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Telemedicine

Telemedicine a term framed in the 1970s, which literally means “healing at a distance”. It signifies the use of information communication technology (ICT) to improve patient outcomes by increasing access to care and medical information.

According to WHO telemedicine is defined as “the delivery of health care services, where distance is a critical factor, by all health care professionals using information and communication technologies for the exchange of valid information for diagnosis, treatment and prevention of disease and injuries, research and evaluation, and for the continuing education of health care providers, all in the interests of advancing the health of individuals and their communities”.

 

Elements related to telemedicine

  • Telemedicine is the use of medical information exchanged from one treatment site to another via electronic communications.
  • It provides clinical support in order to improve health outcomes.
  • It overcomes geographical barriers, connecting users who are not in the same physical location such as from rural and remote areas.
  • It involves the use of various types of ICTs.
  • It is useful in emergency and critical care situations where moving a patient may be undesirable and/ or not feasible.
  • It facilitates patients and rural practitioners’ access to specialist health services and support.
  • It lessens the inconvenience and/or cost of patients transfers.
  • It comprises videoconferencing, transmission of still medical images, document sharing, remote monitoring of vital signs.

 

Uses of telemedicine in India:

For universal outreach of healthcare services in an affordable manner, MoHFW has aligned its initiatives along with the Sustainable Development Goals (SDGs) to ensure healthy life and well-being of the citizens. MoHFW has proactively taken a leap to utilize the effective fusion of ICTs with existing health infrastructure in meeting the challenges of healthcare delivery to rural and remote areas to ensure continuum of care.

The key initiatives of the MoHFW in this direction include National Medical College Network, National Telemedicine Network, Use of Space Technology for Telemedicine etc.

 

National Medical College Network(NMCN):

Under National Medical College Network (NMCN) scheme, 50 Govt. Medical Colleges are being inter-linked with the purpose of tele-education, e-Learning and online medical consultation by utilising the connectivity provided by National Knowledge Network (NKN).

Under this initiative a virtual layer of specialty/super specialty doctors from these medical colleges is created for providing online medical consultation facility to citizens similar to OPD facility through a web/ portal.

 

Tele-education:

Tele-Education is a part of distance education. eClass rooms are also being set up at various Medical Colleges for sharing and streaming the important Lectures/seminars

 

National Telemedicine Network (NTN):

National Telemedicine Network (NTN) has been envisaged to provide Telemedicine Services to the remote areas by upgrading existing Government Healthcare Facilities (MC, DH, SDH, PHC, and CHC) in States. Telemedicine nodes across India are being created inter connecting these health facilities.

 

State Telemedicine Network (STN):

The States/UTs have been supported under National Health Mission (NHM) under Program Implementation Plan (PIP) for strengthening State Telemedicine initiatives under STN & to create reliable, ubiquitous and high speed network backbone, all available and future network.

 

Establishment of SATCOM based Telemedicine Nodes

Indian Space Research Organisation (ISRO) through its Department of Space (DoS) had initiated a nationwide telemedicine (TM) programme in 2001 and provided TM systems hardware, software, communication equipment as well as satellite bandwidth for 384 Hospitals with 60 specialty hospitals; connected to 306 remote/rural/district/medical college hospitals. Eighteen (18) Mobile Telemedicine units were also enabled for Satellite connectivity.

 

Tele-Medicine Nodes at Pilgrim Places

MoHFW & Department of Space (DoS) jointly have sat up Satellite communication based Telemedicine nodes at various unreachable geographical locations including Chardhams and other important pilgrimage centres as Amarnath cave-J&K; Ayappa temple, Kerala; Dwarkadheesh Temple,Gujarat; Kashi Vishwanath Temple, Uttar Pradesh; and Vidhyanchal Devi Temple, UP to provide health awareness, screening of non-communicable disease (NCD) and specialty consultation to the devotees visiting these places. Initially the tele-health services are operationalized in the field of medicine, orthopedics, respiratory and cardiology disciplines. All these telemedicine nodes are now part of the ISRO National Telemedicine network and could also be serviced by any of the specialist nodes across the country like, PGI-Chandigarh, SGPGI-Lucknow, JIPMER-Pondicherry and AIIMS-New Delhi etc.

Disaster Management: Telemedicine also plays an important role to provide healthcare facilities to the victims of natural disasters such as earthquake, tsunami, tornado, etc and man-made disaster such as war, riots, etc. During disaster, most of the terrestrial communication links either do not work properly or get damaged so a mobile and portable telemedicine system with satellite connectivity and customized telemedicine software is ideal for disaster relief.

Tele-Evidence: Tele-evidence is a modality via which doctors can testify in the judicial process utilizing the video conferencing facility without visiting the courts in person. This service was launched at PGIMER, Chandigarh. MoHFW has decided to rollout the service in every State/.

Resource Centers in India:

One national resource center and seven regional resource centers. To know more about RRCs- Click here

  • National Resource Center (NRC) – Sanjay Gandhi Post Graduate Institute of Medical Sciences (SGPGIMS) Lucknow
  • Regional Resource Centre (RRC) Eastern region -Institute of Medical Sciences, Banaras Hindu University Varanasi
  • RRC North- Postgraduate Institute of Medical Education and Research ( PGIMER) Chandigarh
  • RRC central- All India Institute of Medical Sciences (AIIMS), New Delhi-Telemedicine Facility AIIMS, Delhi
  • RRC North-East –North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS) Shillong
  • RRC West- KEM Mumbai
  • RRC South I- Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER) Puducherry
  • RRC South II- Government Medical College, Thiruvananthapuram

 

Other telemedicine centers

  • Arvind Mobile Eye Screening VAN
  • Apollo Telemedicine Networking Foundation (ATNF)
  • Common service center
  • C-DAC telemedicine solutions
  • Naranaya Health -http://www.nhtelrad247.com/
  • Shankara Netralaya Teleophthalmology
  • SATHI
  • Telemedicine Mobile Bus
  • Telemedindia
  • World Health Partners
  • eVaidya

References-

  • https://www.who.int/goe/publications/goe_telemedicine_2010.pdf
  • https://mohfw.gov.in/about-us/departments/departments-health-and-family-welfare/e-
  • Health%20%26%20Telemedicine)
  • http://www.sgpgi-telemedicine.org/telemedicine/PPT/Infocom12_SK%20Mishra.pdf