eGovernance in India

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National Informatics Centre’s Tele – CME for Peripheral Doctors through 487 CIC’s in Northeast

Posted by egovindia on June 22, 2006

National Informatics Centre’s Tele – CME for Peripheral Doctors 

[Dr (Ms.) Shefali S. Dash, Sr. Tech. Director, Ms. Naina Pandita, Sr. Tech. DirectorNational Informatics Centre,
New Delhi – 110003; email: dash@hub.nic.in]
 

Abstract:Continuing Medical Education (CME) plays a vital role in knowledge up gradation and when medical professionals are located in remote areas of the country, and then it becomes vital for them to somehow participate in these programmes.  The Northeastern part of the country has many prestigious institutions with a large number of specialists catering to the health care of the common man.  Participating in CMEs becomes a difficult task with poor or average telecommunication networks. National Informatics Centre’s network, NICNET reaches the far and remote areas of the country thus solving the problem of telecommunications. Using NICNET CME programmes were launched for doctors in the North East and
Sikkim under its Community Information Centre (CIC) programme. Using the videoconference facilities available, NIC has conducted several such sessions wherein specialists are invited to deliver a lecture on a specific topic for the benefit of doctors in these State capitals.  In addition, the specialists’ lectures are being broadcast to 483 CICs in all the North Eastern states and
Sikkim.  Doctors from Uttranchal and Lakshwadeep also benefit from these programmes.  This way doctors in the remotest areas are able to benefit from these Tele-CME programmes.
 

Introduction: 

CME programmes using the concept of “teleconferencing” is a real time and live interactive program in which one set of participants is at one or more locations and the other set of participants are at another location. The teleconference allows for interaction, including audio and/or video, and possibly other modalities, between at least two sites. In India it has been found that since many areas are very far away from medical facilities, a number of persons do not adequate treatment due to lack of contact with specialists. Also doctors in remote locations do not have access to the latest information in their field and are unable to discuss cases with their peers as well as specialists due to distances and poor communication facilities. Many parts in the Northeast as well as in other remote areas do not have access to adequate medical care. This is especially due to a hilly terrain, lack of good roads and the absence of speciality referral hospitals in the area.  Since videoconferencing effectively shortens distances, it can be a powerful tool for providing equity of health care delivery across the country. These two major applications – teleconsulting and Tele-education can provide better health care as well as training of doctors in all areas of the country.  

Community Information Centres (CICs) The North-East of
India is a land of breath-taking natural beauty. The region comprises eight states viz. Arunachal Pradesh, Assam, Manipur, Meghalaya, Mizoram,
Nagaland, Sikkim and Tripura. The hills with dense forest cover make traditional forms of communication very difficult. A vital need has been felt to extend the reach of modern day technology to the area in order to enable rapid socio-economic development and bring the area closer to the national mainstream.  With this objective in mind, the Prime Minister announced a plan for the establishment of IT facilities at the block level in the North-Eastern Region in February 2000. In April 2000, the then Ministry of Information Technology launched a project to establish Community Information Centres (CICs) in all blocks in North-Eastern States [1]The CICs were set up with the following objectives:

  • Establish IT infrastructure at Block level.
  • Create IT awareness amongst local population.
  • Provide email and web access.
  • Conduct computer based training programmes.
  • Provide citizen centric services.
  • Provide access to socio-economic databases.
  • Facilitate CME programmes.
  • Use IT tools for sustainable regional development.

 

At present Community Information Centres have been set up in 457 blocks of the North East and these were dedicated to the people of the region on 17th August 2002 by the Hon’ble Minister Shri. Pramod Mahajan.  Under this computer and communication infrastructure is being set up in each block with the centres being located in local schools, colleges or suitable government buildings. In order to ensure uninterrupted communication, the Centres are connected through a satellite based computer communication network and each CIC is equipped with a VSAT, computer systems, printers and networking equipment.NIC’s Videoconference Facilities:The network used for NIC's videoconferencing services is a SCPC VSAT link operating at 128 Kbps from each of the 206 locations. All the locations are connected to
Delhi in a star configuration. NIC is also providing videoconferencing services from many Central and State Government Ministries using ISDN lines. LAN/WAN Gateway is also installed in NIC's network to transcode between the H.323 environment over LAN and H.320 environment over WA [4].
 

Portable Videoconferencing Facility – "Anytime…Anywhere…Videoconferencing 

NIC has two portable SCPC VSATs of 1.8 m and 1.2 m dish size, which can be easily carried to any destination by air cargo within few days. Once oriented towards the satellite wherein NIC has leased transponder capacity, portable VSAT provides full duplex network connectivity at higher speeds. With this facility, videoconferencing and high speed internet access can be provided from any city / district /

village of
India in a short time. This service can be utilized to provide temporary videoconferencing service for conferences, exhibitions and other important events.
 

Voice, Video & Data Services over SCPC DAMA Network 

NIC has established SCPC DAMA network Management System at
New Delhi and has started voice, videoconferencing and high speed Internet access services in an integrated manner using a single VSAT. Using this technology, any DAMA location by simply using a handset can initiate a voice, video or data call, without the manual intervention of Hub operator. Connections are made in a mesh topology on a point-to-point basis between any nodes in the network using on demand SCPC carriers.
 

The key feature of SCPC DAMA is that bandwidth is provided to the remote VSAT only when it is required. This helps in better utilization of satellite bandwidth amongst various VSATs in a closed user network. 

SCPC DAMA NMS is like a telephone exchange in the sky, which works on circuit-switching concept. It sets up Voice circuits at 8 Kbps, Videoconferencing circuits upto 384 Kbps and asymmetric data circuits upto 2 Mbps within 5 seconds of demand by application in an automatic manner.
 

CME Programmes:As the CIC’s were being set up NIC decided to experiment in “bringing” the specialists to the doctors in North East using the existing Videoconference facilities.  These CME programmes sessions were aimed at small groups of doctors in different areas of specialization and were restricted to a brief lecture/presentation by a specialist followed by a question answer session.  In these sessions’ doctors from the Northeast were able to discuss different aspects of a disease like the diagnostic aspects, treatment and management aspects or a drug.  The 1st such session was organized in October 2001 wherein a senior Gastroenterologist, Dr. Randhir Sud was invited from
Sir
Gangaram
Hospital,
New Delhi.  The specialist, while sitting at NIC Hqrs.,
New Delhi could address the problem of Diagnosis and Management of Hepatitis A & B, areas of great interest to the doctors in the North East.  Following this, doctors from Sikkim requested a session to be arranged with Dr. Naresh Trehan, Director of Escorts Heart Research Institute,
New Delhi.  He was requested to speak on Coronary Artery Diseases.   After these two successful CME programmes sessions a schedule was drawn up to hold regular sessions. Some of the specialists invited were: Dr. U. Kaul from Batra Hospital to speak on “Balloon Angioplasty Techniques”, Dr. Sita Naik from SGPGIMS, Lucknow to speak on "Basic Serological Profile of Hepatitis Infections and the Diagnostic Tests and their Interpretation”; Dr. Bupesh Kaul from Magee Women’s Hospital, Pittsburgh, USA who delivered a talk on “Painless Labor Techniques”, Dr. Suman Bhandari from Escorts Hospital to discuss different aspects of “Stress and Hypertension” and Dr. A.K. Dutta from Kalavati Saran Hospital, New Delhi to talk on “Perinatal Asphyxia and its Management”.   A specialist was also invited from Manipur, Dr. Loukham Manglem Singh, from

J.N.
Hospital, Porompat, Imphal to discuss the various aspects of “Neonatal Sepsis”. The sessions are announced on the CIC webpage (http://www.cic.nic.in) and the minutes of each session are posted on this page enabling the doctors to note down the major issues discussed in each CME programmes session [2].For over one year NIC has tied up with SGPGI,
Lucknow to bring in specialists from that institute to conduct the CMEs for the benefit of doctors not only in the North East, but also from Lakshwadeep and Uttranchal.  These programmes are broadcast to all the 450 odd CIC’s in the North East enabling the doctors in the remotest part of the country to participate in these programmes. Questions are asked either interactively or posted a few days prior on the website or during the lecture session [3].

Some of the CME programmes that have been conducted were:

"HIV Post Exposure Prophylaxis in Health Care Workers" by Dr Renu Dutta, Professor of Microbiology,

Lady
Hardinge
Medical
College,
New Delhi"De-stress Stress" by Mr Atul Gandotra, VP, Morepan Labs,
New Delhi
"Depression in General Practice" by Dr Achal Bhagat,
Apollo
Hospital,
New Delhi "Pelvic Inflammatory Disease" by Dr Aruna Batra,
Safdarjang
Hospital,
New Delhi
 

“Congenital Malformations: before and after birth” by Dr (Mrs.) Shubha Phadke, Additional Professor,

Medical Genetics, SGPGI,
Lucknow“Principles of management of Diabetic Foot and its prevention” by Dr. A.K. Verma, SGPGI,
Lucknow.

Diagnostic Approach to Infective Diarrhea in Community & Rational Antibiotic therapy

by Dr Archana Ayyagari, SGPGI,
Lucknow
 

“Recent Trends in Management of Rheumatoid Arthritis” by Prof. R.K. Mishra, SGPGI,
Lucknow
 

“Budd Chiary Syndrome” by Dr. Kartar Singh (Director), SGPGI,
Lucknow
 

“Birth Defects of heart, its presentation and treatment” by Dr. Nirmal Gupta, SGPGI,
Lucknow
 

Respiratory distress in Children” by Prof. A. K. Baronia, SGPGI,
Lucknow
 

“Management of Acute Coronary Syndrome” by Prof. Nakul Sinha, SGPGI,
Lucknow
 

“Diabetic Retinopathy” by Prof. Kumudani Sharma, SGPGI,
Lucknow         
 

“Molar Pregnancy” by Prof.  Mandakini Pradhan, SGPGI,
Lucknow        
 

“Advances in Laboratory Technology" by Prof. Sita Naik, SGPGI,
Lucknow
 

“Pelvic Inflammatory Diseases” by Dr. Anju Rani, SGPGI,
Lucknow
 

“Dysfunctional Uterus Bleeding” by Dr. Mandakni Pradhan, SGPGI,
Lucknow

 

 

Conclusion 

These CMEs, covering a range of topics have attempted to overcome the problems faced by the doctors in the peripheral areas of the country in knowledge enhancement and upgradation. These doctors without having to leave their cities/towns can participate in these programmes to provide better health care facilities to the common man in these parts of the country with the assistance  of NIC’s telecommunications infrastructure.  

 

Bibliography 

  1. CIC website : http://www.cic.nic.in

 

  1. Dash S.S, Kumar, S. National Informatics Centre’s initiatives in Distance Education for medical professionals in remote areas of North East & Sikkim. Biennial Conference of Indian Association of Health Informatics at PGI,
    Chandigarh, 18-19 October 2002

 

3.       Dash S, Chakarborty S, Ray D, Pandita N. Health services for the common man over National Informatics Centre’s network (NICNET) Asia Pacific Telemedicine Conference, New Delhi, 25th – 26th February 2004. 

4.       NIC’s Videoconference Services website http://vidcon.nic.in/

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