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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