Telemedicine in a supporting role

Presented by Dr S B Gogia President SATHI (www.sathi.org) gogia7@gmail.com

Abstract
Telemedicine projects have not had the desired impact as projected by their promoters. Though there are many reasons for this, one of the main ones had been that telemedicine was given too much primacy and largely seen as an end in itself.. We believe that telemedicine should be a slave and fit into the particular needs of a project. Proper implementation and planning are to be the key drivers of the project along with orientation and relevant capacity building. In the past SATHI1 achieved success in telemedicine by doing extensive preliminary work on how to leverage telemedicine with the existing needs of the disaster affected population. Needs Assessment, planning, along with training and orientation of the stakeholders was a big factor which contributed to success. Currently we have two projects which are just starting and we expect some outcomes to be available by the time the conference takes place.

a) Supporting Eye care in the Northeast.

The plan is to create fixed vision centres in the periphery which are equipped with all requisite equipment like Eye charts, Slit Lamp, Computer and Net connectivity etc. Telemedicine trained Ophthalmic assistants will select patients for surgery as well as provide medicines in consultation with Eye surgeons from the district hospital. They will send them in groups for required surgery and then do the follow up care like providing spectacles as well as suture removal and dressing etc. More than the equipment and technology, the emphasis is on proper training and hand holding to get the project going.

b) Lymphoedema care in Coastal Maharashtra

Lymphoedema after Filaria as well as Cancer is an important problem with over 25 million affected persons in India. Other causes include, limb trauma, repeated infections as well as idiopathic. Sadly it is largely treatable, but has mostly been neglected due to lack of knowledge on how to do it. It rarely causes death although the cosmetic disfigurement does lead to suicidal tendencies. Treatment however has to be lifelong sometimes making it similar or actually less worse than diabetes and hypertension. SATHI will be providing equipping health workers in areas close to CSCs (Common Service Centres equipped with Computers and Internet facilities) with the relevant equipment and training to diagnose as well as treat patients with Lymphoedema. Local surgeons will largely oversee the care and do the requisite procedures as and when required. Online education, counseling, and discussions will be a constant retraining and motivating factor. A tie up has been obtained with the company running CSCs in Maharashtra currently but we plan to expand with such centres across the endemic areas across the country in collaboration with suitable NGOs. An initial orientation and training centre for post cancer patients has already been started at AIIMS in association with volunteers from Rotary. 1Book Title Cases in Managing eServices Chapter Title Providing Tele mental health services after disasters based on the Post Tsunami experience Editor Ada Scupola, Roskilde University, Denmark Publisher IGI Global Pennsylvania, USA, See http://www.igi-global.com/reference/details.asp?ID=8260&v=tableOfContents Published in the inaugural issue of Ehealth magazine