health centres, 14 urban medical clinics, 9 diagnostics centres, 1800 pharmacies, with over 25 general physicians and paramedics hosted at a call-centre like facility in Delhi and Patna. Experiments to enable village level providers to connect patients from their homes with doctors in cities using cell phones have been successful. Future adoption of such paradigms is expected to integrate this data also into the current EMRs. Type of node Type of transactions Infrastructure components employed 127 Village Health Centres and 14 clinics Patient registration, referral to call centre/specialist, primary diagnostic measurements and upload to patient EMR, primary care intervention Bio-medical devices: ECG, NIBP, Rate, SPO2, thermometer; Desktop PCs with Windows and proprietary client application; conferencing with G.723.1 and H.264, Telecom: 256 Kbps DSL with 64 Kbps VSAT fall back, UPS with power generator 1200 Health workers Home visits for medicine supply, care follow up and data gathering into EMR Mobile phones with GPRS/SMS/MMS Central Medical Facility (2 locations) Patient history, symptoms capture; primary consultation and diagnosis; prescription for treatment, second level diagnostics; referral to specialist; Tele- support for patient logistics; Billing, auditing, MIS, collection, supply chain management, etc. Desktop PCs with proprietary client application, CRM software, 2-tier system with Windows client and Linux server and MYSQL database, connectivity: DSL 2Mbps link 1800 Pharmacies Medication supply based on electronic prescription Desktop PCs with internet browser, pstn/isdn/dsl links 9 Diagnostic labs Upload diagnostic reports and data onto EMR Desktop PCs with Tele-Health client app and internet browser, DSL connectivity Hospitals Upload admission, discharge and transfer documents billing and insurance related information into EMR Desktop PCs with Tele-Health client app and internet browser with DSL links Case Study 3: Remote Continued Medical Education (CME) Network – Sanjay Gandhi Post Graduate Institute of Medical Sciences (SGPGIMS), Lucknow, India SGPGIMS is a leading government medical education institute attached to several super speciality tertiary hospitals [21] to [32]. In one initiative, SGPGIMS is spear-heading several pioneering initiatives of tele-health in form of continued education, disease surveillance and other allied area in server
AMRITA KRIPA VILLAGE RESOURCE CENTERS Patient registration, specialist, primary diagnostic measurements and upload To EMR, distance education delivery Desktop/Laptops PCs with Windows-Java based Tele-Health client application; PTZ camera with Desktop videoconferencing, Telecom ISRO VSAT(384 Kbps)/ISDN 128 Kbps/Leased line (2 Mbps to Andaman island), biomedical devices ECG, NIBP, thermometer AIMS mobile telemedicine unit Patient counselling, screening, tele-consultation, diagnosis, surgery, therapy, medication Bio-medical devices for echocardiography, cardiac treadmill, gastro copy, colonoscopy, retinal camera, ultrasonography, X-ray radiography, electrocardiography, biochemical analysis, microscopy and a digital photography; videoconferencing capability (adopting H.264 and G.711 compression, H.323/SIP protocol); extended C band satellite connectivity(min 384 Kbps) Case Study 6: Private Sector Tele-Consultation network – Apollo Hospitals Group, India This case study is an example of initiative run by Apollo Hospitals Group, a private enterprise owning a chain of over 45 tertiary hospitals, over 110 Telemedicine centres and 740 pharmacy outlets across the country. Now known as the Apollo Telemedicine networking Foundation (ATNF), it was the first in the country to setup a Rural Telemedicine centre in 1999 in Aragonda (in Andhra Pradesh). Today, ATNF is perhaps India's largest private turnkey provider in the area of telemedicine with over 150 telemedicine centres in India and abroad. ATNF works with multiple entities including the Central and State Governments, medical bodies, private and public sectors and offers customized solutions addressing telemedicine support for primary, secondary and tertiary level of healthcare. The telemedicine centres serve as information kiosks as well as out-patient consultations with physicians and specialists and occasionally for some emergencies, disaster management and critical care. Apollo Hospitals connected to these telemedicine centres provide the specialized medical care. The expenses of care delivery are mostly borne directly by the patient, except in some cases where government programs pay partially or fully, especially for the underprivileged classes of the society. FIGURE : Apollo Tele-Health Network