India has a population of 1 billion plus and more than 70% of its citizens still reside in villages. In numbers this will be around 700 Million or more and what is striking, is the dismal state of healthcare facilities for a majority of this population. There is a huge supply gap in the health care delivery system be shortage of hospitals , doctors, nurses and associated medical infrastructure. According to the Planning Commission, India is short of 600,000 doctors, 1 million nurses and for every 10,000 Indians, there is barely one doctor available. More interestingly the majority of the available healthcare facilities are concentrated in urban areas only.
The problem is quite acute and a silver lining on the horizon is the concept of ‘Telemedicine’. The US Food and Drug Administration defines Telemedicine as “The delivery and provision of healthcare and consultative services to individual patients and the transmission of information related to care, over distance, using telecommunications technologies. Telemedicine incorporates direct clinical, preventive, diagnostic, and therapeutic services and treatment; consultative and follow-up services; remote monitoring of patients; rehabilitative services; and patient education.”
According to various research reports, India's Telemedicine market is worth US$ 7-8 million and is estimated to grow at a CAGR of around 20-21 percent over the next 5 years. India will also see a significant rollout of new IT infrastructure during the next five years in both the public and private sectors. In a country where penetration of mobile subscribers is predicted to cross 1 Billion by 2014 there is definitely a hope for the concept of Telemedicine to be adopted. Telemedicine can definitely bridge geographical distances and provide remote consultancy to sites where access to quality healthcare is difficult to reach. The telemedicine platform can be used in a variety of applications like , Second /Special Opinion through Remote Consultation, Disaster Management , Virtual Patient Visits , Setting up Healthcare Knowledge Base , Administering Tele-mentored Procedure / Surgery and many more. For rural masses in India, this delivery model of health services is more of a necessity than an experiment.
Modern Healthcare Touching Lives
Major players in this sector are; The Apollo Telemedicine Enterprise Ltd. , Narayana Hrudayalaya, Asia Heart foundation and Escorts Heart Institute. Government hospitals also providing similar services are AIIMS Delhi, PGI Chandigarh and SGPGI Lucknow. The primary consultation is being provided in Tele-pathology, Tele-radiology, Tele-ophthalmology, Neurology, Cardiology, and Rheumatology etc.
While searching for information I came across the fact that The Apollo Telemedicine Enterprise Ltd. is the largest telemedicine provider in India in the private sector. Apollo Telemedicine Networking Foundation (ATNF), a not-for-profit organization, is a part of the Apollo Hospitals Group. ATNF has emerged as India's single largest turnkey provider in the area of Telemedicine with over 125 peripheral centers including 10 overseas. Apollo Telemedicine has been operational from more than a decade. It has provided about 71 thousand telemedicine consultations in 25 different disciplines, so far. They are even one of the tele-consultation providers for Pan-African e-Network initiatives. Similar cutting edge medical solutions are being provided by Apollo Hospitals group across the breadth of country and even overseas - http://www.apollohospitals.com/cutting-edge.php .
Things to come
Very recently I came across a news article in Economic Times ‘IITian Amit Bhatnagar quits Hollywood to design lab in suitcase’. Amit has designed a portable biochemistry laboratory, which comes packed in a suitcase and can perform 23 crucial medical tests including for kidney, liver, heart, anaemia, diabetes and arthritis. The lab includes devices like blood analyzer, centrifuge, Micro pipettes, incubator, Laptop with Patient Data Management Software and consumables.
General Electric (GE) has developed low-cost ECG machines in India that are capable of taking digital images that can be emailed to cardiologists. Another example is 3nethra from Bangalore-based Forus Health. 3nethra is a portable, non-invasive device that helps in early detection of eye diseases like cataract, diabetic retina, glaucoma and cornea related issues. The digital information taken by 3nethra can be easily transmitted electronically. On the similar lines we will see enough gadgets available at home to check blood pressure, blood sugar, ECG, oxygen saturation, even ultrasound that can help in early detection of lifestyle diseases like diabetes, cardiac problems and emergencies as well.
The Telemedicine program has its own share of challenges which range from lack of awareness, poor infrastructure, absence of proven business model, shortage of trained manpower, lack of common standards and legal issues etc. In spite of these hurdles the potential of e-health, telemedicine, cloud based health services have an undisputed potential to touch millions of lives.