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The healthcare Industry today after twenty five years, since computers started influencing our society, is standing at the threshold of a world of possibilities thrown up by technologies such as Virtual Reality, Cyber surgery, Micro - robotic Surgery and 3D image modeling.

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It is said that the Internet should be used for the benefit of mankind.

Internet pundits have always felt that development and delivery of Medicine will be one area where this medium is likely to have immense benefit to mankind.

For e-healthcare and telemedicine to emerge as a viable alternative modality for delivering medical care and expertise there are a few preconditions that are to be met.

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1. Adaptation of Information technology by hospitals especially in terms of networking and Hospital Management systems.

2. Increasing awareness on IT among medical professionals.

3. Better Internet access; possibility the advent of broadband in India that can transfer video files faster.

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Some of these are,Some of these are,

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4. Standardization of various protocols (like DICOM in teleradiology) and acceptance of these protocols by the relevant equipment manufacturers.

5. Decline in the cost of telemedicine hardware to make it more financially viable.

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Information Technology At present, the major constraint is in terms of the financial

viability of e-healthcare initiatives. However there have been several isolated initiatives from various organizations and hospitals for implementation of projects.

For example The Indian Space and Research Organization has today 32 telemedicine location in India and is investing heavily to help Indian healthcare to graduate in this technology and then use it for its own purpose in the future to monitor Indian astronauts who undertake journeys in space.

Most of the developments in this field are likely to focus around the needs of ISRO.

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The answer to make projects financially viable also probably lies in pooling together resources by various facilities within a geographic locality and sharing the benefits and revenues thus created.

To elaborate on this point, several hospitals within a city like e.g. Salem can share a common Tele-pathology service or Teleradiology service.

The benefits of such a pooled service are obvious. Investigations can be viewed by a group of expert consultants.

Such a model will reduce the initial project costs and with the patient traffic from several affiliated hospitals can achieve economy of scale and thus reduce costs of trained manpower and material costs and also provide a very efficient and optimal service to the community. 7

Information Technology

India is well placed and potentially the ideal location for experimenting with e-healthcare solutions for the

following reasons: India has best computer Technocrats India has a very skilled medical

fraternity private healthcare emerging as a key-player in the country Indian Healthcare spending likely to increase to 200,000 crores by 2012 from present86,0000 crores. Potentially India a very suitable location and resources pumped in this sector now are likely to be of great benefit.

The government has the responsibility for the framing the basic standards guidelines to make use of IT in Healthcare possible. The ICT Ministry has come out with its recommendations by recommending some basic standards.

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Tamil Nadu particularly is well positioned to benefit for the following reasons:

1. Lowest cost of skilled manpower.2. Highly developed healthcare System.3. Highest numbers of Hi-tech surgeries like. By-pass

surgeries & Transplants.4. Large Tamil NRI population.

A pool of patients from Northeast who regularly frequent Chennai and Vellore for their treatment requirements. These regulars and loyal patients can use Telemedicine facilities effectively.

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Continue .. .5. Three leading institutions for Telemedicine solutions -

Apollo, Sri Ramachandra Hospital and Sankar Nethralaya .

6. Govt. encourages a Public - Private enterprise7. Three large Corporate leading in overseas healthcare

contracts - TCS, Cognizant, KJ Medical Transcription unit.

8. Large number of smaller companies undertaking overseas medical contracts.

9. Broadband connectivity are being offered and available at a reasonable cost.

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Telemedicine in principle is well suited for countries like India, Africa and South America where there is a large rural based population separated by large distances and needing access to regular medical care of quality.

The telephony revolution of nineties of India has linked most of our smaller towns and villages with rest of the world.

The railway also has a vast network of fibre-optics cables already laid out on many of its routes.

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The Space scientist of our country have placed strategic satellites of communication making a broadband network not too difficult to achieve with expenditure of minimum resources, These gateways of communications should be all used to help with the project of telemedicine and hence reduce applications costs.

Even subsidies could be incorporated to facilitate telemedicine projects in our country.

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Information Technology Revolution It is the question of bringing together these different

agencies and forums to make the revolution of telemedicine happen and to provide our humanity with the best possible medical care.

If these experiments work in India over the next decade, the vast population living in developing countries will be the winners and bear the fruit of our success.

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Internet and Telemedicine should be a used as style of practice of modern medicine rather than be exhibited vulgarly as a technological showcase. Perhaps the slogan "Health for all by 2000" which was forgotten by our politicians towards the end of last century can still be achieved by the year 2020 by making "the Information Technology Revolution happen in healthcare in India ".

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Medical Computer Society of India

The "Medical Computer Society of India" promotes the use of IT in healthcare including Telemedicine. The goal of the society is to get both computer technocrats and medical professionals on one platform and speak the same language of developments for the healthcare applications.

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DICOM - Digital Imaging and Communications in Medicine

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User Consortia (e.g., HL7)

Organizations (e.g., NEMA, IEEE)

US Government Agencies (e.g., ANSI, NIST)

Foreign Government Agencies (e.g., CEN)

United Nations (e.g., ISO, CCITT)

The name was changed to separate the standard from the originating body

1991 - Release of Parts 1 and 8 of DICOM 1992 - RSNA demonstration, Part 8 1993 - DICOM Parts 1-9 approved,

RSNA demonstration of ALL parts 1994 - Part 10: Media Storage and File Format 1995 - Parts 11,12, and 13 plus Supplements

MAGN

ETOM

Information Management System

Storage, Query/RetrieveStorage, Query/Retrieve, , Study ComponentStudy Component

Query/Retrieve, Patient & Study ManagementQuery/Retrieve, Patient & Study Management

Query/RetrieveQuery/RetrieveResults ManagementResults Management

Print ManagementPrint Management

Media ExchangeMedia Exchange

LiteBox

SOPSOP

Data DictionaryData Dictionary

Real-World ObjectReal-World Object

Information ObjectInformation Object DIMSE Service GroupDIMSE Service Group

Composite Verification Storage Query/Retrieve Study Content Notification

Normalized Patient Management

Study Management Results ManagementBasic Print Management

Joint CEN-DICOM development Medicom = DICOM MIPS 95 work is underway with JIRA IS&C Harmonization is also in progress HL7 Harmonization continuing interest New DICOM organization

Companies: NEMA and non-NEMA ACR, ACC, CAP, ... individuals

Networking is a critical component of all

medical imaging systems

Support for Open Communication Standards is a

MUST

DICOM is here, NOW

DICOM products exist on the market

DICOM is emerging as THE common protocol for

medical image communication - WORLD WIDE!

Electro-Magnetic Spectrum

IR Imaging (Performance)

Fig. Thermal / IR view of a Chip

IR Imaging (Natural Calamity)

Fig. IR satellite view of Augustine volcano

IR Imaging (Night Vision)

Fig. IR image of a sloth at night

IR Imaging (Night Vision)

Fig. Night vision system used by soldiers

IR Imaging (Weather)

Fig. IR Satellite Imagery

IR Imaging (Astronomy)

Fig. Nebula NGC 1514 01 in Visible (left) and Infrared (right)

Ultrasound imaging (Medical)

Fig. Fetus and Thyroid using ultrasound

Seismic imaging (Earthquake)

Fig. Detecting Earthquakes and its cause using cross sectional view

UV imaging (Ozone)

Fig. Detect ozone layer damage

UV imaging (Sun spots)

Fig. Identify sun spots

UV imaging (Solar flares)

Fig. Identify solar flares

X-Ray imaging (Medical)

Fig. X - Ray of neck

X-Ray imaging (Medical)

Fig. X - Ray of head

X-Ray imaging (Circuits)

Fig. X - Ray of a Glucose meter circuit

Gamma-Ray imaging (Medical)

Fig. Gamma ray exposed images

Gamma-Ray imaging (Astronomy)

Fig. Gamma ray bursts in space

Gamma-Ray imaging (Astronomy)

Fig. Gamma ray bursts in space

Gamma-Ray imaging (Astronomy)

Fig. Gamma ray bursts in space

Remote Sensing

Fig. Satellite images of Mumbai suburban(Left) and Gateway of India (Right)

Remote Sensing

Projection X-ray (Radiography)

Ultrasound

X-ray Computed Tomography (CT)

Magnetic Resonance Imaging(MRI)

1. X-Rays

2. Computer Tomography (CT or CAT)

3. MRI (or NMR)

4. PET / SPECT ((Positron Emission Tomography, Positron Emission Tomography, Single Photon Emission Computerized TomographySingle Photon Emission Computerized Tomography

5. Ultrasound

6. Computational

7. Mammography

8. Angiography

9. Fluoroscopy

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