1. Project Background and Justification
1.1. The Objective
The objective of this project is to deploy a cost-effective remote diagnostic telemedicine solution at select villages and monitor the social and economic benefits of such a healthcare solution to the villagers.
1.2. The Rationale for the Project
Healthcare is a vital need in the rural areas. Though they have been efforts by the Government to address the needs of rural India through Primary Healthcare Centres, it has been observed that this network is inadequate due to the problems of access and availability of good doctors in rural areas.
In the absence of healthcare facilities in the villages, the rural people tend to visit the nearest towns for their healthcare needs. Since a visit to a doctor in town has financial implications for the villagers in terms of transportation and consulting costs, not to mention loss of work/pay, the villagers tend to use this as a last resort. This usually means that they either tend to self-medication or that they approach a doctor at a late stage. More dangerous is to use remedies prepared by unauthenticated practitioners.
n-Logue is a rural services organisation which is creating ICT infrastructure across India by setting up rural internet kiosks in each village. Through its internet kiosks, n-Logue already has a remote consultation service between villagers and doctors in that region, which is at present implemented through a low-bit rate video conferencing facility. However, this has some limitations as doctors are very often unable to provide reasonable diagnosis in the absence of measurable basic physiological parameters.
Neurosynaptic Communications is a telemedicine solutions company which has developed a remote low cost diagnostic kit to measure four primary parameters, viz temperature, blood pressure, ECG and heartbeat (stethescope) for teleconsultation. n-Logue proposes to deploy this kit in select locations to facilitate a remote telemedicine services.
Through this deployment, n-Logue seeks to improve the access of the rural population to adequate and timely healthcare services. What n-Logue seeks to monitor is the direct economic benefits to the villager as well as the indirect benefits associated with timely medical support.
1.3. The Remote Diagnostic Kit
The remote diagnostic kit is a portable kit which is connected to a personal computer via infra-red. The kit can measure four basic physiological parameters – temperature, blood pressure, ECG and heartbeat (Stethoscope). The kit has probes which are attached to the patient physically and there are separate probes for each measurable parameter.
The doctor is connected to the patient via internet. Product-specific software is loaded at both ends – on the doctor’s computer as well as on the computer to which the kit is linked. When a consultation begins, the doctor determines the parameter(s) to be measured. The doctor then activates the parameter on the software in his/her computer. At the kiosk, the relevant probe is attached to the patient’s body and the reading can be seen both by the doctor and the patient on-screen. A record of the reading(s) is also stored in the database for future reference. Based on the readings, the doctor then provides, either a prescription or advice to visit, to the patient.
2. Project Objectives
2.1. General Objective
To improve access to healthcare in Rural India through the deployment of telemedicine solutions using a low cost medical diagnostic kit connected to wirelessly connected internet kiosks.
2.2 Specific Objectives
The objective of this project is to deploy a cost-effective remote diagnostic telemedicine solution at select villages and monitor the social and economic benefits of such a healthcare solution to the villagers.
3. Project Methodology
Stage I : Identification of Right Locations
n-Logue proposes to deploy the kits at 10 of n-Logue’s existing rural internet kiosks. Locations will be identified based on
- non-availability of a Primary Healthcare Centre. The need for remote healthcare solutions is likely to be higher in such villages
- existing teleconsultation locations, where a patient-doctor relationship is already established and trust built up. Also kiosk operators at such locations will already have exposure to the medical consultation process on the internet.
Stage II : Implementation of the Remote Diagnostic Solution
n-Logue will procure from Neurosynaptic 10 remote diagnostic kits to be deployed at the locations. Doctors who are to participate in this experiment will be provided a personal computer loaded with the proprietary software to operate the kits. Neurosynaptic will be responsible for the installation of the kits in the rural kiosks and for the software installation at the kiosk and the doctor’s end. Neurosynaptic will also train the person at the rural kiosk, who will operate the remote diagnostic solution.
Consultation will be provided by the doctors at a fixed time three times a week. Charges for the consultation will be fixed between the consulting physician and n-Logue. The kiosk operator will be responsible for collecting the charges from the patients and he/she will also get a revenue share/commission for the collection services thus performed. The kiosk operator will also maintain a separate register for the usage of the remote diagnostic solution.
n-Logue and the kiosk operator will jointly promote this service at the location where the solution is being deployed.
Stage III : Monitoring the Project.
Each fortnight , n-Logue will check the register being maintained at the kiosk for the project and correlate the data with internet usage data and data from the doctor’s end. This will be with objective of streamlining the process of maintaining records and collections.
At the end of every three months, n-Logue will do a feedback session with the patients and the doctors. The feedback will be through the filling of questionnaire and personal interactions between the doctor/patient with a n-Logue appointed executive. Such monitoring will continue over a period of one year. Questions will be focussed on understanding the villagers’ views on the service quality, the fees, the perceived benefits and issues of discomfort.
Stage IV : Compilation of information and preparation of a final report.
This stage involves the collation of data compiled at all the kiosk locations, collation and confirmation. Post the compilation, the data will be analyzed, findings discussed and documented and the final report will be prepared for submission.
