Challenges and Path of Telehealth since 2001 till today!

Indian Space Research Organization (ISRO) is one of the six government space research agencies that have full launch capabilities out of a total 70 such organizations all across the world. On September 24, 2014, India’s first interplanetary mission to Mars was successful. With such advanced equipment at hand, ISRO embarked on a Telemedicine Pilot Project back in the year 2001, linking Apollo Hospital in Chennai to the Apollo Rural Hospital in Aragonda village in Chittor, Andhra Pradesh.

With studies that span more than a decade and a half, ISRO has given us some very useful insights on the Indian ways of life that contest the growth and development of Telemedicine by throwing in difficult challenges in various aspects that can influence the upshot of the initiative. This article highlights the bumps and blocks that stand before Telemedicine and how the focus on improving healthcare is employing alternative potentials to tackle these.

Telemedicine - Connecting the whole nation for better healthcare delivery! Photo Courtesy

Telemedicine – Connecting the whole nation for better healthcare delivery!
Photo Courtesy

Telemedicine or Telehealth is not a separate medium of medical specialties but it is a branch of healthcare delivery services that is not rapidly gaining importance in daily life. According to Wikipedia, Telemedicine “is the use of telecommunication and information technologies to provide clinical health care at a distance. It helps eliminate distance barriers and can improve access to medical services that would often not be consistently available in distant rural communities. It is also used to save lives in critical care and emergency situations. It is essentially a product of 20th century telecommunication and information technologies. These technologies permit communications between patient and medical staff with both convenience and fidelity, as well as the transmission of medical, imaging and health informatics data from one site to another.”

Compared to the conventional mode of healthcare delivery, telemedicine has a couple of plus points, such as
• Economical mode of medical consultation (saves money in travel and other costs, especially for rural patients)
• Saves time (no time spent on traveling and waiting at the dispensary)
• Can reach out to a remote patient in emergency situation
• Cost-effective for patients with chronic ailments, old age issues and temporarily long term health management necessities (pregnancy, jaundice, etc.)

Yet, the growth of Telemedicine in India has been affected by certain incubating issues:

1. Problems with implementing Telehealth properly—It was intended that Telehealth should reach the remote nooks and corners of the country’s rural areas and the people there. But given India’s vast area and drawbacks in distribution of electricity and other basic infrastructural requirements, the scale of Telemedicine has remained constricted.

2. Not enough dedicated medical professionals—A study from Karnataka expressed a grave lack of medical professionals (doctors and specialists) dedicated to take Telemedicine to the next level. Telemedicine requires a host of trained and interested healthcare professionals to help increase the resourcefulness of a Telemedicine initiative.

3. Issues with the human mindset—In general, the human mindset quickly opposes a sudden change in an effective and comfortable process at a personal level. This is the ideology that blocks out a wave of change from making a great impression in due time. Telemedicine is facing the same problem. However, with time, more research, experiments and studies has helped find a better understanding of Telemedicine and it benefits. Although some hospitals, clinics and individual doctors are riding the wave of opportunities with Telemedicine at present, the numbers are too less to make a visible difference.

4. Technical Difficulties—The lack of proper satellite connectivity, electricity supply, noise free zones, funds for necessary equipment, lack of trained professionals etc. are some of the major technical difficulties that obstruct the development of Telemedicine.

Bangalore’s famous establishment, National Institute of Mental Health & Neuro Sciences (NIMHANS), and a couple of other popular such organizations are working together to promote Telemedicine training as a part of academic curriculum for all medical professionals.

5. Legal Issues—There are no set laws yet in India to tackle the medico-legal issues, specifically pertaining to Telemedicine. In the year 2005, the Ministry of Health and Family Welfare (MoH&FW) Government of India set up a National Task Force on Telemedicine. From the President’s office of Telemedicine Society of India, a draft for protective interest laws has been submitted to the Ministry of Health recently. It is an on-going process and will not be long before we see good progress.

6. Ethical Issues—There are still some unresolved issues about confidentiality and privacy, security of patient data in Telemedicine consultations. Large healthcare organizations, such as Columbia Asia Hospitals, deal with this issue by taking a written consent from the patients before moving onto Telemedicine consultation. But addressing this issue with a standardized draft of norms and regulations is a necessary step awaiting acknowledgement.

Telemedicine is a great process for a number of Healthcare delivery criteria. For example:
• Emergency when time is a crucial factor
• Any disaster where people need medical help
• Post-operative follow-ups
• Monitoring programmes and training of primary doctors
• Providing healthcare in custodial settings
• Facilitate 24×7 medical healthcare to anyone, anywhere

ISRO has been actively deploying Telemedicine nodes under their GRAMSAT (rural satellite) programme in collaboration with State Governments. Ministry of Health and Family Welfare (MoH&FW) has also implemented an integrated Disease Surveillance Programme network with the help of ISRO. Studying the slow but steady growth of Telemedicine, ISRO has envisioned the development of “HEALTHSAT”—an exclusive satellite to promote telemedicine across the country. Serious efforts are being made to promote Telemedicine to a greater level and make it a successful mode of healthcare delivery. It is a united belief that Telemedicine has the capacity to change the overall quality of life and healthcare efficiency across the country.

Bibliography:

http://www.tsi.org.in/

http://shiksha.isro.gov.in/pdf/brochures/4.pdf

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2782224/http://stbmi.ac.in/matter/international%20pub/31_Current%20Telemedicine%20Infrastructure,%20Network,%20Applications.pdf

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