December 2012

“Our technology addresses medical imbalances”


India needs to embrace technology not only to treat the medical imbalances, but also to leapfrog into the future,Cisco President (Inclusive Growth)Aravind Sitaraman says

Kindly tell us about the telemedicine solutions you have designed for Indian healthcare?
On an average, India has one doctor for 1700 citizens while the optimal average should be one doctor for 600 citizens. In some cases, the ratio is up to 25,000 citizens to a doctor. The United States has one doctor for 350 citizens. If India aspires to be a superpower like the United States, we need to increase the numberof doctors, among other things, by six times.

This is impossible as no country can organically grow their medical population six times and meet quality.


In Ciscos view, India needs to embrace technology not only to treat the medical imbalances, but also to leapfrog into the future.

Our solution virtually delivers a doctor, specialist, or a super-specialist in remote areas through networking technology. The interaction between them is through video and vernacular language. The doctor can read and see all vital tests that are done on a patient. The patient can interact with the doctor conveniently.

Finally, the doctor can dispense a prescription or recommend a course of treatment that can be taken by the patient just as he would in a real-life situation. This fundamentally balances out the doctor-citizen imbalance we see in India as well as the urban-rural divide in terms of resource availability.

How do you think telemedicine is crucial for Indian healthcare? How the Indian healthcare is making full use of it?
The doctor patient imbalance is a definite disabler for the growth of the nation. Further, urban areas house 30 percent of the countrys population whereas they have 80 percent of doctor population.

Instead of trying to force the doctor population to work in rural areas even through giving incentives, the easier alternative is to deliver the population medical practitioners over the network so the citizen can get at least basic consultation.

This approach will immediately address the medical imbalance as well as the urban-rural divide of resource availability. When the nation grows with economic and infrastructure reaching the rural population causing a reverse exodus of trained medical population to rural areas, telemedicine infrastructure will morph to virtual specialty and super-specialty treatments only.

In the interim 15- 20 years, telemedicine is the only way for Governments to deliver their medical security
obligation to their people.

What is your take on Indian telemedicine market? How organised is it?
Currently, there is no telemedicine market. Over the past decade, the country had inaugurated over 60 pilots and none of them survive today. This is primarily because we chose to adopt satellite-based delivery of these services when the whole world was gravitating towards fiber-based delivery of network.

Of course, India has to contend with tele-density and other fundamental issues of telecommunications first before it embarked on fiber. So in one sense, satellite based communications, especially when most technology was denied to India, was the only alternative. However, this is like wanting to race an Ambassador car in a grand-prix racing circuit.

Not that we as a country is beyond technology denial phase and have over a million route-kilometer of fiber. Going back to satellite based delivery of telemedicine is akin to listening to music on gramophone records when digital music is where everyone is at.

However, this situation presents a country like India an excellent opportunity here it can innovate, choose the latest technology to advance its healthcare needs, and create large number of jobs in rural areas. This will not only address the healthcare needs of the country but also inject money into rural areas in a responsible and scalable manner.

Instead of trying to force the doctor population to work in rural areas even through giving incentives, the easier alternative is to deliver the population medical practitioners over the network

What are the top five challenges that a telemedicine player like you face in Indian market?
The major issue that we need to overcome in this country is a mindset that we need to use only those technologies that we have created. During the Cold War era, this mindset is valid but that era died about 15 years ago and the world has moved on.

Secondly, we need to adopt technologies that will not infuse complexity in the edge because that would make maintenance and scaling a major challenge.
Thirdly, there is basic infrastructure issue like power, networking availability, etc.

Fourthly, we need to normalise the telecommunication rates that resonate with the rest of the world. This is especially true for humanitarian applications.
Fifth, we need to create an incentive system for Government and private doctors to participate in telemedicine as they can view this as a direct challenge to their livelihood.

How the CISCO telemedicine is different from other telemedicine products?
Our solution is significantly different from other offerings in this space. For one,
we provide a very scalable video-based architecture delivered securely from a cloud using our latest collaboration technologies at the cost of USD 1 per consultation for technology. For another, we offer an end-to-end project management, reporting, and technology support for our customers. We do not believe in selling our equipment and disappearing.

Where do you see the future of telemedicine in India is heading?
India has no option but to embrace telemedicine to provide medical care services to its citizens. If the country wants to safeguard the health of its citizens and bring them into the economic mainstream as productivity constituents, we have to embrace telemedicine. If we do it right, I see that telemedicine centres will be ubiquitously present in India in the next five years which will not only result in a dramatic improvement in our Human Development Index scores but also a great prosperity for the rural areas.

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