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Telemedicine in a Disconnected Environment Dr Sakti Srivastava, MBBS, MS Adjunct Professor Indian Institute of Technology, Delhi.

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Presentation on theme: "Telemedicine in a Disconnected Environment Dr Sakti Srivastava, MBBS, MS Adjunct Professor Indian Institute of Technology, Delhi."— Presentation transcript:

1 Telemedicine in a Disconnected Environment Dr Sakti Srivastava, MBBS, MS Adjunct Professor Indian Institute of Technology, Delhi

2 August 06, 2008 TIDE project/ IIT Delhi / Srivastava Outline  Healthcare and Telemedicine in India  Continuing Challenges Today  Our Proposed Solution  Results and Further Work Background Challenges Solution Results

3 August 06, 2008 TIDE project/ IIT Delhi / Srivastava Healthcare in India  India spends <1% GDP on health  Urban/Rural mismatch of health professionals and population  >70% of India’s population is rural  Most lack access to basic health facilities Background Challenges Solution Results

4 August 06, 2008 TIDE project/ IIT Delhi / Srivastava Telemedicine in India  Aravind Hospitals – Teleopthamology Network  Apollo Hospitals – Aragonda Project  OTRI (Online Telemedicine Research Institute)  Asia Heart Foundation  OncoNet (Kerala)  Common Service Centers e-governance Background Challenges Solution Results

5 August 06, 2008 TIDE project/ IIT Delhi / Srivastava Telemedicine in India  VSAT based (ISRO)  Broadband based (BSNL)  High cost (setup and maintenance)  High technical expertise  Low bandwidth  Limited scalability Background Challenges Solution Results

6 August 06, 2008 TIDE project/ IIT Delhi / Srivastava Continuing challenges  Remotest of remote  No connectivity  Limited infrastructure  “Bottom of Pyramid” (<$1 per day)  Landless farmers, illiterate Background Challenges Solution Results

7 August 06, 2008 TIDE project/ IIT Delhi / Srivastava Criteria  Inexpensive and low maintenance  Easy and quick to setup  Robust and durable  Minimal new technology usage and skills requirement  User-friendly, able to cope with infrastructure  Support large datasets and scalable Background Challenges Solution Results

8 August 06, 2008 TIDE project/ IIT Delhi / Srivastava Our proposed solution  Asynchronous (Store & Forward)  Delay tolerant network (DTN)  Large datasets  Several unique features  Highly scalable Background Challenges Solution Results

9 August 06, 2008 TIDE project/ IIT Delhi / Srivastava Application overview Background Challenges Solution Results Kiosk- PC

10 August 06, 2008 TIDE project/ IIT Delhi / Srivastava Case Flow 1 Internet Region D1 (Neuro) D2 (Pediatrics) D3 (Ortho) D4 (Ortho) Dispatcher New Case Submission Path Reply from Doctor Health Care Worker Primary Healthcare Centre (Rural) Radiology Equipment DICOM Background Challenges Solution Results

11 August 06, 2008 TIDE project/ IIT Delhi / Srivastava Case Flow 2 Internet Region D1 (Neuro) D2 (Pediatrics) D3 (Ortho) D4 (Ortho) Dispatcher New Case Submission Path Reply from Doctor Health Care Worker Primary Healthcare Centre (Rural) Radiology Equipment DICOM Background Challenges Solution Results

12 August 06, 2008 TIDE project/ IIT Delhi / Srivastava DICOM Internet Region D1 (Neuro) D2 (Pediatrics) D3 (Ortho) D4 (Ortho) Dispatcher New Case Submission Path Reply from Referred Doctor Referral to another Doctor Health Care Worker Primary Healthcare Centre (Rural) Radiology Equipment Background Challenges Solution Results Case Flow 3

13 August 06, 2008 TIDE project/ IIT Delhi / Srivastava Design Overview Kiosknet Hardware DTN – Communication Infrastructure DICOM Interfacing Automatic Case Allocation Forwarding Consolidation Background Challenges Solution Results

14 August 06, 2008 TIDE project/ IIT Delhi / Srivastava Design Overview Kiosknet Hardware DTN – Communication Infrastructure Automatic Case Allocation Forwarding Consolidation Background Challenges Solution Results DCMTKCreator Decomposer GUI DICOM Viewer

15 August 06, 2008 TIDE project/ IIT Delhi / Srivastava Design Overview Kiosknet Hardware DTN – Communication Infrastructure Background Challenges Solution Results DCMTKCreator Decomposer GUI DICOM Viewer DtnReceiverDocDBSync DB NetReceiverConsolidation Sender ReceiverGUI

16 August 06, 2008 TIDE project/ IIT Delhi / Srivastava Automatic Case Allocation  Physician database at proxy  Doctor’s Name, Specialty, Location, ID, IP, address  Case specifies only specialty  Based on specialty and availability, allocation done  Any allocation algorithm can be implemented now Background Challenges Solution Results

17 August 06, 2008 TIDE project/ IIT Delhi / Srivastava Automatic Case Consolidation  Unique Case ID assigned to a case at creation  One consolidated file per case ID maintained at the proxy  Consolidated file can be retrieved from any location Background Challenges Solution Results

18 August 06, 2008 TIDE project/ IIT Delhi / Srivastava Implementation Details  Components  Hardware  Software  Databases  Application level routing  Screenshots Background Challenges Solution Results

19 August 06, 2008 TIDE project/ IIT Delhi / Srivastava Hardware Components Background Challenges Solution Results Via Box, 512MB RAM, 40 GB HDD, Ethernet, Wireless PC, Low RAM, No HDD, Ethernet, Wireless Soekris Box, 256MB RAM, 40 GB HDD, Wireless Soekris Box, 256MB RAM, 40 GB HDD, Wireless PC (P4), 512MB RAM, 80 GB HDD, Ethernet Wireless PC, 512MB RAM, 40 GB HDD, Ethernet

20 August 06, 2008 TIDE project/ IIT Delhi / Srivastava Software Components Background Challenges Solution Results Debian OS Apache 2.2, PHP 5.2.6, DICOM Viewer Mricro Debian OS dtnd, dcmtk toolkit, dhcp, nfs Creator, Decomposer (java modules) Debian OS dtnd Linux OS Apache 2.2, PHP Receiver, Sender (java modules) Debian OS dtnd Debian OS dtnd, dcmtk toolkit, dhcp, nfs Creator, Decomposer (java modules)

21 August 06, 2008 TIDE project/ IIT Delhi / Srivastava Screenshots Background Challenges Solution Results

22 August 06, 2008 TIDE project/ IIT Delhi / Srivastava Results  1 GB data bidirectional transfer  Measured time for link detection and transfer time  Time to link detection: Worst case – 10 mins  Throughput: 1 MBPS Background Challenges Solution Results

23 August 06, 2008 TIDE project/ IIT Delhi / Srivastava Future Work  SMS integration  Call allocation methods  Enable querying  Security and privacy  Utility based routing Background Challenges Solution Results

24 August 06, 2008 TIDE project/ IIT Delhi / Srivastava Acknowledgments  IIT Delhi  Prof Huzur Saran  Prof Sanjiva Prasad  Rohan Jain  Varun Sharma  CDAC  Mr B S Bedi

25 August 06, 2008 TIDE project/ IIT Delhi / Srivastava


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