| A B Sivasankar |
The poor ratio of radiologists to the country’s population is accelerating the necessity for telereporting and helping radiologists report more studies per day, enlarging the scope of healthcare. Teleradiology as a concept is slowly gaining acceptance by the same people who initially perceived it as a threat to their practice. We find a majority of present day Indian radiologists telereporting radiology studies in methods that are not compliant with international standards and practices.
Health Information Portability and Accountability Act (HIPAA) ensures that the patient`s health information is protected while allowing the flow of health information to provide and promote high quality healthcare. In India, where there is no enforcement of HIPAA, non-standard technology, designed and created by local vendors, are being used for tele-reporting. Some of the popular tele-reporting techniques are through e-mail attachments, dropbox.com etc., which being highly insecure, violate HIPAA. In Western countries, these methods of reporting are punishable by law.
The high investment cost on technology (both software and hardware) is a major reason for radiologists to look at cheaper solutions which end up compromising the quality of care and the privacy of the patient. Although hardware costs have dropped substantially, the cost of bandwidth is still high and network infrastructure more oriented towards urban rather than rural localities. More advanced 3G/4G technologies will help in making high quality, and cost effective bandwidth available in rural areas where the number of radiologists is abysmally low as a ratio of the general population.
Integration of the radiology workflow with a telemedicine platform, plus the addition of smart medical devices which monitor the patient`s vital parameters like ECG, pulse, BP, temperature and heart beat using an electronic stethoscope is an important development in the healthcare scenario. The patient can also upload the radiology scan/study images (both DICOM/JPEG), which will enable the teleconsulting physican located anywhere in the globe to decide on the future course of medication for the patient. The teleconsulting physician could also be a teleradiologist , from whom the patient can get a second opinion on his/ her case.
The Cisco Health Presence (CHP) integrated with Teleradtech`s radiology work flow software, RADSpa is a unique platform which includes the above feature as a value addition to the remote patient-healthcare delivery system. Teleradtech has deployed this integrated technology in few remote centres of the country. The solution combines a high definition video and advanced audio platforms coupled with the patient`s medical data to create an environment similar to the one a patient experiences when visiting a doctor. The system is flexible with minimum infrastructure and dedicated space. It can be set up anywhere, a village`s public health centres (PHC), corporate offices, homes, mobile medical vans etc.
Telmedicine modules can be one to one tenant (point to point) or one to many tenants or multi-point enabling concurrent sessions with a robust monitoring solution for hardware and application failures. The product is highly secure and HIPPA compliant. A user friendly interface with the option to integrate the hospital information systems (HIS), lab information system (LIS) or electronic medical records (EMR).
Few states like Karnataka, Madhya Pradesh, Maharashtra etc., have set up teleconsulting units to reach out to population living in Tier-II and Tier-III cities. This needs to be extended to all states through the public private partnership (PPP) or corporate social responsibility (CSR) models. Active government support by taking the local population into confidence through awareness programmes and health camps is required.
All these measures combined with uninterupted internet connectivity and power supply will help to create a medical revolution, uplifting the quality of life of millions of Indians.