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Telemedicine

INTRODUCTION TO TELEMEDICINE

The delivery of healthcare services, where distance is a critical factor, by all healthcare professionals using information and communication technologies for the exchange of valid information for diagnosis, treatment and prevention of disease and injuries, research and evaluation, and for the continuing education of healthcare providers, all in the interests of advancing the health of individuals and their communities. In simple words, telemedicine facilitates the provision of medical aid from a distance. It is an effective solution for providing specialty healthcare in the form of improved access and reduced cost to the rural patients and the reduced professional isolation of the rural doctors. Telemedicine can enable ordinary primary care doctors to perform the function of specialist doctor’s tasks under the supervision of the specialist through telemedicine.

Telemedicine is an effective interface between Information Technology and Medical Science. The Telemedicine system consists of simple hardware and software at both the Patient and Specialist doctor ends with some of the Diagnostic Equipments like ECG, X-ray and pathology Microscope/Camera provided at the patient end.

They are connected through a Very Small Aperture Terminal (VSAT) system and controlled by the Network Hub Station of ISRO. The patient data, medical images and other information pertaining to the patients can be sent to the specialist doctors, either in advance or on a real time basis through the satellite link in the form of Digital Data Packets. These packets are received at the specialist centre, the images and other information is reconstructed so that the specialist doctor can study the data, perform diagnosis, interact with the patient and suggest the appropriate treatment during a Video Conference with the patient end. Telemedicine facility thus enables the specialist doctor and the patient separated by thousands of kilometers to see visually and talk to each other. This enables the specialist doctor to assess the physical and psychological state of the patient and suggest treatment.

ADVANTAGE OF TELEMEDICINE

One of the major advantages of Telemedicine technology has been

  1. a) saving money
  2. b) saving time and
  3. c) effort to the rural patients, as theyare not required to travel long distances for obtaining consultation and treatment.
  4. d) specialist consultation

APPLICATION OF TELEMEDICINE

Application of telemedicine is much more valuable in case of

  1. a) emergency, when time is a critical factor in the outcome of the diseases
  2. b) during disaster situation, a specialist can provide his services through telemedicine in disaster affected area
  3. c) post operation (Post Surgery) follow up since the patient is not required to travel unnecessarily and hence saving money and time.
  4. d) providing training for primary health doctors
  5. e) monitoring national health programs
  6. f) providing medical care in custodial settings such as prison, juvenile home, rehabilitation centers etc.

In this way, the systematic application of Information and Communication Technologies to the practice of healthcare has changed the medical practice and training.

NIMHANS TELEMEDICNE

The Indian Space Research Organisation (ISRO) has implemented the Karnataka Telemedicine Project, to bring multi-specialty healthcare, to a significant section of the rural population of the state of Karnataka, India. Technology wise, this network would be state-of-the-art and unique. This network would also serve as a model for the utilization of “Healthsat” proposed for launch in the future. In this phase the state-of-the-art “Server/Browser-based, Multi-point-to-Multi-point” type of Telemedicine System/Network (provided by TeleVital) is put into operation. This Multi-Specialty Network has a network consisting of a pool of specialty hospitals. Under this network specialty hospital for Psychiatry, Neurology, Neuro-surgery, Cardiology, Oncology, Gynaecology, Nephrology, etc provides telemedicine service to various district hospital across Karnataka.

This new era of consultation was initiated by Indian Space Research Organisation (ISRO) in the form of a Telemedicine Pilot Project in the year 2001. Later, National Institute of Mental Health Sciences (NIMHANS), Bangalore also adopted this novel initiative in 2005 to provide for the rural patients through tele-consultation.

This collaboration between National Institute of Mental Health Sciences (NIMHANS), Bangalore and Indian Space Research Organisation (ISRO) has successfully linked many hospitals across India and almost all District hospitals across Karnataka to provide tele-consultation. Thus, connectivity between non-specialist doctor at remote end (District Hospital) and the specialist doctors at NIMHANS centers has been effectively established.

Types of telemedicine consultation from technical aspects

Asynchronous teleconsultation (store and forward) – in which Specialist and Client center work independently; physician ordering consultation prepares patient’s medical test results and after interpreting them, forwards them to a specialist. At this stage, it is possible to arrive at an initial diagnosis with the request for its verification. After receiving test results, specialist makes a diagnosis, which is forwarded, to the physician who requested it. Electronic mail seems to be the most appropriate way of conducting teleconsultation in this case.

Synchronous teleconsultations (live/real time tele-video conference) – in which Specialist and Client center communicate simultaneously in a joint session using video-conference. Synchronous ones significantly improve the quality of consultation: depending on the capabilities of the system, participants may use voice calls, chat, video call or interactive pointer which may point to significant areas of interest.

NIMHANS telemedicine is using both Asynchronous tele-consultation (store and forward) and Synchronous tele-consultations (live/real time tele-video conference).

Types Of Tele Consultations From Personnel Involved

Tele consultation can occur between

ü two doctors (primary care doctor and specialist at the tertiary care)

ü doctor and a para-medical personnel, (between a specialist and para-medical staff such as nurse, pharmacist, care-giver etc)

ü doctor and a patient

in NIMHANS, tele-consultation is between two doctors (i.e. primary care doctor and specialist at the tertiary care).

Beneficiary of the tele-consultation

Tele-consultation is method in which a specialist assisting the primary care physician/ district hospital doctor in rendering a diagnosis, treatment and rehabilitation. This service is available only for government institute/hospitals. This may involve the use of live interactive video or the use of store and forward transmission of diagnostic images, vital signs and/or video clips along with patient data for later review.

NIMHANS tele-consultation is between two doctors, in which NIMHANS specialist assisting the primary care physician/ district hospital doctor in rendering a diagnosis, treatment and rehabilitation.

To be specific, patients who are getting benefit from tele-consultation are

  1. a) Patients visiting District Hospital (Government) in Karnataka
  2. b) Regional Rehabilitation Center, Bangalore
  3. c) Bangalore Central Prison patients, Bangalore

 

Number of Tele-consultation with district hospital across karnataka done till date

YEAR

PSYCHIATRY

NEUROLOGY

NEURO

SURGERY

OTHERS

2010

-

4

2

2011

2

32

35

2012

7

18

31

13

2013

157

107

18

97

2014*

116

48

2

96

TOTAL*

282

207

90

206

Tele-consultation with Regional Rehabilitation center and Central Prison Bangalore

PLACE

PERIOD

PSYCHIATRY

NEUROLOGY

NEURO-SURGERY

REGIONAL REHABILITATION

CENTER, BENGALURU

OCT 2013

TO SEP 2014*

448

-

-

CENTRAL PRISON,

BENGALURU

JULY 2014

To

SEP 2014*

25

8

3

 

 

Frequently asked questions

(Q) I am a patient, can I get an appointment for the NIMHANS specialist on telemedicine?

(A) No. NIMHANS telemedicine services is offered is tele-consultation in which NIMHANS specialist will assist the primary care physician/district hospital doctor in rendering a diagnosis, treatment and rehabilitation. This service is offered only for government hospitals. The consultation occurs between doctors only for specialist opinion.

(Q) How to get an appointment for the NIMHANS specialist through tele-medicine?

(A) Please contact nearest district hospital specialist for treatment of your illness. If the doctor in the district hospital/primary care physician is unable to treat, then he will place a request for specialist consultation. NIMHANS telemedicine unit will give an appointment for tele-consultation with your doctor. Finally, tele-consultation will occur between the NIMHANS specialist and the doctor in the district hospital.

(Q) I am a private doctor, can I get an appointment for the NIMHANS specialist?

(A) No. NIMHANS telemedicine services are offered is tele-consultation in which NIMHANS specialist will assist government hospitals/public sector institutions only. No private hospitals or individual doctors are entertained.

(Q) What is the cost for tele-consultation?

(A) NIMHANS tele-consultation is free of cost. Tele-consultation is provided only for government hospitals/public sector institutions doctors only.

(Q) Do I need to have a special hardware to do tele-consultation?

(A) NIMHANS tele-consultation occurs through two secured modes of communication

(i) Indian Space Research Organisation satellite and requires special equipment called LINK-STAR Receiver S2A TM HUB VIA SAT, connected to a dish antenna configured to receive satellite communication. This communication is secured and patient’s confidentiality is well maintained. This service is provided across India.

(ii) Karnataka State Wide Area Network (KSWAN) is implemented by the Centre for e Governance, Government of Karnataka. This project implemented as part of the National e Governance Programme, seeks to establish a secured State Information Highway, connecting the Government from the State Level down to Taluka level. This will be a vehicle for effective implementation for telemedicine only across Karnataka. This is a network requires specially configured secured CISCO 2801 Router.

(Q) Do I need to have special software to do tele-consultation?

(A) Yes. The software is called Tele-vital (Version 2.0) specialist end and client end software is required.

(Q) Does consultation is given on emergency basis?

(A) Emergency basis teleconsultation is not provided. The tele-consultation occurs only by prior appointment. Usually, teleconsultation is provided after 24-36hrs after placing the request/appointment from the client hospital.

(Q) Can I choose the specialist consultant (specific doctor)?

(A) Tele-consultation specialists are posted on rotation basis, hence client center cannot request for specific doctor.

(Q) What are the specialties in which tele-consultation can be sort from NIMHANS?

(A) Following are the specialties in which tele-consultation can be sort from NIMHANS only through appointment from District Hospital (Government).

  1. Psychiatry
  2. De addiction
  3. Child Psychiatry
  4. Clinical Psychology
  5. Speech Pathology & Audiology
  6. Transfusion Medicine
  7. Neuro – Rehabilitation
  8. Bio Chemistry
  9. NeuroVirology
  10. Haematology
  11. Neuro-Pathology
  12. Neurology
  13. Neurosurgery
  14. Plastic surgery cranial nerve
  15. Ayurveda

Faculty in-charge of Tele-medicine

Dr. Suresh Bada Math,

MD, DNB, PGDMLE, PGDHRL, PhD

Additional Professor of Psychiatry,

In-charge head of Telemedicine and Nodal Officer,

Department of Psychiatry,

National Institute of Mental Health and Neuro Sciences, (Institute of National Importance)

Bangalore - 560029

INDIA

Office: +9180 2699 5276

Email:sbm@nimhans.kar.nic.in

Dr. Naveen C Kumar,

DPM, MD

Associate Professor of Psychiatry,

Department of Psychiatry,

National Institute of Mental Health and Neuro Sciences, (Institute of National Importance)

Bangalore - 560029

INDIA

Office: +9180 2699 5254

Email:naveen.nimhans@gmail.com

Dr. Sydney Moirangthem,

MD

Assistant Professor of Psychiatry,

Department of Psychiatry,

National Institute of Mental Health and Neuro Sciences, (Institute of National Importance)

Bangalore - 560029

INDIA

Email: sydmoir2006@yahoo.com

Dr. Sabina Rao,

MD

Specialist Grade Psychiatrist, Community Psychiatry,

Department of Psychiatry,

National Institute of Mental Health and Neuro Sciences, (Institute of National Importance)

Bangalore - 560029

INDIA

Telemedicine Technician

Mrs Neelaveni S,

Dip CS&E, BCA

Telemedicine Technical Assistant,

Department of Psychiatry,

National Institute of Mental Health and Neuro Sciences, (Institute of National Importance)

Bangalore - 560029

INDIA

Landline: (+91) 080-2699 5377 / (+91) 080-2699 5250

Mobile: 09480829548

09480308415

Email: nimhanstelemedicine@gmail.com

 

Contact Addresses of Nodal Officer/Telemedicine Technician of District Hospital (Government)

  1. Bhavya

Telemedicine Technical Assistant

K.Gurushanthappa General Hospital,

Maddur – 571428

Email id: bhavya.mr15@gmail.com

Mobile no: 9449436438

2.Madhura

Telemedicine Technical Assistant

Sub divisional Hospital,

Sagar – 577401

Email id: sdhsagar76@yahoo.com, madhug65@gmail.com

Mobile no: 9448979968

3.Shilpa

Telemedicine Technical Assistant

General Hospital,

Lingasur – 584121

Email id: ghlgs20@ymail.com

Mobile no: 9449846995

4.Anitha

Telemedicine Technical Assistant

District Hospital,

Navanagar, Bagalkote – 587103

Email id: bagalakottelemedicine@gmail.com

Mobile no: 9448922293

5.Guruprasad

Telemedicine Technical Assistant

District Hospital,

B.D.Road, Chitradurga – 577501

Email id: telemedicinechitradurga@gmail.com

Mobile no: 9482375346

6.S M Lokesh

Telemedicine Technical Assistant,

Chigateri General Hospital,

P.J.Extention, Davangere – 577002

Email id: lokesh_sm2001@yahoo.co.in, dsdavangere@gmail.com

Mobile no: 9480350379

7.Kashyap.S

Telemedicine Technical Assistant , ICU Department

District Level Hospital,

Shikaripura, Shimoga – 577427

Email id: telemedicineskp@gmail.com

8.Vanitha

Telemedicine Technical Assistant

District Hospital,

B.H.Road, Tumkur – 572102

Email id: dstumkur@gmail.com

Mobile no: 9535782144

9.Santhosh

Telemedicine Technical Assistant

Dialysis Department,

District Hospital,

Chamrajnagar – 571313

Email id: dschamarajanagar@gmail.com

Mobile no: 9480678306

10.Ullas

Telemedicine Technical Assistant

District Hospital,

Udupi– 576101

Email id: dsudupi@gmail.com

Mobile no: 9480405677

  1. Ishrath,

Telemedicine Technical Assistant

District Hospital,

Kaveri building, Near Tollgate,

Madikeri – 571201

Email id: madikeritelemedicine@gmail.com

Mobile no: 8105492605

  1. Manohar, Telemedicine Technical Assistant

District Hospital,

Hassan – 573201

Email id: televitalhassan@gmail.com

Mobile no: 9448967796

  1. Suvarna, Telemedicine Technical assistant

District Hospital,

(Mallasamudra) Gadag –

Email id: telemedicinegadag@gmail.com

Mobile no: 9481764832

  1. Ravikumar Lambi

Telemedicine Technical Assistant

District Hospital,

Killa road, Dharwad – 580008

Email id: dsdharwad@gmail.com

Mobile no: 9449443891

15.Sahana

Telemedicine Technical Assistant

District Hospital,

Karwar – 581301

Email id: telemedicine.dkwr@gmail.com

Mobile no: 9482132435

16.Mallamma S

Telemedicine Technical Assistant

District Hospital,

Gulbarga – 585105

Email id: telemedicinegulbarga@gmail.com

Mobile no: 9482423516

  1. Kavitha

Telemedicine Technical Assistant

District Hospital,

Anathpur road,

Bellary – 583101

Email id: telemedicinebellary@gmail.com

  1. Choudhry

Telemedicine Technical Assistant

District Hospital,

Yadgir – 585202

Email id: dsdhyadgiri@gmail.com

Mobile no: 9886813741

19.Jagadish,

Telemedicine Technical Assistant,

S N R District Hospital,

Opposite Mahila Samaja School,

Bangarpet Circle, Kolar – 563101

Email id: jagadishsnr@yahoo.com

Mobile no: 9448713838

20.Rekha,

Telemedicine Technical Assistant,

District Hospital,

Bijapur – 580102

Email id: dsbijapur@gmail.com

Mobile no:

21.Dr. Shivakumar

District Surgeon,

District Hospital,

Mandya -

Email id: dsmandya@gmail.com

Mobile no: 9448974701

  1. Telemedicine Technical Assistant,

District Mallegowda Hospital,

Belur Hassan Road, Azad Park near,

Chikkamagalur – 577101

Email id : sunil.chins@gmail.com

Mobile no: 9449620571

23.Khadri

Nodal Officer - Telemedicine,

District Hospital,

Bidar – 585401

Email id: telemedicinebidar@gmail.com

Mobile no: 9449464299

Contact Addresses of Nodal Officer/Telemedicine Technician at Specialist Center:

  1. Neelaveni S

Telemedicine Technical Assistant,

Department of Psychiatry,

NIMHANS

Bangalore - 560029

Email id: nimhanstelemedicine @gmail.com

Mobile no: 9480829548/9480308415

  1. Shruthi T

Telemedicine Technical Assistant,

Bowring & Lady Curzon Hospital

Lady Curzon, Tasker Town,, Lady Curzon Rd,

Shivaji Nagar, Bengaluru, Karnataka 560001

Email id: shruthi_damsel@rediffmail.com

Mobile no: 080-25592766

  1. Gururaj

I/c Telemedicine Technical Assistant,

Bannerghatta Main Rd, Jayanagara 9th Block,

Jayanagar, Bengaluru, Karnataka 560069

Email id: hk_gururaj@rediffmail.com

Mobile no:

  1. Sandhya

Telemedicine Technical Assistant,

INSTITUTE OF NEPHRO UROLOGY

Victoria Hospital Campus,

Bangalore-02.

Email id: nephrourology.institute@gmail.com

Mobile no: 080-26706777

  1. Telemedicine Technical Assistant,

Sri Jayadeva Institute Of Cardiology Campus,

Bannerghata Road, 9th Block, Jayanagar East,

Bangalore – 560069

Email id: info@kidbangalore.in

Mobile no:

  1. Asha

Telemedicine Technical Assistant,

South Hospital Complex, Near NIMHANS,

Hombegowda Nagar, Bengaluru, Karnataka 560029

Email id:

Mobile no: 9482052540

  1. Mahesh

Telemedicine Technical Assistant,

Ramanuja Road, K R Mohalla, Ramanuja Road,

Mysore, Karnataka 570004

Email id:

Mobile no: 9972281804

  1. Srinivas

Telemedicine Technical Assistant,

St. John’s National Academy of Health Sciences

Sarjapur Road, Bangalore – 560034,

Email id: srinivas.mpnlr@gmail.com

Mobile no: 9964500455

  1. Jayashree

Narayana Institute of Cardiac Sciences Helpline: 080-71222222

258/A,Bommasandra Industrial Area, Emergency Dept.: Extn - 1380, 1381, 71222684/09980807980

Anekal Taluk. OPD Reception: 1666/1111/1808/9686600393

Hosur Road Healthcheck Reception: 09686600393 , Extn - 1849

Bangalore, Karnataka -560099

Telemedicine Technical Assistant,

Email id: telemedicine@hrudayalaya.com

Mobile no: 9980556911