The Karnataka Telemedicine Project was inaugurated today (April 8, 2002) by Shri S M Krishna, Chief Minister of Karnataka at a function organised at Narayana Hrudayalaya, Hosur Road, Bangalore. Dr K Kasturirangan, Chairman, ISRO, presided over the function. Dr H Sudarshan, Chairman, Karnataka Task Force on Health was the Guest of Honour. Dr Deviprasad Shetty, Cardio Thoracic Surgeon & MD of Narayana Hrudayalaya described the Tele-medicine concept and demonstrated the working of the network connecting Narayana Hrudayalaya with the District Hospital at Chamarajanagar and Vivekananda Memorial Hospital, Saragur in HD Kote Taluk.Reference ISRO Website Info regarding Inauguration of Karnataka Telemedicine Project in year 2002
In the first phase they were started in District hospital Chamarajanagar, Mandya, Tumkur, Chitradurga, Shimoga, Karwara, Chikmagalur, Gadag and Taulk hospitals at Maddur, Sagara and Yadgir. Hub centers (Centres from whom expert advice is given) identified are - Jayadeva Institute of Cardiology, ST. John’s Medical college Hospital, Narayana Hrudayalaya, NIMHANS at Bangalore and JSS Hospital at Myosre.
During 2008-09 in 2nd Phase Telemedicine centres were started at District hospitals- Kolar, Madikeri, Belgaum, Bellary, Dharwad, Davangere, Gulbarga, Udupi, Bijapura & GH Lingasagur, Raichur District. Hub centres at Bowring and Lady Curzon hospital, Indira Gandhi child health Institute, Institute of Nephro & Urology centre. ISRO was unable to continue V-SAT Connectivity due failure of V-Sat in September 2010. Later onwards telemedicine facilities are functioning through Broad band connectivity.
In 2013-14 through Keonics with the help of KSWAN connectivity from e-govrnance department connectivity established to all the centres along with new centers, they are Wenlock Hospital Mangalore, District hospital Koppal, Haveri & General Hospital Hospete. New hub centres are Kidwai Institute of Oncology, Karnataka Diabetic centre and K.R. hospital, Mysore. 34,624 patients were given expert advice through telemedicine during 2013-14.
The Indian Space Research Organisation (ISRO) has implemented the Karnataka Telemedicine Project, to bring multi-specialty healthcare, to a significant section of the rural population of the state of Karnataka, India. Technology wise, this network would be state-of-the-art and unique. This network would also serve as a model for the utilization of “Healthsat” proposed for launch in the future. In this phase the state-of-the-art “Server/Browser-based, Multi-point-to-Multi-point” type of Telemedicine System/Network (provided by TeleVital) is put into operation. This Multi-Specialty Network has a network consisting of a pool of specialty hospitals. Under this network specialty hospital for Psychiatry, Neurology, Neuro-surgery, Cardiology, Oncology, Gynaecology, Nephrology, etc provides telemedicine service to various district hospital across Karnataka.
This new era of consultation was initiated by Indian Space Research Organisation (ISRO) in the form of a Telemedicine Pilot Project in the year 2001. Later, National Institute of Mental Health Sciences (NIMHANS), Bangalore also adopted this novel initiative in 2005 to provide for the rural patients through tele-consultation.
This collaboration between National Institute of Mental Health Sciences (NIMHANS), Bangalore and Indian Space Research Organisation (ISRO) has successfully linked many hospitals across India and almost all District hospitals across Karnataka to provide tele-consultation. Thus, connectivity between non-specialist doctor at remote end (District Hospital) and the specialist doctors at NIMHANS centers has been effectively established.Reference Weblink: NIMHANS Website
Since 2014, NIMHANS has been using this tele-mentoring model with local adaptation to cater the community need of capacity building. The heart of the this model is hub and spokes knowledge sharing network linking expert interdisciplinary specialist teams located at academic medical center of NIMHANS (hub) with PCPs (Primary Care Physicians/Providers) in rural and underserved areas (spokes) virtually through virtual clinics (tele-ECHO), where experts mentor and share their expertise via patient-based learning, enabling PCPs to develop the ability to treat patients with complex conditions in their own communities (Figure 3&4).
|Figure : NIMHANS Hub & Spokes topology (Communication channels) and NIMHANS ECHO model|
Every fortnight/weekly, the remote district physicians (spokes) joined through multi-point videoconference from their workplace through their smart phone/laptop/Tablet/Desktop computers using 4G/3G Internet/broadband. Even participants can attend tele-ECHO clinics by basic mobile phone (without internet) through calling toll free number with unique meeting ID. They will be present presenting five or six case summaries in a simple semi-structured format and raised questions regarding diagnosis and management. The hub multidisciplinary team consist of an expert Psychiatrist, psychologist and psychiatry social work. During the tele-ECHO clinic, the other district PCPs would raise clarifications about the presented case and also respond to the challenge raised by the presenter. At the end of each case, a NIMHANs HUB team member would summarize, recommend and shares their recommendations on each case. The case discussions would end with a “brief didactic” by an expert on relevant topics. The curriculum topics for the didactic lectures were selected through a needs assessment consisting of a provincial needs assessment of PCPs. Each didactic lecture was followed by a short-question session for Spoke sites to ask clarifying questions related to topic.
Figure : LIVE tele-ECHO clinic by using multipoint secured connection. The remote district PCPs engaged in case discussions with NIMHANS experts through digital modes (smartphones, laptops, and tablets)
The Department of Health and Family Welfare, Government of Karnataka, has recently launched a new initiative titled “Primary Health Centre Management Information System” in 1,000 selected Primary Healthcare Centres (PHCs)eHealth Reference: Karnataka Telemedicine System in 2335 PHCs