Objective="Improve access to cancer care and cancer initiatives in underserved areas."
Details for Reform Option "Telemedicine at Dr. B. Barooah Cancer Institute, Assam"
Telemedicine (health care delivery system where physicians examine distant patients using communications technologies) has been heralded as one of the several possible solutions to some of the medical dilemmas that face many developing countries. Telemedicine has brought a plethora of benefits to the populace of India, especially those living in rural and remote areas (constituting about 70% of India’s population).
The North East states have a far higher incidence of cancer than many other regions of the country. The region has for long struggled to deal with the large number of cancer patients. Dr. B. Barooah Cancer Institute (BBCI), Guwahati, Assam, which is one of the largest institutes in the region, has been designated as the Regional Institute for Cancer Research and Training.
But, despite the existence of institutions like BBCI in Guwahati, most of the cancer patients from the region, especially those who can afford it, make a beeline to the metropolitan cities for consultation and treatment. Mumbai is a top destination. Apart from being a huge drain of resources, it also means a great deal of inconvenience for the patients and their attendants.
But now the patient’s sufferings from cancer in the North East have expert help available at their very doorstep. A telemedicine centre has been established at BBCI on December 2003, with the following objectives:
* Improve access to cancer care and cancer initiatives in undeserved areas.
* Reduce cost of cancer care delivery.
* To standardise and ensure practice of Evidence Based Medicine.
* Export clinical expertise, increasing the availability of cutting edges cancer protocols and procedures to all affiliate facilities.
A tripartite agreement was made between the Department of Atomic Energy (DAE), North Eastern Council (NEC) and the Assam Government for funding the Dr. B. Barooah Cancer Institute. The telemedicine centre was commissioned by Indian Space Research Organisation (ISRO), Department of Space and Government of India. It was linked to Tata Memorial Hospital (TMH) and BCCI which is the referral centre for the under served North-Eastern States. It has been linked with other government referral hospitals in the region, including Sikkim. It is a server- based multi channel link. Besides, facilitating point- to point communication, it also enables forward and backward linkages.
Since May 2005 till June 2006 around 60 tele - consultations have taken place in the telemedicine centre. The details are as follows :
* Department of Surgical Oncology - 11 consultations
* Department of Gynaecological Oncology - 9
* Department of head and neck oncology -16
* Department of Medical oncology - 7
* Department of Radiation oncology - 7
* Department of preventive oncology - 2
* Programme transmitted by TMH and participated by doctors from BBCI - 1
* Official meetings (technical committee) and TMH -3
* Planning committee meeting – 2
* Other official meetings- 2
The full package of entire equipments and connectivity support in case of this facility at BBCI was provided free by ISRO and was implemented in cooperation with TMC. So no separate cost can be assigned for this particular facility.
Dr. B. Barooah Cancer Institute, Guwahati, Assam.
Improved access: Telemedicine has provided and improved access to cancer care in previously un-served or under-served areas.
Reduced Cost: The travel cost of the patients for speciality care to the premier centres, the personnel/equipment cost for not having to keep speciality care facility in rural hospitals and other costs can be reduced.
Reduced isolation: Provides a peer and specialist contact for patient consultations and continuing education. It has also been reported that colour, full-motion video is critical to the health professionals for stimulating face to face communication between colleagues in consultations and between patients and physicians.
Improved quality of care: It has allowed consultation to take place among the referring physician, the consulting physician, the patient, and the patient’s family thought interactive video with critical information of the patient being made available on-line. Telemedicine facilities allows optimal use of resources at both ends of the connectivity; saves time, energy and resources both of the patients, their families and hospitals.
Distance learning: The physicians and other personnel at remote locations can be educated during consultations with speciality physicians and other experts, increasing their ability to treat other similar cases in future.
Difficulty in Maintenance: Day to day maintenance becomes difficult if there is a lack of technical support. It can take a long time for any technical snag to be fixed.
Critical mass of patients, who will utilise the telemedicine facility; hardware software and connectivity infrastructure; technical support manpower; treaties between linking institutions with support from link providers.
Who needs to be consulted
* Tata Memorial Hospital/Dr. B. Barooah Cancer Institute, Guwahati
* ISRO, Govt. of India
* State Government of Assam & North Eastern States
Telemedicine centres are serving well in the country.
Chances of Replication
Telemedicine centres have been running in other parts of the country also. It’s a highly replicable venture. With increasing application of IT in medicine. Such venture will multiply. Apollo is already in telemedicine in a big way.
Dhrub Kumar Singh, Consultant, Central Bureau of Health Intelligence, New Delhi. October 2006.