What is your vision of e-Health and how do you foresee the future prospects of Medical Informatics in India and beyond?
The concept of e-Health is that each and every citizens data is available at the time of need, and that data is utilised at the time of epidemics or disasters such as Tsunami so that needy patients or victims can be identified with their case history. So making a National Population Database is essential. A person, where ever he or she is staying, can be facilitated a good quality health care through this process of e-Health. These are the basic things  which telemedicine and utilisation of Medical Informatics in India can provide. The future of e-Health in India is bright. It can help in the progress of healthcare in our country.

Keeping the patients history is very important for the success of e-Health programmes in totality. The very base of telemedicine depends on keeping the basic patient record. When the doctor knows what the basic problem is, he or she can give a much more focused attention to the problem of patient. The diagnosis will be accurate. Till now what is being done in telemedicine is sending the x-ray across to the doctor but on that basis, accurate analysis cannot be done. So what is required is the availability of text data to the doctor. Diagnosis will be easier and accurate if it is done on the basis of the text of the patients basic health record. So each and every doctor should have an EMR (Electronic Medical Records) system for recording patients health records.

Why is it important for a country to adopt the system of e-Health? Has it become a necessary requirement of our times?
e-Health is definitely a necessary requirement especially in a large country like India as we are in such diverse locations. People, for instance, in the hilly areas have to travel long distances to bring the patient to the doctor. With the introduction of e-Health, at least 50% to 60% of this travel can be cut down. But e-Health is much more than that. There has to be National Population Database, and availability of this data online as well as its effective utilisation.

Please let us know briefly about the project you did during Tsunami disaster in Tamilnadu, India.
We did a project for an organisation called SATHI (Society for Administration of Telemedicine and Healthcare Infor-matics), which is into promoting the concept of medical informatics. The devas-tating Tsunami occurred at the end of  2004. The very first effort of telemedicine that happened  from our side was psychia-tric consultation at the Tsunami affected areas where we arrived for the rehabilita-tion phase of disaster management. With the help and association of OXFAM, SCARF (Schizophrenia Research Foundation) and other non-governmental organisations, we could provide psychiatric treatment using the various tools available for Medical Informatics.

The key to e-Health is to connecting the patient using Information and  Communication Technologies. Are patients at present prepared enough in developing countries, especially in rural areas, to adopt this?
While doing our first project we connected together the cities of Bhopal and Itarsi (in Central India) with telephone network, and we found that patients are very eager to use this. In fact the medical community is less so. And for the patients where there is no health care available anything is better than nothing. How ever, the only way to make telemedicine a success, is to incorporate the travel cost as genuine health care cost.

As networking and interactivity are the main attributes of e-Health and well structured network is a must have phenomenon for the success of any e-Health programme, what should and can be done to enhance the system of interactivity and networking?
This is very interesting. The biggest advantage, which has been in favour of e-Health in our country is that now, the Ministry of Health has started taking an active part. The Ministry of Health has taken the initiative of setting up a task force for telemedicine, which is an advisory body. I happen to be a very key member of that task force. One of the first things they are doing to facilitate this networking to take place is to develop the standards. The main reason for standar-dising is that there are so many vendors in the market having different standards, resulting in escalating costs. We are trying from our side to make it cheaper so that telemedicine becomes a day-to-day reality.

Please elaborate on the various e-Health initiatives, which has been taken by your organisation in association with Oxfam India Trust.
The main project was the Tsunami project about which I have mentioned earlier. Since now we have the domain experience, what we are really branching out to is the National e-Governance initiative in which 100,000 Common Service Centres are going to be started. There we have been approached by a lot of  rganisations because they do not have the experience of telemedicine.

Telemedicine has to be a key element for these kiosks. If this initiative is restricted to government only, then it is not going to work. The common masses, to whom the government wants to reach, cannot afford high costs. The government has to work with the local providers who are affordable. This is what we are trying to focus.

As President of IAMI, please let us know briefly about your future initiatives?
IAMI started in 1993 to basically provide the computerisation of medical facilities. But over the years, as the concept of telemedicine and e-Health came up, we are now expanding our activities for the entire gamut of IT and medical care. So far we have been a small association but fortunately this year we have taken a big leap in terms of membership. We are the official member of International Medical Informatics Association. Our main goal is that each and every medical facility should use IT because we feel that it will help in bringing in efficiency and will also provide quality health care services.

Narayana Hrudalaya: Creating excellence in telemedicine network
Narayana Hrudalaya Telemedicine Network (NHTN) is one of the largest telemedicine networks in the world, running through 26 locations in India and overseas. Established at the same time as the Narayana Hrudalaya (Bangalore, India), NHTN aims to provide cardiac care to the rural population. The Network offers video consultation round-the-clock, primarily for heart patients from remote areas. Through the ECG Network, using ordinary telephone lines, a large number of family physicians are networked with NH for early diagnosis of heart attacks. The network has been instrumental in treating over 12,000 patients in the last two years, entirely free of cost, proving to be a boon for a developing country like India.

Sponsored by the Indian Space Research Organisation (ISRO), the basic infrastructure of telemedicine is provided in remote locations whereby the remote centres can interact directly, using audio and video support with the specialist using digital communication link. The software to transmit data is provided to the remote centres to transmit the basic data of the patient to the specialist location before the schedule of tele-consultations.

For details: https://www.hrudayalaya.com/

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