Copyright © 2017 CARE Foundation - All Rights Reserved.      Created by CARE Foundation IT-Team
Non-Profit Organization
CARE Foundation

Experience of setting up Telemedicine projects

Public-private partnership model - Telemedicine Project with District Hospitals

With   the   goal   of   eventually   ensuring   delivery   of   quality   medical   care,   a   telemedicine   system   has been   designed   to   make   quality   health   care   accessible   at   an   affordable   rate   to   people   living   in remote   areas.   The   purpose   of   the   system   is   to   give   health   care   providers   at   remote   locations   the ability   to   consult   with   specialists   using   a   combination   of   video,   audio,   and   externally   acquired medical   images.   The   system   can   also   be   used   for   education   purposes   to   support   bi-directional video/audio   communications   for   grand   round   lectures,   classes,   and   case   conferences.   In   order   to maximize   the   utilization   of   the   available   transmission   medium   (ranging   from   land-based   copper   and fiber   optic   cable   to   satellite   link)   while   providing   the   best   possible   video   and   audio   quality,   the compression performed by the system is adaptable to a wide variety of bandwidths. Telemedicine   in   Mahabubnagar,   a   project   executed   by   CARE   Foundation   for   the   district   hospital   at Mahabubnagar    is    via    a    public-private    partnership,    with    the    Andhra    Pradesh    Vaidya    Vidhana Parishad   (APVVP)   on   behalf   of   the   Government   of Andhra   Pradesh.   The APVVP   provided   a   facility at   the   district   hospital   with   a   fully   operational   CT,   X-ray,   ECG   and   Echocardiography   units.   Care Foundation   was   in-charge   of   providing   in-house   developed   software,   dissemination   of   training   to   a local   field   project   executive,   proving   timely   diagnosis   with   the   help   of   the   specialists   at   CARE hospitals and daily maintenance of the communication and IT network. The   ideology   behind   the   entire   set-up   was,   to   have   these   equipment’s   operational   at   the   primary health   care   centre   along   with   a   videoconferencing   equipment   and   a   computer   and   at   the   hub   centre a   sever   computer   with   a   teleconferencing   unit.   The   patients   availed   the   diagnostic   facilities   at   the remote   site   and   the   doctors   at   the   hub   centre   are   empowered   to   interact   with   the   patients   through the videoconferencing unit. Along   with   delivery   of   timely   healthcare,   the   system   has   been   designed   to   cater   to   the   lower economic   strata   too.   Over   40,000   cases   from   Mahbubnagar   and   more   than   8000   cases   from Tandur   have   so   far   been   transmitted   and   diagnosis   /   treatment,   been   rendered   to   the   patients without   them   having   to   travel   to   cities.   The   strata   of   people   using   this   facility   were   distinguished based   on   two   factors   namely,   white   card   holders,   (WC)   people   below   the   poverty   line,   and   non- white    cardholders    (NWC)    and    accordingly    these    tests    have    been    subsidized    to    ensure    the affordability factor.  The costs of the tests were assigned by APVVP.

Telemedicine to diagnostic units abroad - Nigeria, Iraq

We   established   connectivity   with   Diagnostic   Center   at   Lagos,   Nigeria   for   facilitating   transmission   of CT,    MRI    and    CR    images    and    with    Medya    diagnostic    center    at    Iraq.        Broad    band    internet connectivity   with   a   bandwidth   of   2   Mbps   was   used   for   the   same.      The   application   software   was developed   in   house   in   the   .Net   platform.   CARE   has   developed   teleradiology   application   software which   enables   transmission   of   DICOM   compliant   CT   scan   images   through   a   DICOM   interface   to   a PC.   The   software   enables   archival,   storage   and   retrieval   of   the   transmitted   images.   The   software enables   post   processing   of   the   image   such   as   grey   shade   levelling,   calculation   of   area   and   volume of   images,   Houndsfield   unit,   window   levelling   and   converting   DICOM   images   to   various   other   video file   formats.   The   software   has   been   created   on   a   .NET   platform   for   uninterrupted   case   reporting   by radiologists.      In   a   period   of   one   and   half   years   over   25,000   cases   have   been   done   over   the broadband network from Nigeria and more than 5000 cases from Iraq. Preliminary   reads   were   provided   for   non-emergency   and   emergency   cases   (STAT)   and   after   a rigorous   quality   check   the   reports   were   sent   as   the   official   patient   record.   The   preliminary   reports included   all   pertinent   findings   and   a   phone   call   was   made   in   case   of   any   critical   findings.   For   this Teleradiology    service,    the    turnaround    time    was    extremely    rapid    with    a    30    minute    standard turnaround   and   expedited   for   critical   and   stroke   studies.   For   a   routine   case,   the   turnaround   time was   3   to   4   hours.   The   final   reports   that   were   sent   as   feedback   for   each   case   included   all   findings with   a   review   of   prior   studies   details   of   the   same   patient   and   all   relevant   patient   information   for   a complete diagnosis.

Telemedicine to PSU’s - The Singareni Collieries Company Limited (SCCL)

The   Singareni   collieries   are   a   government-owned   PSU   coal   mining   company   in   Pranhita-Godavari Valley   region, Andhra   Pradesh,   India.   There   is   a   very   high   prevalence   of   respiratory   disorders   such as   ARDS   (acute   respiratory   distress   syndrome)   which   has   remained   unrecorded   and   untreated. Telemedicine    between    SCCL    and    Care    Foundation    via    CR    and    Echocardiography    units    was established   in   2010.   Telemedicine   model   was   designed   to   address   issues   of   lack   accessibility   due to paucity of nearby tertiary care units.
Inauguration of Telemedicine Link with Dist. Hosp.  Mahabubnagar - 25th Oct2001 Tele-echocardiography - Dr B Soma Raju explaining to  Dr A P J Abdul Kalam 5th May 2002 Live ECHO performed at District Hospital, Mahabubnagar & read by Cardiologist at CARE, Hyderabad Inauguration of Telemedicine Link MeCure Diagnostic Center,  Nigeria
Note: CT- Computed Tomography; MRI – Magnetic Resonance Imaging; CR – Computed Radiography