Telemedicine has made a lot of news for the wrong reasons. Partly because there has been a little understanding about the same.
I remember that in the earliest articles I had laid a case for nationwide roll out of Telemedicine. However, it has become increasingly clear to me that beyond its novelty value, there isnt much to recommend it.
At the most, people might use it for “second opinion”; this itself is dicey. In their own enthusiasm, people might be willing to ignore their own best interests. I remember a particular case who had cancer of the food pipe. Of course, the poor lady had no hope for survival; yet surgery would have given her syptomatic relief. There was of course, a difference of opinion between two consultants. It is an isolated case, but there might be many ways to approach a problem.
I am not suggesting that one ought to throw out the baby with the bathwater. I have already mentioned, the utility and a viable business model of Teleradiology. What else can it do?
It maybe possible in say screening for diseases in the periphery or for reporting the extent of the diseases. Very often, the reporting is delayed and relies on the good old postal system. It maybe possible in the future to alert the authorites to take corrective action in case there is any isolated outbreak of a disease.
It can also be used for training of the health workers in the periphery. The same equipment can be used for streaming videos or perhaps as a part of the literacy campaign- the digital projector and the computer in one unit. Of course, it would work in Linux!
How often I have wished that there were adequate facilities in the periphery. One may argue that this is possible via television- which has arguably more reach than telecom companies can hope to reach. However, these are value added services. It is possible to generate localised content and offer it as means of health education in people’s own language. Prevention is better than cure anyday. With increasing health care costs, it makes sense to educate people about the means of prevention; rather than treat them for complications.
As I mentioned about the teleradiology model, I believe that it maybe useful to access the services for radiology in the peripheral areas; digitised XRays are available. Offline loading on to a computer and hooking it up to the central database. This would facilitate diagnosis of the people suffering from various ailments. Of course, they would prove themselves to be great teaching slides.
There are various ways and means in case we wish to utilise the existing infrastructure to solve our present problems. It needs clear articulate thinking and application of mind. Not go gaga over it.
Comments are invited.
I just thought I should mention something based on personal experience.
I used to have a close friend who, after getting a medical degree MBBS from one of the best schools in India, decided to go to the US to study “preventive and social medicine”.
When asked why not practice the same directly in rural India and learn things hands-on, the answer was “You get paid so much more for working in healthcare over there”.
Do you think people like them will stay back if we give them the ability to access all that information here?
By the way I also know a doctor (yes a qualified MBBS) who works in a call centre as the pay is more, and if you ask me, I think broadband and cheaper bandwidth rates is helping the person, though not as “Telemedicine”.
I am too young to answer these questions, and I think yes the initiative should be taken to help doctors get the information they need, but ….oh well.
I totally disagree on the point made that telemedicine has un-necessorily got a hype without content.
There are telemedicine kits now made in India and for India at offordable price which serves the basic need of a Specialist consultation at remote places where our So called qualified doctors are hezitant to go for obvious reasons like money and life style.
if interested mail me for details on the kit with capabilities to conduct online Video conferencing at a very nominal cost
Hemant, please let me know how to contact you.
And dont take a moral high ground here about Doctors not going in to serve in the rural areas. There is frankly nothing there to recommend. Doctors have been campaigning to get the infrastructuire right. We cant help it when there isnt anything there.
A fresh MBBS passout is paid less than a class 4 employee.
You need to be a doctor to realise that physical contact with the patient in VERY important to elicit signs of the disease. Tele medicine cannot overcome this problem.