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India Country Report on Tele-health Initiatives
Prof. S K Mishra, MS, FACSHead, Dept. of Endocrine Surgery &
Faculty I/C, SGPGI Telemedicine Programme Sanjay Gandhi Postgraduate Institute of Medical
Sciences (SGPGIMS) Lucknow,[email protected]
www.sgpgi-telemedicine.org
United Nations/India/ Regional Workshop on Using SpaceTechnology for Tele-Epidemiology to Benefit Asia and the
Pacific RegionOctober 20th 23rd , 2008
School of Telemedicine & Biomedical Informatics,SGPGIMS, Lucknow, India
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Content
Introduction: India Demography & Health DeliverySystem
Electronic Medical Record and Hospital Automation Brief review of Telemedicine projects around the
country Standardization & Policy initiatives (National Task
Force) E health Capacity building, Scientific Societies,
Education, Research & Development Major national & international Projects in near future Critical issues for integration of e health in Medical
Tourism
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India Demography & Health DeliverySystem
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India
Total Area :3 million sq. km
No. of Provinces : 29Union Territories : 6
Coastal line : 6,700 km
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Health Scenario in India Total population: 1,151,751,000
Gross national income per capita (PPP international $):3,800
Life expectancy at birth m/f (years): 62/64
Healthy life expectancy at birth m/f (years, 2003): 53/54 Probability of dying under five (per 1 000 live births): 76
Probability of dying between 15 and 60 years m/f (per -1000 population): 276/203
Total expenditure on health per capita (Intl $, 2005): 100
Total expenditure on health as % of GDP (2005): 5.0Figures are for 2006 unless indicated
World Health Statistics 2008 Source: http://www.who.int/countries/ind/en/
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Health care in India
Private clinics
Nursing homesCorporate hospitals
Teaching hospitalsTertiary
Private clinicsSmall nursing homes
District hospitalsSecondary
Traditionalpractitioners
PHCs and its subcenters
Primary
PrivatePublicLevel
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Potential of ICT to improve Healthcare
65% of 1100 million are literate
60% of rural India has access to TV coverage
650,000 existing PCOs internet kiosks
400,000 villages already have telephone connections
Mobile user in India 156.3 million
Internet users in India 2m Dec 2001, 8.5m 2003
Hardware, software and brain ware all available
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Current Status of e-health in India
Mostly limited to medical transcription and
Health awareness through portals
Telemedicine
Hospital management system
Customer service using internet
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Electronic Medical Record and
Hospital Automation
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EMR & Hospital Information &Management System (HIMS)
Application
Large corporate hospitals
Academic Medical
Institutions
(SGPGIMS, Lucknow; Institute
of Medical Sciences,
Sevagram; SRMC, Chennai;
AIMS, Kochi; CMC, Vellore)
Solution Providers
Center for Development of
Advanced Computing
Wipro GE Healthcare Tata Consultancy Services
Siemens Information Systems
Ltd (SISL)
Vepro (PACS)
Sobha Renaissance
Information Technology
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Brief review of Telemedicine projectsaround the country
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Telemedicine InfrastructureTelemedicine
(more than 500 platforms)
Major Implementing Agencies Indian Space Research Organisation
Department of Information Technology , Ministryof Communication & IT
Ministry of Health and Family Welfare
State Governments
Medical Institutions
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DIT - Initiatives
Telemedicine module forTropical Medicine in WestBengal - Webel (Kolkata), IIT,Kharagpur and School ofTropical Medicine, Kolkata
Telemedicine and TelehealthEducation facilities in Kerala 3 specialty hospitals with 4District/ Rural Hospitals
Telemedicine network (CMEprogramme) for Naga HospitalKohima with Apollo Hospital,Delhi
Onconet Network - Kerala and
Tamilnadu States
State wide Telemedicine networkbased on terrestrial communicationin the state of Himachal Pradesh,Tamilnadu, Punjab
Telemedicine network for Tripura
2 referral hospitals with 4 nodes Networking of District Hospitals of
Mizoram & Sikkim with ApolloHospital, Delhi
Setup Community InformationCenters in 30 blocks of the NorthEastern states and Sikkim incollaboration with National
Informatics Center using NICNET
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Telemedicine at SGPGIMS,Lucknow
Application project
Constancy, project
planning and
implementation of network
in states
Tele-health care & Distant
Education in Medicine
Tele-mentoring
Research and Productdevelopment
Organizational Activities
Telemedicine Awareness
National & International
collaboration in policy
initiatives, technical
knowledge exchange &
HRD
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All India Institute of Medical
Sciences, New Delhi
J & K network, Haryana ( RohtakMedical College, BallabhgarhCommunity Centre)
SCB Medical College Cuttack,
Guwahati
SRMC, Chennai
AIMS, Kochi
Post Graduate Institute ofMedical Education and
Research (PGIMER),Chandigarh
Mata Kaushalya Hospital atPatiala
Sub-divisional GovernmentHospitals at Dasuya andAjnala in Hoshiarpur andAmritsar in Punjab state
A ll T l di i N t k
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Amrita Institute of MedicalSciences, Kochi
36 Telemedicine Centers allover India Emergency Medical Center at
Pampa
Apollo Telemedicine NetworkFoundation
Corporate Group of Hospitalshaving branches in India andAbroad
Networked all its hospitals anduse in-house software
Telemedicine consultancy andsoftware providers
Active participants in theStandardization and ITIH activity
Installed a number of peripheraltelemedicine nodes throughfranchise under Apollo HealthStreet Company
Fortis Hospitals
HIS & PACS
13 nodes
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National e-Governance Action Plan (NeGP)(DIT Initiatives)
100,000, Common Services Centers (80 services) by 2007 Health
Vaccination Schedule Maternity Care Family Planning
Medicines Ambulance Services and Transportation Hospital / Primary Health Centers information Blood Bank
Life Saving Drugs Doctors Database Appointment with Doctors E-Diagnostics
Materials Management System (Medicines)
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Govt of India InitiativeVillage Resource Centers (VRCs)
600,000 villages
Communication and remote sensing satellite providedby ISRO
Information on agriculture, health, education, naturalresources
Initially in the Andaman and Nicobar Islands &Wayanad and Palakkad areas of Kerala and in someparts of the northeast
http://www.apnic.net/mailing-lists/s-asia-it/archive/2004/10/msg00018.html
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Tele-health Industry(Hardware & Software)
Center for Development of Advanced Computing Apollo Telemedicine Network Foundation
Online Telemedicine Research Institute
Televital India Vepro India
Prognosys Medical Systems Pvt. Ltd.
Medisoft Telemedicine Pvt. Ltd I-diagnosis Technologies
Karishma Software Ltd
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Standardization & Policy initiatives(National Task Force)
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Policy Initiative National Health Information Infrastructure
& Standardization (www.mit.gov.in ) Undertook initiative, in a project mode, for defining Theframework for Information Technology Infrastructure for Health(ITIH) to efficiently address information needs of differentstakeholders in the healthcare sector
Prepared documents Recommended Guidelines & Standards for Practice of Telemedicine in India to standardize services ofdifferent Telemedicine centers
National Broadband Policy (Telecom RegulatoryAuthority of India)
Dedicated Satellite for Education (EDUSAT) & health(HEALTHSAT) Revision of Medical Curriculum in process National Telemedicine Task Force, Ministry of Health &
FW, Govt. of India
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National Task Force on Telemedicine Terms of References
To work on inter-operability,standards for data transmission,software, hardware, training etc.
To define a national telemedicinegrid and consider its standards andoperational aspects
To identify all players and projectscurrently involved in telemedicine inIndia and evaluate theirperformance, capacity andreplicability.
To prepare pilot projects forconnection of super specialtyhospitals/ medical colleges withdistrict hospitals and/or CommunityHealth Centers / Primary HealthCenters especially keeping in mindto provide access to remote areas
To prepare national cancertelemedicine network
To examine possibilities ofutilization of stand alonecenters of department ofcommunication in rural areas
To define standards andstructures of electronic medicalrecords and patient data basewhich could be accessed on anational telemedicine grid
To enable telemedicinecenters in teaching institutionsto impart training to allgovernment medical/ dental/nursing colleges inthree years time
To prepare curriculum andprojects for CMEs through
telemedicine
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Standardization Initiative (DIT) Recommended Guidelines & Standards for Practice of
Telemedicine in India
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Major national & internationalProjects in near future
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National/ International e-Health Projectsunder planning/ implementation
Ministry of Health & FW Project, Govt. of India Integrated Disease Surveillance Project
Tele-ophthalmology project
National Telemedicine Grid National Onconet Project
National Medical College Network
National Digital Medical Library Consortium Ministry of External Affairs Project, Govt. of India
SAARC telemedicine network
Pan-African e network project
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E health Capacity building, Scientific
Societies, Education, Research &Development
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e-Learning in Health Sciences
Online Open Access Bibliography
NIC-ICMR (MEDLARS) Digital Hub Consortium
Collaborative Knowledge sharing throughtelemedicine network
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Education & Training in e-Healthtowards Capacity building
Apollo - Anna University, Chennai (certificate course)
School of Telemedicine and Biomedical InformaticsTelemedicine, SGPGIMS (structured courses)
Hospital Information System, Biomedical Informatics, MedicalMultimedia and Image management, Medical KnowledgeManagement, Artificial Intelligence, Virtual Reality andRobotics
National Institute of Health & Family Welfare (Tele TrainingCenter) MoH&FW - Proposed
Rad Gurukul, Bangalore - Teleradiology Solutions, provider ofteleradiology services - Teleradiology training center
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Research & DevelopmentDIT Initiatives
Center for Development of Advance Computing
HIS, SGPGIMS
Telemedicine Software (Mercury & Sanjeevani)
Media Lab Asia Initiative
In collaboration with many premier medical and technical
institutions
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Research Publications
More than 100 publications in various national &international peer reviewed Journals
List available at
http://www.telemedindia.org/original_articles.pdf
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National Scientific Activities
Medical Computer Society of India
Telemedicine Society of India
Indian Medical Informatics Association
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Challenges ahead
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Challenges Ahead
Development of National Plan for e-Health Identification of Best Practices for ClinicalTelemedicine and Public health Applications
E-health adoption by stake holders
Development of e-Health Program sustainabilityModels Promotion of inter-operability using the universal
standard Integration into prevailing Health System Development of National e-Health Observatory Capacity Building in e-health technology & System Research & Development in e-health technology and
system appropriate for local situation with global
impact
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www.sgpgi-telemedicine.org
Thank You