provided
Training Provided
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Discipline wise Patient Consultation
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Public-Private Partnership in Tele-medicine
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

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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

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Utilization of Tele-cardiology Facilities
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Live session using 512 Kbps Leased Line
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Images
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Video Clip
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Vector Data
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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

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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)
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• . way forward
• 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.

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THANK YOU