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Healthcare IT

Making telemedicine effective in rural India

By Jianggan Li | 13 November 2009

Dr Shabbir Syed Abdul runs Surya Hospital Telemedicine Centre, a primary care facility 200 kilometres from Hyderabad, in the Indian State of Andhra Pradesh. No satellite connections, no high-definition telepresence screens, his telemedicine facility consists of a digital camera, a computer with Microsoft Excel, a dial-up internet connection and a Gmail account.

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“When I returned from my studies, I wanted to start telemedicine service to show people how quality care can be efficiently delivered by simple means,” says Dr Shabbir, who was educated in Norway. “I want to make a model of future primary care centres in rural India.”

He and his team take pictures of patient’s wounds and symptoms, then send them to a professor based in Chennai, the biggest city in Southern India, for a second opinion. He has also recently obtained the consent of another specialty hospital to offer second opinions free of charge.

“It is a pilot project and I am not taking any extra fee from patients,” he says. “Otherwise this might never take off.”

Not being able to purchase costly software to manage his patients, Dr Shabbir uses Excel file. “You need to know clearly what you want,” he says. “Then you can move ahead with whatever resources you have.”

Dr Shabbir currently receives around 15 to 20 patients a day for his telemedicine service. The number is growing and he expects this to increase dramatically once people know the benefits of having their diagnosis from an expert far away with no additional cost. “I am expecting 50 to 60 per day by next year.”

“I want to show other people you will be getting more patients by adopting such a service,” he says. “This will be a real incentive for rural doctors.”

Dr Shabbir hopes this can be a model for other primary care practitioners. “I believe this will change medical practice in rural India.”

Barriers for adoption remain. Dr Shabbir thinks they are mainly economical constraints and low awareness. He says that two years of study in Norway taught him how to appreciate such devices, while lots of primary doctors in rural India are reluctant to make such investment.

He believes the government should be sponsoring cameras and the network for rural care providers. “This will complement the telemedicine projects they are already running to include everyone,” he says.

“The most obvious benefit is that now patients would know whether they need to travel hundreds of kilometres to the nearest city for surgery,” Dr Shabbir says. “For a rural household, this means a lot.”

Talking about possible privacy concerns that images sent over a public network with no additional security measures throw up, Dr Shabbir says that he only treats villagers, not celebrities. “Images are sent anonymously,” he says. “And for poor rural dwellers, getting well to be able to work in the field again is their main priority.”

However, Dr Shabbir says getting insured should also be a priority for rural residents so that they can be less vulnerable to the costs of healthcare.

“The greatest problem with insurance is people don’t want to get insured themselves. They are not willing to pay a few dollars without seeing the immediate effects,” Dr Shabbir comments. “We should have new projects, new awareness programmes to encourage people to get insured.”