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Tele-Medicine to Combat Cancer

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Now cancer detection and cervical cancer treatment is possible using Mobile Telemedicine Unit

A Mobile Tele-Oncology Unit with VSAT connection was developed and used in 16 medical camps organised in rural areas of Kannur and Wynad districts for cancer detection and treatment of initial stage cervical cancer among the rural population. In these camps 1584 people were screened, and 68 pre-cancerous cases were detected. 16 ladies in whom cervical pre-cancerous lesions were detected were given cryotherapy. 6 persons who were detected with oral pre-cancerous lesions were referred to dentists for oral surgery and two suspected breast cancer cases were referred for
confirmation and treatment.

Replication of Mobile Units for service in rural areas will bring down morbidity and mortality.

A Mobile Tele-Oncology Unit with VSAT communication facility for Cancer Detection, follow up consultation for patients’ undergoing treatment for cancer and treatment of initial stage Cervical Cancer at the patient location was built.
The Mobile Unit is equipped with digital X-ray Unit, Ultrasound Scanner, Digital Video Colposcope, Cryosurgery Unit, Hematology Analyser, Biochemistry Analyser, DigitalMicroscope, Surgery table, Oxygen and nebulizer units, Sterilizer, Video Conferencing facility, centrifuge, blood mixer and a 50 litre refrigerator. Also, it has two water tanks of 135 litres each for storing fresh water and waste water. The unit is equipped with video conferencing facility for follow up consultation and for confirmation of doubtful cases with doctors of regional cancer centre, Trivandrum.

The mobile unit is designed and built by C-DAC, Thiruvananthapuram, on an Ashok Leyland Viking Chassis (Wheel Base 222inches). Lead Shielding for radiation protection, as per the AERB guidelines, is provided for the X-Ray room. The medical equipments are powered by a 6 KVA online UPS. The mobile unit can operate from local grid power and a 75 meter cable is provided for drawing grid power. When grid power is not available, power for the unit can be taken from the14Kw LPG generator mounted below the chassis. As the generator fuel is LPG, the generator is noiseless, vibration free and smokeless.

Video conferencing room

The Mobile Unit is equipped with a work station for creation of the Electronic Medical Record (EMR) of the patient. EMR is created with e-Dhanwantari software developed by C-DAC, Thiruvananthapuram

e-Dhanwanthari is a web based, easily replicable and configurable, W3C compliant Telemedicine Software which  facilitates Tele-consultation for patients at remote rural areas and with specialist doctors at urban hospitals. It facilitates
creation, storage, transfer and retrieval of EMR of patients with a unique patient ID, interface with bio medical   uipments, medical image processing, DICOM viewer, scheduling of appointment with doctors at specialty hospitals,  udio/ video/text communication between patients/ doctors at distant hospitals, generation of various reports etc. It  an be deployed and accessed from anywhere in a Telemedicine Network in which rural and urban hospitals are linked through Satellite, ISDN, State Wide Area Network (KSWAN for Kerala), Broad Band/Leased Line internet etc. EMR of patients visiting the Mobile Unit can be created, stored in the Mobile Unit and uploaded through the network to  -Dhanwanthari server at the RCC. Doctors at both hospital and Mobile Unit and patients can discuss about the case through video-conferencing  with the help of the EMR.

Objective

Cancer detection and treatment of initial stage cervical cancer among the rural population.
Solution ArchitectsM C Kartha –ProjectManager, Medical Informatics, C-DAC, Thiruvananthapuram. He has 28 years of experience in electronics hardware, software design and development.

S Sudhamony
has 32 years experience in hardware, software design and development. Currently working as Additional Director, C-DAC. Thiruvananthapuram and Section Head, Medical Informatics Group

Conclusion

Early detection of cancer will save patients from huge financial expenditure, morbidity and mortality. Cervical cancer is can be fully controlled if we can create awareness, have early detection and the treatment of CIN is available  immediately after detection. A cervical cancer is asymptomatic in early stages, proactive approaches for early detection and creating awareness at patient locality is extremely important. Mobile tele-oncology unit helps detection of cancers at patient locality, refer patients to treatment centres without loss of time and provide treatment for CIN there itself. Providing treatment for CIN in patient locality ensures treatment to the needy since women from low resource setting neither have the means for getting treatment away from their locality nor the sense of urgency to seek medical attention.

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