Lok Sabha Question No. 869 (UNSTARRED), answered on 2015-07-24
Subject: Telemedicine and e-healthcare
Ministry: HEALTH AND FAMILY WELFARE
Asked by: KANWAR SINGH TANWAR, AJAY (TENI) MISRA, RAKESH SINGH, RAVINDRA KUMAR PANDEY

**GOVERNMENT OF INDIA**

**MINISTRY OF HEALTH AND FAMILY WELFARE**

**DEPARTMENT OF HEALTH AND FAMILY WELFARE**

**LOK SABHA**

**UNSTARRED QUESTION NO.869**

**TO BE ANSWERED ON 24** **TH** **JULY, 2015**

**Telemedicine and e-healthcare**

**869. 	SHRI KANWAR SINGH TANWAR:**

**SHRI AJAY MISRA TENI:**

**SHRI RAKESH SINGH:**

**SHRI RAVINDRA KUMAR PANDEY:**

Will the Minister of **HEALTH AND FAMILY WELFARE** be pleased to state:

(a) the steps taken/proposed to be taken by the Government to become a global leader in the field of telemedicine, indicating the proposals and policies formulated to achieve the same:

(b) whether the Government has introduced/proposes to introduce any 24x7 toll free helpline and emergency services (108) to provide healthcare related information and emergency services in the country;

(c) if so, the details thereof indicating the benefits accruing to the general public from the said service along with the funds earmarked, allocated and spent thereunder during each of the last three years and the current year;

(d) whether the Government proposes to set up National e-health Authority in order to centralise and standardise medical history of patients so as to allow healthcare professional access to complete and accurate medical history for better diagnosis and treatment of patients without compromising on confidentiality of the

centralised data and if so, the details thereof; and

(e) whether the Government has awarded contracts to private institutions for providing ambulances and emergency medical services under the National Rural Health Mission, if so, the details thereof indicating the names of the institutions to which the said contracts have been awarded, State/UT-wise?

**ANSWER**

**THE MINISTER OF HEALTH AND FAMILY WELFARE**

**(SHRI JAGAT PRAKASH NADDA)**

(a):	Following steps have been taken by the Government to encourage usage of remote technology to promote healthcare:

1. MoHFW is establishing National Medical College Network (NMCN) wherein 41 Govt. medical colleges are being networked in the first phase riding over National Knowledge (NKN) with the purpose of e-Education and   e-Healthcare delivery.

1. One National Resource Centre and six Regional Resource Centres have been identified for promoting technologies like remote patient monitoring.

(b):	Public health being a state subject primarily responsibility to provide healthcare service to citizens lies with the States / UT Governments. However, under the National Health Mission (NHM) financial and technical support is provided to States for strengthening health system based on the requirements posed by them in the Programme Implementation Plans (PIPs), including for emergency response ambulances and for toll free helpline (usually Dial 104).

(c):	The state-wise funds approved and spent under NHM for ambulance services during the last three financial years are placed at **Annexure I.**

(d):	No, the proposed National e-Health Authority (NeHA) would not be responsible for centralization of the medical history of the patients. Establishment of National e-Health Authority is at a concept stage, as of now and views/suggestions invited from various stakeholders have been received.

As per Concept Note, NeHA would promote standardization of Electronic Health Records (EHRs) &facilitate its exchange across facilities in a secured manner.

(e):	As stated above, Public health is a State subject and Govt. of India provides financial and technical support to States / UTs to strengthen their healthcare system. The decisions pertaining to availing services of private institutions for providing ambulances and emergency medical services fall within the jurisdiction of the State / UT Governments. The state-wise details of service providers are placed at **Annexure II** .

**Annexure I**

**Statement Showing SPIP Approval and Expenditure for ambulance services**

**(Rs. in Lakhs)**

|                                                                                                         |                                                                                                         | **2012-13**                                                                                             |                                                                                                         | **2013-14**                                                                                             |                                                                                                         | **2014-15**                                                                                             |                                           |
|---------------------------------------------------------------------------------------------------------|---------------------------------------------------------------------------------------------------------|---------------------------------------------------------------------------------------------------------|---------------------------------------------------------------------------------------------------------|---------------------------------------------------------------------------------------------------------|---------------------------------------------------------------------------------------------------------|---------------------------------------------------------------------------------------------------------|-------------------------------------------|
| **Sl. No.**                                                                                             | **Name of State/UT**                                                                                    | **SPIP Approval**                                                                                       | **Exp.**                                                                                                | **SPIP Approval**                                                                                       | **Exp.**                                                                                                | **SPIP Approval**                                                                                       | **Exp.**                                  |
| **A**                                                                                                   | **High Focus States**                                                                                   |                                                                                                         |                                                                                                         |                                                                                                         |                                                                                                         |                                                                                                         |                                           |
| 1                                                                                                       | Bihar                                                                                                   | 337.80                                                                                                  | 635.07                                                                                                  | 641.29                                                                                                  | 544.40                                                                                                  | 1818.03                                                                                                 | 474.59                                    |
| 2                                                                                                       | Chhattisgarh                                                                                            | 3,701.90                                                                                                | 3,195.68                                                                                                | 1,228.40                                                                                                | 4,463.93                                                                                                | 4028.84                                                                                                 | 6250.37                                   |
| 3                                                                                                       | Himachal Pradesh                                                                                        | 1,179.69                                                                                                | 2,725.00                                                                                                | 722.40                                                                                                  | 935.88                                                                                                  | 650.15                                                                                                  | 645.20                                    |
| 4                                                                                                       | J&K                                                                                                     | 2,601.00                                                                                                | 44.02                                                                                                   | 16.87                                                                                                   | 2,034.48                                                                                                | 56.76                                                                                                   | 641.36                                    |
| 5                                                                                                       | Jharkhand                                                                                               | 3,572.00                                                                                                | 424.93                                                                                                  | 858.40                                                                                                  | 34.10                                                                                                   | 2980                                                                                                    | 7.84                                      |
| 6                                                                                                       | Madhya Pradesh                                                                                          | 2,562.03                                                                                                | 1,620.80                                                                                                | 2,763.79                                                                                                | 6,696.30                                                                                                | 4150.73                                                                                                 | 3787.16                                   |
| 7                                                                                                       | Orissa                                                                                                  | 791.67                                                                                                  | 420.37                                                                                                  | -                                                                                                       | 3,485.32                                                                                                | 1411.2                                                                                                  | 1545.53                                   |
| 8                                                                                                       | Rajasthan                                                                                               | 1,344.00                                                                                                | 1,708.00                                                                                                | 2,258.48                                                                                                | 2,258.48                                                                                                | 784.72                                                                                                  | 1795.52                                   |
| 9                                                                                                       | Uttar Pradesh                                                                                           | 14,347.40                                                                                               | 11,456.80                                                                                               | 8,043.03                                                                                                | 1,602.41                                                                                                | 17580.55                                                                                                | 13962.90                                  |
| 10                                                                                                      | Uttaranchal                                                                                             | 1,284.39                                                                                                | 1,068.43                                                                                                | 486.24                                                                                                  | 212.20                                                                                                  | 639.5                                                                                                   | 609.88                                    |
|                                                                                                         | **Sub Total**                                                                                           | **31,721.88**                                                                                           | **23,299.10**                                                                                           | **17,018.90**                                                                                           | **22,267.51**                                                                                           | **34,100.48**                                                                                           | **29,720.35**                             |
| **B**                                                                                                   | **NE STATES**                                                                                           |                                                                                                         |                                                                                                         |                                                                                                         |                                                                                                         |                                                                                                         |                                           |
| 11                                                                                                      | Arunachal Pradesh                                                                                       | 84.60                                                                                                   | 43.59                                                                                                   | 92.08                                                                                                   | 86.14                                                                                                   | 77.08                                                                                                   | 37.27                                     |
| 12                                                                                                      | Assam                                                                                                   | 5,653.05                                                                                                | 3,000.86                                                                                                | 2,822.40                                                                                                | 2,936.16                                                                                                | 2034                                                                                                    | 1756.20                                   |
| 13                                                                                                      | Manipur                                                                                                 | 223.50                                                                                                  | 5.36                                                                                                    | 265.20                                                                                                  | 141.79                                                                                                  | 301                                                                                                     | 114.95                                    |
| 14                                                                                                      | Meghalaya                                                                                               | 573.72                                                                                                  | 187.11                                                                                                  | 110.88                                                                                                  | 342.69                                                                                                  | 110.98                                                                                                  | 10.31                                     |
| 15                                                                                                      | Mizoram                                                                                                 | 155.56                                                                                                  | 75.90                                                                                                   | 139.69                                                                                                  | 68.57                                                                                                   | 170.13                                                                                                  | 91.26                                     |
| 16                                                                                                      | Nagaland                                                                                                | 103.93                                                                                                  | 58.15                                                                                                   | 82.90                                                                                                   | 52.31                                                                                                   | 113.73                                                                                                  | 33.04                                     |
| 17                                                                                                      | Sikkim                                                                                                  | -                                                                                                       | 0.78                                                                                                    | 22.01                                                                                                   | 2.02                                                                                                    | 36.7                                                                                                    | 57.62                                     |
| 18                                                                                                      | Tripura                                                                                                 | 668.79                                                                                                  | 35.14                                                                                                   | 357.96                                                                                                  | 17.12                                                                                                   | 0                                                                                                       | 0.00                                      |
|                                                                                                         | **Sub Total**                                                                                           | **7,463.15**                                                                                            | **3,406.89**                                                                                            | **3,893.12**                                                                                            | **3,646.81**                                                                                            | **2,843.62**                                                                                            | **2,100.64**                              |
| **C**                                                                                                   | **Non High Focus States**                                                                               |                                                                                                         |                                                                                                         |                                                                                                         |                                                                                                         |                                                                                                         |                                           |
| 19                                                                                                      | Andhra Pradesh                                                                                          | -                                                                                                       | -                                                                                                       | -                                                                                                       | -                                                                                                       | 2932.4                                                                                                  | 4079.42                                   |
| 20                                                                                                      | Telagana                                                                                                | -                                                                                                       |                                                                                                         |                                                                                                         |                                                                                                         | 2594.4                                                                                                  | 758.40                                    |
| 21                                                                                                      | Goa                                                                                                     | 353.80                                                                                                  | 244.00                                                                                                  | 79.20                                                                                                   | 138.00                                                                                                  | 249.6                                                                                                   | 209.99                                    |
| 22                                                                                                      | Gujarat                                                                                                 | 100.00                                                                                                  | 325.06                                                                                                  | -                                                                                                       | -                                                                                                       | 0                                                                                                       | 0.00                                      |
| 23                                                                                                      | Haryana                                                                                                 | 1,253.96                                                                                                | 1,338.99                                                                                                | 3,573.56                                                                                                | 2,109.94                                                                                                | 2018.27                                                                                                 | 2722.30                                   |
| 24                                                                                                      | Karnataka                                                                                               | 4,842.13                                                                                                | 1,417.23                                                                                                | 4,784.87                                                                                                | 212.51                                                                                                  | 1257.63                                                                                                 | 3184.03                                   |
| 25                                                                                                      | Kerala                                                                                                  | 3,441.38                                                                                                | 1,585.82                                                                                                | 1,033.36                                                                                                | 579.88                                                                                                  | 2502                                                                                                    | 206.26                                    |
| 26                                                                                                      | Maharastra                                                                                              | 10,011.31                                                                                               | 12,531.61                                                                                               | 7,809.20                                                                                                | 8,762.00                                                                                                | 2872                                                                                                    | 17560.10                                  |
| 27                                                                                                      | Punjab                                                                                                  | 2,669.31                                                                                                | 1,599.19                                                                                                | -                                                                                                       | -                                                                                                       | 0                                                                                                       | 0.00                                      |
| 28                                                                                                      | Tamil Nadu                                                                                              | 4,293.58                                                                                                | 1,417.57                                                                                                | 2,025.20                                                                                                | 2,530.33                                                                                                | 1408.05                                                                                                 | 5052.31                                   |
| 29                                                                                                      | West Bengal                                                                                             | -                                                                                                       | -                                                                                                       | -                                                                                                       | -                                                                                                       | 0                                                                                                       | 0.00                                      |
|                                                                                                         | **Sub Total**                                                                                           | **26,965.47**                                                                                           | **20,459.46**                                                                                           | **19,305.39**                                                                                           | **14,332.66**                                                                                           | **15,834.35**                                                                                           | **33,772.81**                             |
| **D**                                                                                                   | **Small States/ Uts**                                                                                   |                                                                                                         |                                                                                                         |                                                                                                         |                                                                                                         |                                                                                                         |                                           |
| 30                                                                                                      | Andaman & Nicobar Island                                                                                | -                                                                                                       | -                                                                                                       | -                                                                                                       | -                                                                                                       | 0                                                                                                       | 0.00                                      |
| 31                                                                                                      | Chandigarh                                                                                              | 41.02                                                                                                   | 9.72                                                                                                    | 122.68                                                                                                  | 10.13                                                                                                   | 38.42                                                                                                   | 10.36                                     |
| 32                                                                                                      | Dadar& Nagar  Haveli                                                                                    | -                                                                                                       | -                                                                                                       | -                                                                                                       | -                                                                                                       | 0                                                                                                       | 0.00                                      |
| 33                                                                                                      | Daman & Diu                                                                                             | 48.00                                                                                                   | 70.62                                                                                                   | 68.07                                                                                                   | 57.71                                                                                                   | 20.57                                                                                                   | 15.41                                     |
| 34                                                                                                      | Delhi                                                                                                   | 1,367.24                                                                                                | 479.61                                                                                                  | 3,040.00                                                                                                | 872.58                                                                                                  | 648                                                                                                     | 288.00                                    |
| 35                                                                                                      | Lakshadweep                                                                                             | 3.00                                                                                                    | -                                                                                                       | -                                                                                                       | -                                                                                                       | 0                                                                                                       | 0.00                                      |
| 36                                                                                                      | Puduchhery                                                                                              | 106.25                                                                                                  | 46.52                                                                                                   | 86.97                                                                                                   | 90.65                                                                                                   | 32.2                                                                                                    | 69.94                                     |
|                                                                                                         | **Sub Total**                                                                                           | **1,565.51**                                                                                            | **606.48**                                                                                              | **3,317.72**                                                                                            | **1,031.07**                                                                                            | **739.19**                                                                                              | **383.71**                                |
|                                                                                                         | **Total**                                                                                               | **67,716.01**                                                                                           | **47,771.93**                                                                                           | **43,535.13**                                                                                           | **41,278.05**                                                                                           | **53,517.64**                                                                                           | **65,977.51**                             |
|                                                                                                         |                                                                                                         |                                                                                                         |                                                                                                         |                                                                                                         |                                                                                                         |                                                                                                         |                                           |
| Note : Above mentioned Expenditure figures  are  as per the FMR (and not audited) and hence provisional | Note : Above mentioned Expenditure figures  are  as per the FMR (and not audited) and hence provisional | Note : Above mentioned Expenditure figures  are  as per the FMR (and not audited) and hence provisional | Note : Above mentioned Expenditure figures  are  as per the FMR (and not audited) and hence provisional | Note : Above mentioned Expenditure figures  are  as per the FMR (and not audited) and hence provisional | Note : Above mentioned Expenditure figures  are  as per the FMR (and not audited) and hence provisional | Note : Above mentioned Expenditure figures  are  as per the FMR (and not audited) and hence provisional |                                           |
| SPIP- State Programme Implementation Plan                                                               | SPIP- State Programme Implementation Plan                                                               | SPIP- State Programme Implementation Plan                                                               | SPIP- State Programme Implementation Plan                                                               | SPIP- State Programme Implementation Plan                                                               | SPIP- State Programme Implementation Plan                                                               | SPIP- State Programme Implementation Plan                                                               | SPIP- State Programme Implementation Plan |

**Annexure II**

|   **S.No.** | **State**         | **Operating Agency for Ambulance Services**   |
|-------------|-------------------|-----------------------------------------------|
|           1 | A&N Island        | State                                         |
|           2 | Andhra Pradesh    | GVK                                           |
|           3 | Arunachal Pradesh | State                                         |
|           4 | Assam             | GVK                                           |
|           5 | Bihar             | Ziqitza and Dr. Jain Video on Wheels          |
|           6 | Chandigarh        | UT                                            |
|           7 | Chhattisgarh      | GVK                                           |
|           8 | D & N Haveli      | UT                                            |
|           9 | Daman & Diu       | GVK - EMRI                                    |
|          10 | Delhi             | CATS                                          |
|          11 | Goa               | GVK                                           |
|          12 | Gujarat           | GVK                                           |
|          13 | Haryana           | State                                         |
|          14 | Himachal Pradesh  | GVK                                           |
|          15 | Jammu & Kashmir   | NA                                            |
|          16 | Jharkhand         | NA                                            |
|          17 | Karnataka         | GVK - EMRI                                    |
|          18 | Kerala            | Kerala Medical Services Corporation           |
|          19 | Lakshadweep       | NA                                            |
|          20 | Madhya Pradesh    | GVK                                           |
|          21 | Maharashtra       | BVG                                           |
|          22 | Manipur           | State                                         |
|          23 | Meghalaya         | GVK                                           |
|          24 | Mizoram           | State                                         |
|          25 | Nagaland          | State                                         |
|          26 | Odisha            | Ziqitza                                       |
|          27 | Puducherry        | GVK                                           |
|          28 | Punjab            | Ziqitza                                       |
|          29 | Rajasthan         | Ziqitza                                       |
|          30 | Sikkim            | State                                         |
|          31 | Tamil Nadu        | GVK                                           |
|          32 | Tripura           | NA                                            |
|          33 | Telangana         | GVK                                           |
|          34 | Uttar Pradesh     | GVK                                           |
|          35 | Uttarakhand       | GVK                                           |
|          36 | West Bengal       | NA                                            |