After painstaking research in labs and on the field, ReMeDi was born. This remote medical diagnostic solution enabled doctors to videoconference with patients who came to seek their services through Internet centres set up in the villages. Innovative technologies developed by TeNeT helped to bridge the last-mile gap. Doctors could remotely view the output of probe-fitted medical equipment like electro-cardiograms (ECG), blood pressure monitors and stethoscopes administered by the local operators, store and analyse medical records online, as well as prescribe medicines. In all, it was almost as if the patient and doctor were sitting across a desk.

It was not all about technology though—the duo had to build a viable business model that split up the health care delivery model into various levels ranging from the doctor to the local Internet centre operator to the pharmacists and diagnostic labs, and ensure that it was profitable for them all to stay in business. Plus, they had to change the firm cultural mindsets of people to make them accept a local operator as a healthcare practitioner. ReMeDi is now being used in states like Uttar Pradesh, Bihar and Tamilnadu, and also being piloted in other countries.

Madurai-based Aravind Eye Care is a highly-reputed institution in India. It is known for its research as well as expert panel of doctors who have treated several seemingly-hopeless cases. More than anything else, they are known for their reach at the bottom of the pyramid, all over the country. While they used to cover this population through eye camps in the past, now they have turned to telemedicine as a more permanent solution. Dr S. Aravind, director of Aravind Eye Care, reasoned in a recent interview, “We realised that camps happen when we choose them to happen, not when the disease happens.”

They then set up several vision centres to reach out to a population of 50,000. Since the localised communities could not afford to appoint ophthalmologists, Aravind posted their own technicians to handle the centres. This gave them the idea of connecting the centres with the base using telemedicine technology from the University of California, Berkeley. They now have about 32 centres connected on a hubsand-spoke model to the base using broadband services available in the areas that they operate in. They have their own telemedicine software, for example, Adres for diabetic retinopathy and EyesTalk to maintain medical records. With these and other solutions, Aravind’s doctors sitting in a clinic in the town of Theni are able to treat a villager in Aandipatti, a tiny dot in the map, who seeks consultancy through a wireless videoconferencing facility.

Last month, the Nanavati Hospital in Mumbai adopted eUNO R10—a mobile ECG application launched by Maestros Mediline Systems, a maker of high-tech medical equipment, in association with Vodafone. eUNO R10 enables cardiologists to monitor patients’ ECG reports on their BlackBerry smartphones. The instrument helps to diagnose and treat heart attacks almost immediately. Without such a mobile diagnosis, the symptoms of a heart attack could easily be mistaken for that of angina, which could turn out to be fatal.

More players in the field
Patho-India is an online community that has garnered over 2300 pathologists since its inception by Dr John Marshall Johnson in 1999. It has been working on tele-pathology at an academic level since then. Recently, it has launched Telepathology India—a telemedicine service that offers free tele-pathology consultancy. Pathologists can send in their slides for a second opinion, which are reviewed by an expert panel of pathologists.

Ahmedabad-based Medisoft Telemedicine offers a range of services including Tele Doctor, an integrated desktop telemedicine application; eHealthopinion, a Web-based telemedicine application; Medisoft Web conferencing, a suite of collaboration tools for education as well as joint consultation; and Medisoft mhealth, a mobile phone based telemedicine system.

eHealthopinion is a classic Web 2.0 application. It serves as a medium to connect patients with doctors as well as other experts across the world. Since its launch in 2007, 285 doctors and 100 hospitals from 46 countries have registered. Patients with a wide variety of problems ranging from minor throat pain to complicated neurological is-sues have registered their cases and received opinions from the respective experts.

Tele Doctor, a clinical telemedicine system, is their flagship product that is being used by clients in eleven countries including India, Pakistan, Cameroon, USA, Nepal, South Africa, France, Israel, Nigeria and Tanzania.

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