Transcript Indra Pratap Singh School of Telemedicine & Biomedical

Innovative Low Cost mHealth tool kit
INDRA PRATAP SINGH
School of Telemedicine & Biomedical Informatics,
Sanjay Gandhi Post Graduate Institute of Medical Sciences
Lucknow, India
[email protected]
Content
• Background
• Introduction
• Material & Method
• mHealth4U®: Integration of ICT & medical
Equipments
• Case Study: Telemedicine enabled specialty healthcare
access for health emergencies
• Discussion
• Conclusion
• Acknowledgement
Background
• Advances in mobile communications and medical technologies has
facilitated development of innovative low cost portable tele-health
tools
• mHealth is the use of information and mobile communication
technology to improve health systems performance
• In India 506 million mobile phone subscribers with Growing
approximatly 10 million per month
• Mobile networks have now become country’s largest distribution
platform, promising to deliver information and public services to the
masses through innovative applications
• Mobility as such brings in added value of continuous availability and
timely information access
• ICT based solutions for various types of customization and allowing
support for a wider set of application requirements
Introduction
• Telemedicine is the use of medical information that is exchanged
from one treatment site to another via electronic communications
• It comprise videoconferencing, transmission of still medical images,
document sharing, remote monitoring of vital signs
• Evolution of wireless communication technologies have enabled
telemedicine systems to operate in the remotest place for rural
health practices, hence expanding telemedicine benefits,
applications, and services
• In India majority of the people are living in the rural and remote
locations where even the basic facilities are not available for the
society
Material & Method
• mHealth4U® a portable low cost mobile
telemedicine kit was conceptualized, designed
and prototype developed at the mHealth
research laboratory, STBMI in the year 2008.
Two versions
• mHealth4U-B (Backpack)
• mHealth4U-S (Suitcase)
Components of Low Cost Telemedicine Platform
1. Computer System
2. Communication Technology
3. Software based Video Conferencing System
4. Integrated Medical Equipments
5. Centralized Telemedicine Software
1. Computer System
• Low cost Atom based Processors for deploying
large number of telemedicine terminals
– Desktop
– Notebook
– Thin client & Cloud computing
– Handheld Mobile tablet
2. Communication Technology
• Low cost communication facilities now be the
alternative solution for transmitting the data,
voice and video to the nearby telemedicine
enabled service provider
– ADSL broadband
– Wireless broadband provided by various ISP in a form
of HSB plug in
3. Software based Video Conferencing System
• Mobility and lowering cost of devices can only be
achieved by replacing hardware with software
based video conferencing system
– People Link
®
mHealth4U
mHealth4U®: Integration of ICT & Medical Equipments
• mHealth4U® is a mobile tele-health solution designed, developed
and validated by School of Telemedicine & Biomedical Informatics.
• Available both in Aluminium polycarbonate case (Aeroplane cabin
bag size) & Standard Backback model.
• Consist atom processor based laptop with Windows vista platform &
Microsoft Office, non-invasive blood pressure monitor, ECG, pulse
oxymeter, Spirometer, Glucometer, Digital Thermometer, Digital
Weighing Machine, Digital Stethescope.
• Mobile high speed broadband (HSB) data card is used to transmit
data from remote rural area to teleconsultation center.
• All medical equipments are integrated with Curesoft® software.
• IP based video conference software is used for telemedicine
interactive session
Integrated Medical Equipments
PC Interface:
USB & Bluetooth
Spirometer
Common
Interface
Digital
Glucometer
Wrist Clinic
Weighing
Machine
SPO2
ECG
Atom based Low Cost Laptop with
Integrated Telemedicine Software
Connectivity via High Speed Broadband (HSB)
Blood
Pressure
Network Architecture
• All Software Servers are Installed at Data Center of
School of Telemedicine & Biomedical Informatics
Screen Shot of Software based Video Conferencing
Screen Shot of Cure-Soft Software
Case Study: “Telemedicine enabled specialty
healthcare access for health emergencies”
2009:
Puri Rath Yatra @ Odihsa
• Telemedicine enabled specialty healthcare access for health
emergencies during Lord Jagannath Rath Yatra at Puri
was
initiated by the School of Telemedicine & Biomedical Informatics
(STBMI), SGPGIMS, Lucknow in collaboration with OTTET,
Bhubaneswar and Govt. of Odisha
• An enterprise based telemedicine network was set up connecting
specialty hospitals at Bhubaneswar and Cuttack using wireless
broadband IP network to exchange E.C.G. and carry out
peoplelink® software based videoconference for tele-consultation
Technical Layout Diagram of Rath Yatra
2010: Field Deployment @ Gujarat, India
•
Kit was deployed in Four Primary Health Center (PHC), one Community
Health Center (CHC) and one state Hospital in the State of Gujarat, western
India
•
Basic orientation, demonstration and hands-on-training programme was
imparted to in-service paramedical, laboratory technician & nursing staff to
give them first hand exposure on the kit
•
All five nodes were connected over mobile wireless internet with expert
hospital located in the city. The electronic medical record was created using
the Curesoft® telemedicine software and the input from integrated medical
devices like ECG, NIBP; Spo2 etc were captured through USB 2.0 port into
this software which was then exchanged between the nodes and
videoconference session followed for tele-consultation after the successful
transmission of the data to specialist.
Video Clip
Result
• The outcome of “Proof of concept” was satisfactory.
• The Doctors involved in the project was quit excited and found
innovative solution for strengthening the healthcare services
at their hospitals.
• Subsequently pilot deployment was started in a different
environment. The patient data was transferred successfully
between the expert doctors and remote end and
videoconference could be possible even in low bandwidth.
• The doctors participating in the study suggested some minor
changes in the software architecture like incorporating more
graphics to represent body parts. Overall performance of the
kit was acceptable to them.
Discussion
• The advancement of mHealth technology should be exploited in
rural healthcare delivery setting in low resource countries where the
mobile telecommunication network has already reached.
• mHealth or mobile health or efficient high-quality healthcare
services for mobile citizens and u-Health or ubiquitous healthcare
that focuses on eHealth applications that can provide healthcare to
people anywhere at anytime using broadband and wireless mobile
technologies.
• The tool kit has been developed keeping in mind the basic health
care needs in remote villages in Indian setting, a situation akin to
countries in developing world. Besides the local available technology
and skill, cost factor has been taken into account. While field
deployment has been successful in testing the local available mobile
network, the human factors such as acceptability of the device and
operational simplicity was also taken into consideration.
Discussion
• Evolving software solutions will help to further the growth,
acceptance and adoption of telemedicine initiatives.
• Healthcare based on broadband and wireless mobile technologies
can only reach to the door step. Although technology cannot take the
place of a visit to the family doctor.
• Web and video conferencing are emerging as powerful components
in telemedicine and telehealth initiatives worldwide. The integration
of web based video conferencing has been able to help many
patients, and has enabled doctors to communicate with specialists in
order to make critical diagnoses faster.
• Software solutions like Peoplelink® will help to further the growth,
acceptance and adoption of telemedicine initiatives.
• Keeping telemedicine costs low will enable providers to reach out to
a broader audience, including those in rural regions and low-income
patients who cannot afford to travel long distances for care.
Acknowledgement
• The authors would like to acknowledge the financial
grant
support
received
from
Department
of
Information Technology, Ministry of Communications
& Information Technology, Government of India
under the Project” National Resource Center for
Telemedicine & Biomedical Informatics”.
School of Telemedicine & Biomedical Informatics, SGPGI, Lucknow
Thank You
www.sgpgi-telemedicine.org | www.telemedindia.org
www.stbmi.ac.in | www.nrct.in