Objective of the research was to analyze the current Telemedicine scenario and identify areas where Design Intervention was required. Our research showed us that though the main idea behind Telemedicine was to increase the accessibility of Health Care to Rural India, it has not yet reached the grass root levels. The major cause were identified as the lack of reach of Technology, Connectivity, initial investment and absence of standards and guidelines. Keeping these issues in mind a model has been proposed which focuses on increasing the reach & accessibility of Telemedicine in Rural areas.

1. Telemedicine in India
Jose K Joy, Manisha Iyer, Nikhil Dev
Information & Interface Design, 2010
Guide: Dr. Bibhudatta Baral
Abstract
Design Concept
Telemedicine is the use of Information and Communication Technology for the delivery of Health Care Services to areas where health services are below the required levels. It can be as simple as a telephone conversation between medical professionals disussing the
condition of a patient or as complicated as performing
a surgery.
Telemedicine Kiosk at Anganwadi centres:
Rural Areas
Urban Areas
Population Distribution
Doctor Distribution
By making use of the existing facilities of Anganwadi and expertise of the Anganwadi workers, telemedicine can be made
more accessible. A simple Telemedicine Kiosk can be installed in the Anganwadi Centre.
Recommended Specifications:
Objective of the research was to analyze the current Telemedicine scenario and identify areas
where Design Intervension was required. Our research showed us that though the main idea
behind Telemedicne was to increase the acessibility of Health Care to Rural India, it has not
been implemented. The major cause were identified as Technology, Connectivity, initial investment and absence of standards and guidelines. Keeping these issues in mind a model has
been proposed which focuses on increasing the reach & accessibility of Telemedicine in Rural
Areas.
Telemedicine Overview
In case the request is rejected, the routing mechanism
routes the call to next Doctor in the priority order.
Error free, reliable and secure transmission has to be
ensured. (The Hippa standards for transmission of
medical information could be used, but it should be altered according to the Indian context).
Location: Small enclosed area, with minimum noise distur- Medical report and prescription can be obtained if scanner and printer is available (optional).
bance, within Anganwadi
Operated by: Anganwadi worker, who already has basic
health care training.
Basic Equipments: Web Cam, Thermometer, Pulse, ECG,
Stethoscope ideally integrated with the Telemedicine interface.
The equipments can be handled by the anganwadi worker
with minimum training.
A stock of regular medicines are maintained in the anganwadi centres. On prescription, the anganwadi
worker gives the medicine to the patient.
In case Tests are required only then the patient needs to
travel to the PHC/CHS.
The telemedicine facility can be used to provide training
Connectivity: Router,Telephone line,ISDN, VSAT, GRAMSAT to the anganwadi staff.
Tele-Consultation: Video Conferencing with the PHC.
If the officer at PHC is busy then, The Request will be routed
to the nearby Community Health Centre or District Hospital.
1 Patient goes to Anganwadi
2 Meets Anganwadi staff
3 Leads to telemedicine room
ANGANWADI
Research Methodology
4 Staff connects to the TM network
Analysis of literature
Gaps in Literature
Identify the sources
User Experience
Implementaion Experts
Narayana Hrudayalaya
Equipment manufacturers
Apollo Hospitals
Service Providers
Manipal Hospital
Technicians
Neurosynaptics
End users
6 Does remote consultation
Patients
sponsored child-care and mother-care centers in
India, Managed by Aganwadi workers.
Each Anganwadi covers a population of 1000.
There are an estimated 1.053 million anganwadi
centers in India.
The duties of anganwadi worker are
Regular health check-up.
Immunization.
Health education.
Non-formal pre-school education.
Field work
Telemedicine in India Websites.
5 Sets up the equipment
Anganwadi is set of nation wide government
Research papers on Telemedicine Initiatives in India
Latest service delivery
models
Papers onTechnology
Issues in Implemenation
Presentations on Rural
telemedicine
General Public
Problem Identification
Technological issues
Technology is not accessible averywhere
Inefficient use of existing technology
Software interoperability issues
Primary level is not equiped
Cost of implementation
Cultural issues of people
Not effective as face to face consultation
Confidentiality and Security issues
Benefits
7 Doctor prescribes medicines
Maintenance issues
Public awareness
Government policies and political influences
Absence of proper standards & rules
Absence in Home based tele-health care
8 Anganwadi has a mini-pharma
9 Satisfied patient
Since the anganwadi workers are already trained in
conducting health check ups, they can efficiently provide assistance.
More anganwadi workers can be trained for this and
becomes an employment opportunity for women in
rural areas.
Kiosk occupies minimum space- just requires a closed
space.
No additional building cost
Care giver to patient ratio: not less than 1: 1000
Automatic Routing mechanism allows the PHC to
quickly avail connection to any of the available speciality hospitals/ doctors and makes Urgent consultation
possible
Medical training
Awareness of telemedicine at grass root level.