American Megatrends India Director & CEO Sridharan Mani discusses the challenges related to rural healthcare and suggest ways to address them with  telemedicine 2.0

Indian rural healthcare has a significant growth potential, as market still remains untapped. Recently, National Rural Health Mission (NHRM) has been allocated close to `20,822 crore (USD 4.14 billion) in 2012-13 for rural healthcare initiatives.

According to  McKinsey, the Indian rural healthcare is expected to expand at a pace of 44 percent by 2015, totaling its worth to USD 8.8 billion.

Indian healthcare “ the way forward

The growth potential for Indian healthcare is immense. The market opportunities are significant. Being the home for 17.5 percent of world population with world-class doctors and state-of-theart medical facilities, India can provide the best in class healthcare across the globe. However, the challenges are many. The big question is is india ready to lead the healthcare across the globe?

Prof K Ganapathy, President, Apollo Telemedicine Networking Foundation, Past President of the Telemedicine Society of India and Adjunct Professor at the Indian Institute of Technology, Chennai say, We cant go far with conventional brick-and-mortal hospitals and Telemedicine is the way forward.

Telemedicine: Market size

Prof Ganapathy points out that 80 percent of Indias population have no direct, physical access to specialist healthcare and gives some back-of-the-envelope calculations: Estimates suggest that the telemedicine market is at least for 800 million Indians. Even if half of these 800 million need to consult a specialist once a year, [that still amounts to USD 400 million specialist consultations per year. Even if 10 percent of these are enabled through telemedicine we are talking about 40 million consultations per year from rural India alone. The market potential for telemedicine is obviously enormous.

According to BCC research, the global telemedicine market in 2010 is USD 9.8 billion and it is expected to be USD 23.0 billion by 2015.

Current state of telemedicine and its challenges

The major challenges of the current telemedicine setup is that it requires dedicated infrastructure, high capital requirements and computer savvy talent pool to access sophisticated systems. The system is not user friendly and not scalable to meet the ongoing demands.

The current infrastructure only provides video conferencing facilities to link patients with specialists. Also, all specialists cannot be made available at the same time as the case requirements may differ. Telemedicine in the current form is not providing better time management for specialists. In some cases, the specialists are required to wait on call for all day long to handle a few patient cases. Also, the current telemedicine system makes the specialist/ physician to be in conferencing location for the day to handle patient calls and it makes them immobile.

With the shortage of specialists and january / 2013 in focus 39 physicians, an intelligent telemedicine system is needed to efficiently identify the patients that require immediate care to be linked with right specialist/physician.

TeleMed 2.0: Technology overview

TeleMed 2.0 architecture is based on M2M Communication Gateway integrated with Publish Subscribe model framework. The illustration of M2M Communication Gateway based on American Megatrends (AMI) M2M Cloud Framework.

TeleMed app for collecting patient information

In todays world, a portable phone that is based on Android with camera, voice, Bluetooth with built-in 3G support costs less than USD150 and a great replacement for traditional desktop infrastructure used in telemedicine. These android-based devices can be instantly integrated with sensors for SPO2, blood pressure, temperature, ECG and blood sugar for collecting the real-time vitals. The TeleMed application running on these devices can do real-time monitoring based on schedule. Also, they can record and upload the patient information and real-time vitals collected through sensors to hospital information system from remote locations. The application in the devices will have SOS alert mechanism to alert the remote physician/specialist on call, whenever a vital sign cross the threshold that is life threatening or indicating a serious disorder.

TeleMed app for healthcare professionals

The specialists and physicians can now benefit from these advancements and they can access all the patient records with real-time vitals on their iPhones/iPads12 from anywhere across the globe with TeleMed application that is integrated with HIS. The real-time notifications received from patients with realtime vitals collected through sensors indicate the seriousness of the issue and the specialist/physicians can take the appropriate call to save lives. They can have live video/audio communication with the patient/paramedic/nurse instantaneously by directly connecting to peers mobile device.

AMI M2M Cloud Gateway

AMI M2M Cloud Gateway provides the middle-ware interfacing layer support. It runs the notification and business routing engine based on publish-subscribe model. All patient and healthcare professional smartphone devices will get themselves registered with TeleMed application integration gateway. AMI M2M Cloud Gateway constantly monitors the key vitals received from the patients and if any abnormality is found, it immediately invokes the alert engine to alert the right healthcare professional based on the information and routing path. The alert engine sends notification to the healthcare professional along with the real-time vitals received from the patients device. This enables the healthcare professional to have a peer-to-peer video conferencing call with a mobile from anywhere in the globe.

TeleMed 2.0: Creating a new vision in healthcare

Provides a healthcare connectivity infrastructure that allows hospitals to extend the proven care benefits and efficiencies of remote health monitoring services to a broader patient population.
Healthcare professionals can be located anywhere around the world and still can provide the best care to their patients by overcoming distance barriers.
TeleMed 2.0 will specially be helpful in monitoring post-surgical patient conditions.
AMIs (compact & removable) TeleMed device will be tied to the patients arm. This device sends health progress reports for every one minute, based on the health condition of the patient. The monitored data gets pooled in HIS and that is accessible only by the authorised surgeon(s).
Prevention is better than cure. Intelligently and accurately programmed

TeleMed device sends health trauma alarm to the hospital, before the patients health condition gets to emergency stage. This alarm will particularly be useful in rushing the patient to Intensive Care Unit, before the condition gets out of control and also helps in preventing time-based emergency cases.
The cost of setting up the infrastructure for Telemedicine is drastically reduced as the adoption of smartphones is increasing in the market.
Improve patient safety, caregiver productivity and operational efficiency with real-time reliable information at the point of care
Link to every hospital and doctors clinics in the province.
Allows providers to deliver quality care in every location no matter how remote
Link nurses to up-to-the minute information about patients, monitors, pumps, medical records and medication schedules, regardless
of where they are working.
Serve more patients and doctors with significantly lower operating cost.


In summary, TeleMed 2.0 provides the state-of-the-art platform for hospitals and healthcare professionals to provide the best quality healthcare for those who need remote monitoring and healthcare support. This enables the healthcare professionals to be located anywhere and yet provide the best medical attention care to their patients. The relationship between the healthcare professionals and patients are strengthened and medical tourists can feel at peace that they are in good hands and their health is safe. The elderly can live in peace that their vitals are constantly being monitored and abnormality will be notified to their healthcare to take the required medical attention.

With TeleMed 2.0 implementation, the patient care can be improved significantly and healthcare professionals can reach out to many patients remotely that need quality medical attention

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