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									                                                                           Annexures


9.2 Annexure 2– Telemedicine Initiatives in India

Telemedicine Initiatives in India

The Ministry of Communications and Information Technology, Government of India,
has classified "Telemedicine" as one of the thrust areas for development in the
country. In sync with the policy, the Government initiated a project called
"Development of Telemedicine Technology". The three tertiary level hospitals of North
India were linked up using Telemedicine Application developed by CDAC. This
included the following institutes:

    1. All India Institute of Medical Sciences at New Delhi.
    2. Post Graduate Institute of Medical Education and Research (Nehru Hospital) at
       Chandigarh.
    3. Sanjay Gandhi Post Graduate Institute of Medical Sciences at Lucknow, Uttar
       Pradesh.

MCIT has also worked extensively on defining the Guidelines and recommendations
for standardization for Telemedicine in India.


9.2.1   Apollo’s Telemedicine Initiatives

Apollo is a pioneer in the field of Telemedicine in India and is credited with being the
first to set up a Rural Telemedicine Centre in the village of Aragonda in the state of
Andhra Pradesh. Even though the first Telemedicine site was launched in 1999,
Apollo’s initiatives with Telemedicine started well before that. Some of the earlier
experiences with Telemedicine applications are given below:

•   Apollo experimented with Telecardiology more than 5 years back through the usage of
    Transtelephonic ECG machines, which were set up in various smaller hospitals whereby
    a doctor based in the Tertiary hospital could monitor his patients from a distance.
•   Simulations of Teleconsultations between Apollo Hospitals, Hyderabad, Chennai and
    Dubai for cases specific to Cardiology, Neurosurgery & Orthopedics were done.
•   Medical Conference - Brussels. Surgical procedure in Cleveland U.S.A - received
    in Apollo Hospitals Delhi, Chennai, & Hyderabad in 1997.

Apollo has now emerged as the single largest Telemedicine solution provider in India.
Apollo’s vision is to provide a successful working model of Telemedicine, which self
propagates throughout India and into the developing world. It will provide a channel for
continuous access to the most sophisticated medical support systems, at all times. Further,
Telemedicine shall improve patient care, enhance medical training, standardize Clinical
practice, stabilize costs and unite clinicians worldwide.
Apollo believes that this will only happen with the use of “user-friendly” technology that is cost
friendly, yet upgradeable and has successfully developed a cost effective and upgradeable
Telemedicine solution.

Apollo has in the last few years worked on providing Telemedicine solutions to various
organizations. Apollo has worked with multiple entities to spread the concept of Telemedicine,
this includes the central and the state governments, medical bodies, private sector, public
sector and others.

Telemedicine Centres set up by Apollo

Apollo has set up over 45 Telemedicine Centres across different locations in the country and
many more are in the pipeline. Apollo has worked with different kinds of entities in the
healthcare industry ranging from large Corporate hospitals and Government hospitals to
small clinics and Information Centres. Apollo has the expertise to execute different kinds of
Telemedicine projects. Some of the existing centre names are as given below:

                           Location                         State
                1)         Apollo Hospitals, Chennai        Tamilnadu
                2)         Apollo Hospitals, Hyderabad      Andhra Pradesh
                3)         Apollo Indraprastha Hospital     Delhi
                4)         Aragonda                         Andhra Pradesh
                5)         Tondairpet                       Tamilnadu
                6)         Madurai                          Tamilnadu
                7)         Sriharikota                      Andhra Pradesh
                8)         Kolkata                          West Bengal
                9)         Guwahati                         Assam
                10)        Kohima                           Nagaland
                11)        Karimnagar                       Andhra Pradesh
                12)        Bhubaneshwar                     Orissa
                13)        Silchar                          Assam
                14)        Burdwan                          West Bengal
                15)        Army Hospital – Chennai          Tamilnadu
                16)        Army         Hospital        -   Andhra Pradesh
                           Secunderabad
                17)        Army Hospital – Golconda         Andhra Pradesh
                18)        Army Hospital – Panaji           Goa
                19)        Army Hospital – Trivandrum       Kerala
                20)        Army Hospital – Belgaum          Karnataka
                21)        Army Hospital – Willingdon,      Tamilnadu
                           Ooty




Mode 1 GATS Report India                Page 97
Apollo’s initiative in Kohima : A Case Example

Apollo Hospitals in coordination with Ministry of Information Technology (MoIT), Nagaland
State Government and Marubeni India Pvt. Ltd. (sponsored by the Government of Japan
through NEDO) has set up a Telemedicine Centre on a turnkey basis in Naga Hospital,
Kohima in the state of Nagaland. The need of the hour was to provide specialty health
services to the remote areas of Nagaland and other regions in the North East.

Kohima is the capital of the state of Nagaland and is located on a hilly terrain where
accessibility is difficult either by road or by air. The hospital in Kohima did not have adequate
medical equipment and specialist doctors. These were some of the main reasons why
Kohima was chosen to set up this Telemedicine Centre.

The various medical equipment installed are as follows:
• X-ray
• Color Doppler
• 12 lead ECG
• Transtelephonic ECG
• TMT
• PFT
• Ultrasound
• Pathological Microscope

3 ISDN lines have been enabled for the Naga Hospital Telemedicine Centre and
teleconsultancies and CME’s take place with Apollo Indraprastha Hospital, New Delhi.

Doctors of the hospital now have access to their counterparts and feel less isolated than
before. Doctors in Kohima are very excited about the CME’s that have been conducted with
Apollo Indraprastha Hospital. The Government of Nagaland has recognized the positive
results of the Telemedicine Centre and is very keen on setting up Telemedicine Consulting
Centres in other parts of Nagaland.


9.2.2 Malaysia – India Initiative
A centre has been set up in Brickfields to allow the poor who are suffering from heart
ailments to seek free treatment at the Narayana Hrudayalaya Heart Institute in
Bangalore, South India.

This collaboration was made possible through a tie-up between the Malaysian
chapter of the institute, Global Organisation of People of Indian Origin (Gopio), the
Malaysian Association of Indian Universities Graduates (MAIUG) and the Asia Heart
Foundation. A tele-cardiology unit had been set up to enable the patients to
communicate “face-to-face” with the specialist providing expert advice from the heart
hospital in Bangalore, India.




Mode 1 GATS Report India               Page 98
9.2.3   Jivan Nirmaya Pradarshan
The first project was implemented of Jivan Nirmaya Pradarshan on 1st of May 1998
for a period of 15 days. More than 550 numbers of patients’ data transferred from
Rajkot and Gandhinagar to Ahmedabad on simple telephone line. The telemedicine
system was installed at Bhuj Military hospital and Ahmedabad Military hospital on
20th December 1999. The System works on simple telephone line and working quite
effectively.


9.2.4   Indian Defense Service
In December 1999, we had installed Telemedicine System in the desert areas of
Kutch, i.e. Military Hospital, Bhuj, which was connected with the receiving unit at the
Main Military Hospital at Ahmedabad and they are transferring the data and images
for the different purposes. We had transmitted data of several patients successfully.
This was later extended to Air Force Hospital at Gandhinagar. Government of Gujarat
funded this pilot project. Indian Defense forces have very well received it and there
are all indications that they would like to extend the services to the entire country.


9.2.5 Kailas-Mansarovar Yatra
In Association with Sanjay Gandhi Post Graduate Institute of Medicine Sciences,
Lucknow, and Kumaon Mandal Vikas Nigam of Government of Uttar Pradesh we
undertook Telemedicine transfer between Kailas Mansarovar (Himalayas) route and
SGPGI, Lucknow. This was successfully conducted via satellite phone as from the
magnanimous height of Himalayas any form of communication between the stations
wasn’t possible. Media, Government authorities, SGPGI and Health Minister, Uttar
Pradesh, very well applauded this transmission. Several Important personalities
viewed this live telemedicine coverage in Lucknow and were greatly impressed by the
performance. The need for such communication in our country was established.


9.2.6   Kumbh Mela Festival
This has been a most prestigious project. Over 5 crores of people attended Kumbh
Mela between 9th January 2001 and 22nd February, 2001. There was a Primary
Health Center situated at the site of Kumbh Mela. Telemedicine transmission unit was
established at the Primary Health Center – Kumbh Mela site which was connected to
five different units (MLN Medical College, Allahabad, SGPGI, Lucknow, Directorate
General of Health, Lucknow and Secretary, I.T., Lucknow). Routine cases were
treated at the Primary Health Center but for major health problem Online Tele-
consultation with video-conferencing was done between Kumbh Mela and SGPGI,
Allahabad Medical College. Over 200 such major medical problems were successfully
transmitted and patients were benefited by expert advice and treatment while at
Kumbh Mela. We have received rave reviews by media as well as from Government




Mode 1 GATS Report India           Page 99
of Uttar Pradesh. This has been a unique project in the world where such a grand
festival has received the benefit of Telemedicine.


9.2.7   Ballabhgarh - AIIMS Project
On 07.11.2000 a telemedicine Network was set up between General Hospital,
Ballabhgarh, INDIA and AIIMS, New Delhi, INDIA. The project was sponsored by All
India Institute of Medical Sciences, New Delhi & Online Telemedicine Research
Institute, Ahmedabad and funded by Online Telemedicine Research Institute,
Ahmedabad. It was implemented by All India Institute of Medical Sciences, New Delhi
& Online Telemedicine Research Institute, Ahmedabad at a cost of Rs. 18.90 Lakhs.


9.2.8  Pithoragarh Project
From 7.08.2000 To 25.09.2000 a telemedicine project was carried out in
the interior of Himalayan region of Uttranchal State where a Telemedicine Network
was set up between the District Hospital, Pithoragarh, INDIA and SGPGI, Lucknow,
INDIA . The project was sponsored by Sanjay Gandhi Post Graduate Institute,
Lucknow & Online Telemedicine Research Institute, Ahmedabad and funded by
Ministry of Information Technology, Govt. of India. It was implemented by Sanjay
Gandhi Post Graduate Institute, Lucknow & Online Telemedicine Research Institute,
Ahmedabad at the cost of Rs. 16.08 Lakhs.


9.2.9  ISRO North East Telemedicine Project
Online telemedicine Research Institute along with ISRO started an ambitious project
in the North Eastern part of India on 15th September 2001 on permanent basis. The
project is implemented by Online Telemedicine Research Institute; Space Application
Center; Sundari District Hospital, Udayapur, Tripura and Rabindranath Tagore IICS,
Kolkata. The project is sponsored by Space Application Center, department of Space,
Government of India and funded by Space Application Center, department of Space,
Government of India.


9.2.10 ISRO Southern India Project Detail
Online telemedicine Research Institute along with ISRO started an ambitious project
in the Southern part of India on 15th September 2001 on permanent basis. The
project is implemented by Online telemedicine research institute; Space Application
Cente. Chamrajnagar District Hospital, Karnataka; SVYM Hospital, Kenchanhalli,
Masore Karnataka and Narayan Rudralaya, Bangalore, Karnataka. The project is
sponsored by Space Application Center, department of Space and funded by Space
Application Center, department of Space, Government of India.




Mode 1 GATS Report India         Page 100
9.2.11  Asia Heart Foundation Southern India Project
Installed in 2002 by Narayana Hrudayalaya, Bangalore, Karnataka, A J Hospital &
Research Center, Mangalore, K.H. Patil Hospital & Research Institute, Hulkoti, and
Vinaya Hospital, Kundapur


9.2.12  Escort Heart Institute & Research Center Project
Installed in 2002 by Escort Heart Institute & Research Center, New Delhi and Online
telemedicine Research Institute


9.2.13  Sankara Netharalaya Telemedicine Project
Installed in 2002 by Sankara Netharalaya, Chennai, Sankara Netharalaya, Bangalore,
Online telemedicine Research Institute


9.2.14  Down Town Hospital Telemedicine Project
Installed in 2002 by Down Town Hospital Limited, Assam, Sankara Netharalaya,
Bangalore, Online telemedicine Research Institute




Mode 1 GATS Report India         Page 101

								
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