“The delivery of healthcare services, where distance is a critical factor, by all healthcare 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 continuing education of healthcare providers, all in the interests of advancing the health of individuals and their communities”
The applications of Telemedicine:
1. To extend affordable quality healthcare services to those places where these are not available due to basic healthcare infrastructure and delivery issues.
2. Electronic transmission of clinical information of both synchronous and asynchronous types, involving voice and data transfer of patients to distantly located experts and get their treatment advice, online.
3. To effectively train the medics and the paramedics located in distant places and proper management of healthcare delivery/service systems.
4. Disaster management.
The Process:
The process can be:
- ‘Real time’ or synchronous when through a telecommunication link real time interaction between the patients and doctors/experts can take place. This technology can be used even for tele-robotic surgery.
- ‘Non-real time’ or asynchronous type, which involves transmission of stored diagnostics/medical data and other details of the patients to the specialists for assessing off-line and advice them at a time of convenience of the specialists.
These processes facilitate access to specialists’ healthcare services by the rural patients and the rural medical practitioners reducing avoidable travel time and related expenses. At the same time such interaction helps upgrading the knowledge of the rural medical practitioners and paramedics.
Relevance of Telemedicine in India:
Telemedicine is very relevant to India as it faces a scarcity of both hospitals and medical specialists. In India for every 10,000 of the population just 0.6 doctor is available. According to the Planning Commission, India is short of 600,000 doctors, 10 lakh nurses and 200,000 dental surgeons. Over 72 percent of Indians live in rural areas where facilities of healthcare are still grossly inadequate. Most of the specialists are reluctant to go to the rural areas. In addition, 80 percent of doctors, 75 percent of dispensaries and 60 percent of hospitals, are situated in urban India.
Telemedicine can bridge the healthcare divide:
Equitable access to healthcare is the overriding goal of the National Health Policy 2002. Telemedicine has a great potential to ensure that the inequities in the access to healthcare services are adequately addressed by the country.
The market of Telemedicine in India:
Frost & Sullivan has estimated the telemedicine market of India at US$3.4 million, which is expected to record a CAGR of over 21 percent between 2007 and 2014.
Practice of Telemedicine in India:
Not only the central government of India, many state governments and private players are also entering into telemedicine in a big way with the Indian Space Research Organization (ISRO) playing a pivotal role.
Telemedicine now shows an immense potential, within the frugal healthcare infrastructure of India, to catapult rural healthcare services, especially secondary and tertiary, to a different level altogether. Current data indicate that over 278 hospitals in India have already been provided with telemedicine facilities. 235 small hospitals including those in rural areas are now connected to 43 specialty hospitals. ISRO provides the hospitals with telemedicine systems including software, hardware, communication equipment and even satellite bandwidth.
In 1999, India based one of the largest healthcare providers in Asia, The Apollo Hospitals Group also entered into telemedicine space. Today, the group has quite successfully established over 115 telemedicine locations in India, It has been reported that a tele-consultation between the experts and the rural centre ranges from 15 to 30 minutes in these facilities.
The state governments and private hospitals are now required to allocate funds to further develop and improve penetration of Telemedicine facilities in India.
Issues with Telemedicine in India:
Telemedicine is not free from various complicated legal, social, technical and consumer related issues, which need to be addressed urgently.
- Many a time, doctors feel that for Telemedicine they need to work extra hours without commensurate monetary compensation, as per their expectations.
- The myth created that setting up and running a Telemedicine facility is expensive needs to be broken, as all these costs can be easily recovered by any hospital through nominal charges to the patients.
- Inadequate and uninterrupted availability of power supply could limit proper functioning of a telemedicine centre.
- High quality of Telemedicine related voice and data transfer is of utmost importance. Any compromise in this area may have significant impact on the treatment outcome of a patient.
- Lack of trained manpower for Telemedicine can be addressed by making it a part of regular medical college curriculum.
- Legal implications, if arise, out of any Telemedicine treatment need to be clearly articulated.
- A system needs to be worked out to prevent any possible misuse or abuse of the confidential Telemedicine treatment data of a patient.
- Reimbursement procedure of Telemedicine treatment costs by the medical insurance companies needs to be effectively addressed.
Conclusion:
Some significant and path breaking advances have indeed been made in the field of Telemedicine in India. It is unfortunate that not enough awareness has been created, as yet, on this novel technology based healthcare service for the common man. The pioneering role of ISRO in this field is also not known to many. It appears that advances of Telemedicine in India to extend quality healthcare services, especially, to our rural folks will continue to remain unsung for some more time. Until of course our all powerful ‘Fourth Estate’ steps in to initiate a healthy discussion on this subject within the civil society.
By Tapan Ray
Disclaimer: The views/opinions expressed in this article are entirely my own, written in my individual and personal capacity. I do not represent any other person or organization for this opinion.