August 2007

Telemedicine Binds India and Ethiopia : J.S. Chhabra, T.K. Roy

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As there is generally no medical specialist in remote areas, there is a great need to provide specialized support for the betterment of health in these areas. In fact, the advantages are manifold; the patients do not have to travel to a super-specialty hospital from distant places, which results in saving his valuable time and money.  It is extremely facilitating in getting specialist opinion on several tests done at the local health centre, where there is no expert available. Moreover, through telemedicine, medical experts at the super-specialty hospitals can also share their expert experiences and opinions on patients …

The ICT initiatives in various countries of Africa and other developing regions have contributed towards the speedy development in those areas in terms of various development parameters like education, healthcare, communication to rural areas, upliftment of women, equitable distribution of commerce, etc. The declining price of broadband communication and long distance connectivity has made communication affordable to evolve various kinds of services. The relentless efforts of various world bodies like IEEE, ITU, etc. in getting interoperable technologies have made it possible to improve key indicators such as life expectancy and infant mortality in widely disparate countries, through cost-effective use of ICT-based healthcare systems.

Telemedicine has been providing meaningful and affordable healthcare to people living in rural and distant areas. Barriers due to distance vanishes when we provide online medical consultation for the benefit of people across the region, country, continents, etc. Already many hospitals in different parts of the country and in the world have adopted telemedicine, which is used for diagnosis of patients in distant, remote and unaccessible areas. Many corporate bodies have started thinking of providing telemedicine as corporate benefits. Employees of those companies who are stationed at  remote sites can avail the  medical facilities at par with employees in the  headquarters of those corporate offices, which is usually located in a big city. Employees thus get confidence while working in remote areas, as they realise that their health would not be compromised just because of their geographic locations.

Telemedicine set up

The main welfare objective of the telemedicine services is to provide medical help to the people located in far-flung areas. Through DICOM compliant modalities, images such as X-ray, ECG, Ultrasound, etc. are transmitted to a medical expert, located at a distance. The videoconferencing between doctors and patients, transmission of still images, patient records, remote monitoring of vital signs, continuing medical education may all be considered as part of telemedicine.

As there is generally no medical specialist in remote areas, there is a great need to provide specialized support for the betterment of health in these areas. In fact, the advantages are manifold; the patients do not have to travel to a super-specialty hospital from distant places, which results in saving his valuable time and money.  It is extremely facilitating in getting specialist opinion on several tests done at the local health centre, where there is no expert available. Moreover, through telemedicine, medical experts at the super-specialty hospitals can also share their expert experiences and opinions on patients, cases and clinical information with the doctors at remote locations for the enrichment of their knowledge.

A telemedicine system consists of customized medical software integrated with computer hardware, along with medical diagnostic equipments connected to communication backbone, like leased line/PSTN/ISDN or VSAT. Normally, the medical record/history of the patient is sent to the specialist doctors, who will in turn study and provide diagnosis and treatment during live tele-interactions from the patient’s end. The facility caters normally for transmission of patient’s medical images, records, output from medical devices, and sound files, besides live two-way audio and video. With the help of these, a specialist doctor could advise a doctor or a paramedic at the patient’s end online, saving critical time and resources.

Recently a telemedicine initiative has encouraged people in Ethiopia to get consultation from CARE Hospital, Hyderabad. It is known as the Ethiopia Pilot project (funded by Govt. of India). Under this project�the forerunner to the main Pan-African e-Network project of the Govt. of India� Telecommunications Consultants India Limited (TCIL) has established the fibre-optic based network between India and Ethiopia, to enable onine medical consultation and continuing medical education from the CARE Hospital, Hyderabad, India to Black Lion Teaching Hospital and Nekemte Hospital in Ethiopia.

TCIL was founded in 1978, with the main aim of spreading Indian telecom excellence in developing and underdeveloped countries. Today it has earned global recognition in this endeavour.

TCIL has earned its name in executing turnkey projects and rendering consultancy services in the fields of switching systems, transmission systems, access networks, optical fibre cable systems, dedicated networks, microwave system and even architectural design and civil works.

For meeting the fast changing telecom scenario, TCIL has expanded its activities by moving into areas of basic telephony, cellular mobile telephony, satellite telephony, OPGW, networking and e-Governance.  Today it has a presence in a number of countries across the globe, and over the years, it has planned, guided and executed traditional wireline, hi-tech wireless satellite and IT projects in more than 55 countries.

Coming back to this project, telemedicine component of the Ethiopia Pilot Project has been designed to provide expert medical consultancy services from CARE Hospital, Hyderabad to Black Lion Teaching Hospital and Nekemte Hospital in Ethiopia.

These two hospitals in Ethiopia are provided and equipped with medical equipments such as X-Ray machine with digitizer, electrocardiogram (ECG), ultrasound machine, telepathology microscope, glucometer, defibrillator, blood pressure measuring instrument, urine analyzer and hot air oven. Very critical and serious patients in ICU or those who have suffered cardiac ailments have benefited through the availability of expert consultation services through this telemedicine set up.

Continuing Medical Education (CME) in Ethiopia

In fact, Ethiopia is making significant inroads in the field of telemedicine. Continuing Medical Education (CME) programme is being conducted for doctors in Ethiopia, which is helping them to gain knowledge on expert medical care and diagnosis. It is to be understood that doctors and nurses are required to expose themselves to various kinds of case studies, which enable them to get familiar with different kinds of medical complications and their remedies. CME sessions provide the opportunity to discuss case studies with the intention to share the experience among doctors/nurses at the other end in Ethiopia. Seeing the benefits of the CME programme, CARE Hospital is arranging regular sessions on various topics like adult cardiology, paediatric cardiology, radiology, pathology, neurology, dermatology, etc.

During the CME session, actual case studies along with medical reports and patient records are submitted to the audience through audio-video presentation. The presence of large number of audiences points to the importance of CME sessions that are serving their purpose. The technology set up for the CME is quite simple and affordable. Various solutions exist and depending upon the situation and requirements, the system can be implemented within a short time. 

It’s All About CARE

Presently three hospitals that is Care Hospital in Hyderabad�a super-specialty hospital in southern India�Black Lion Teaching Hospital in Addis Ababa, and the  Nekemte Hospital in the provincial town of Nekemte, are linked by this pilot project, which will eventually be rolled out all over Africa. India has not only provided technical support to this project, but the project has been set up through Indian aid. India will set up the project and run it free of charge for the first five years. The project was officially inaugurated recently by Pranab Mukherjee, the Foreign Minister of India, on his visit to Ethiopia, but even before the official inauguration, some 40 patients had benefited from this telemedicine tie up.  The next step is to bring a total of 20 hospitals across Ethiopia into the ambit of this network, which will help rural Ethiopia to access international standard of medical care from the CARE Hospital in Hyderabad. This tie up will also enhance the knowledge and expertise of rural health workers in Ethiopia.

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