Grant Amount: US$ 29,313

Keywords: HEALTH, TELEHEALTH, SOCIAL SERVICES, INDIA

Geographic coverage: India

Objective

The objective of this project is to study the impact of remote telemedicine in selected villages in India.

Research context

Internet kiosk operator, n-Logue, currently offers rural people access to doctors from its Internet kiosks using video-conferencing. The service has been limited because vital medical information of patients is not available. This project aims to field test a low-cost medical kit, called ReMEDiTM, developed by a partner company Neurosynaptic Communications Pvt Ltd. that works in conjunction with a rural kiosk and transmits data to a doctor in a town. The data sets that can be captured are electrocardiogram (ECG), blood pressure, temperature and heart rate. The project expects to study the impact of this product in the selected villages over a 24-month period.

Target beneficiaries

Through this deployment n-Logue seeks to increase the rural population’s access to adequate and timely health care services. The project monitors the direct economic benefits to villagers and the indirect benefits associated with timely medical support.

Outputs

• Identification of test-site locations;
• Implementation of the remote diagnostic solution;
• Monitoring of the project; and
• Compilation of information and preparation of a final report.

Research results and outcomes

This project is still in process at the time of writing and was proceeding well towards meeting its stated goals and objectives. The project had selected the kiosks to test its programme, it has trained kiosk operators in the use of the ReMEDiTM, has secured a partnering doctor, and begun conducting field tests of the system.

The selection of kiosks was based on criteria defining their readiness to take on the ReMEDiTM kit. The criteria took into account such factors as distance from nearest hospital, location of nearest pharmacy, gender of users, location and age of the kiosk, and available space to set up the system. The project selected villages of Sivagangai District in rural Tamil Nadu. In the Sivagangai District medical facilities of one type or another are available in 163 villages, which constitutes 33.54 percent of the total number of inhabited villages. n-Logue has set up the project with the Access Centre at Tirupattur and five Internet kiosks in the villages around it. The partnering doctor is based at a hospital in Tirupattur about 25 km radius away from the selected villages. Consultation hours are 5 pm to 7 pm daily.

A kiosk operator training methodology was developed and implemented in three parts. First, Neurosynaptic Communications Pvt. Ltd. trained the operator on the use of the ReMEDiTM. Training covered kit operations, maintenance, troubleshooting and Do’s and Don’ts. The second part involved training by a doctor on how to attend to a patient and administer the tests. Topics included how to deal with a patient, what kind of cases can be handled by the kiosk operator, what kind of cases must not be handled under any circumstances, instructions on the customer waiver form and training on using the various tools – where to place the stethoscope, thermometer and so forth. The third part of the training was provided by n-Logue and covered the business model and service promotion. The training included cost and revenues, rates for various tests and consultations, features, advantages and benefits of the telemedicine service, and how to communicate these to the villagers.

The project promoted the service through conducting a Health Camp where all visitors were given a free blood pressure and ECG test. To gain the support of the District Administration for the effort and to increase the acceptability of the service in the village, the project held an inauguration of the service with the District Collector, who is the highest-ranking administrative official in the district.

Immediately after the launch of the service, a spike in visitors to the kiosk was observed. Subsequently, the number has dropped to a few regular, repeat visitors. A survey instrument was designed to analyse the reasons for the drop in the consultations. Some of the possible reasons being analysed are: kiosk operator’s inability to administer the kit properly, unacceptability by the villagers, poor identification of the kiosk as a place where medical care is dispensed, lack of awareness of the service, distance of the doctor from the village, and availability of competing services such as registered Indian medical practitioners, primary health centres and local doctors. Based on feedback the service is being refined.

While the project is still underway and final results have not been reached, the project team has noted the importance of creating public-private partnerships with governments, non-governmental organizations and health institutions for remote health delivery to rural areas. They see that such partnerships can improve the quality of services being offered and increase acceptance of it by villagers.

Duration

Start Date: January 2005
End Date: October 2006
Total Duration: 22 Months

Contact information

P.G. Ponnapa, Chief Executive Officer
n-Logue Communications Pvt. Ltd.
5th Floor, Gokul Arcade, 2 Sardar Patel Road, Adyar
Chennai, Tamil Nadu 600020, India
Telephone: +91 44 3918 1920
Fax: +91 44 2445 5335
Email: ponnapa@n-logue.com

Website: http://www.n-logue.com