Monday, May 7, 2001		Article

Doing surgery in Chandigarh from USA
By Sumesh Raizada

A TV commercial of a telecom company currently being aired shows a woman delivering a baby girl in the middle of a stadium on the guidance provided by her doctor. Though the advertisement is meant for publicising business operations of that company yet it highlights an important application of Information Technology (IT) that is telemedicine. So now if a doctor in New York performs live surgical operation on a patient lying on operation table at a hospital in Chandigarh it won’t make much on news.

Science has made rapid strides in the field of medicine and surgery over the past few years. It is now being extended to a large cross-section of society, both rich and poor mainly due to telemedicine. While the Internet, Intranet or broadband have introduced several applications during the past two to three years they mostly revolve around the concept of e-commerce or business activities. Telemedicine is perhaps among the first application of the Internet or satellite communication that is meant for social welfare and providing health care directly at the doorsteps of patients.

Telemedicine in its simplest form may be termed as a phenomenon in which data, voice, graphic or video-related to medical services are transferred through communication medium like the Internet or satellite. It facilitates prompt and effective health-related services to the patients in remote villages from a well-equipped hospital in a large town. Though patients have been seeking consultation from their doctors at distant places through telephone since long yet in that case a doctor cannot examine the patient visually. However in the case of telemedicine, through specialised software as well as computerised machines, detailed data and images regarding patient’s body can be transmitted.

Radiological and pathological reports like ECG, CT scan, ultrasound, blood sugar, haemoglobin all can be transferred to the specialist doctor for consultation. A specialist examines the reports and gives his opinion on treatment to be imparted. Through digital cameras, doctors from their telemedicine centre can examine patients for disorders in eye, ear or other body parts and may even rectify them.

Day-by-day with improved telecommunication network and introduction of broadband, quality of voice and image transmission has also improved. Telemedicine is available in different functional areas. These are Teleradiology in which specialist doctors examine radiographic images like X- rays or ultrasound; Telementoring in which experts guide doctors actually attending on the patients on surgical and clinical processes; Telepathology relates to transfer and examination of tissue samples from one location to another, Telehomecare that provides medical support to pregnant women or those suffering from blood pressure and diabetes. Patient can directly interact with their doctor and seek treatment through videoconferencing. Patients’ case history and electronics records like ECG, angiography is not only transferred to distant locations but is also stored in the computers for further references. Thus a huge database is created for each ailment making it easier to treat patients with similar symptoms.

Telemedicine has been found extremely beneficial for patients with cardiac problems, nephrological diseases, neurological or psychiatric problems, ophthalmic / ENT problems and dermatological diseases. These are some of the chronic ailments for which expert doctors are not available at the nearest health centres or hospitals. As a result, patients have to move to hospitals in large cities like Delhi, Mumbai or Chennai.

In some surgical cases they even have to go abroad to the USA or other countries for getting the latest treatment. This also adds up to the travel costs. This is besides expense that a patient or his family shall incur in getting treatment; say fees of doctors, pathological or radiological tests as well as accommodation charges.

Also, in case of large hospitals like AIIMS, Apollo, PGI, it creates a problem of providing resident accommodation to patients. With telemedicine this drawback in advanced medical care shall be reduced to some extent. Telemedicine also has its application in medical education through which medical students or doctors can get access to the information on latest advancement in the field or can interact with specialists in other countries.

Telemedicine had been in use by NASA or Russian space agencies since decades for extending medical support to their astronauts, it has now found an important application in airlines where a patient suffering from cardiac or other emergency cases is treated in the aeroplane in mid-air itself. This is done by sending electronic data of patient like heartbeats, ECG etc. to the base station of that airline through satellite communication.

A doctor or nurse is available 24 hours at the telemedicine centre for assisting airline crew. Telemedicine has another important application in Army where soldiers in advanced area areas need specialised treatment that is sometimes not available. In such a case, experts from other hospitals interact to advise course of treatment.

In India, Telemedicine Technology Centre has been established at Mumbai for promoting this wonderful application of the IT and medical sciences. Recently Telemedicine Society of India was formed with its headquarter at SGPGI, Lucknow, indicating telemedicine shall be a major focus of the policy-makers in providing economical, efficient and advanced medical treatment to the rural and underprivileged population also.

Apollo hospital has set up a telemedicine centre in Andhra Pradesh village through which patients diagnostic reports and case history are transferred electronically through satellite to base hospital at Chennai or Hyderabad. At Vijayawada (Andhra Pradesh), another telemedicine project is being set up by Soumya International for providing remote diagnostic system for rural population and that too at an affordable price.

The government has also taken initiative in this field by networking three premier medical institutions of North India mainly AIIMS, Delhi, SGPGI, Lucknow and PGI, Chandigarh. These hospitals shall be linked to telemedicine centres in small towns or villages from where resident doctors can send patient’s diagnostic reports for investigation and also seek medical opinion.

Since India has a large number of qualified, English-speaking doctors, it can become a centre for outsourcing telemedicine services for the USA and European countries where cost of medical treatment is high.

A Web site has been developed by an entrepreneur along with a doctor at Pune called ruksunanywhere.com that facilitates doctor-to-doctor communication through the Net. A member doctor can seek medical opinion on critical cases through conferencing with eminent doctors in related field.

Job opportunities are available in different functional areas both in lower as well as middle management level. Those having proficiency in computers can work as systems executives or managers. They are required for maintenance and operation of computerised machines and software in the hospital or telemedicine centres. Opportunity also exists for those who are working in pathology or radiology departments to enhance their skills and competency in computers or telemedicine-related technology and then join telemedicine centres in India or abroad. Persons with engineering or software background can work for development of specialised Web-based programs or software for computer-operated equipment.