How Tele-Health can bring quality healthcare to remote parts of India. Government data shows that Community Health Centers have shortage of specialists varying from 60% to 100% at CHCs in NE-India. The Tele-Health solution can solve this problem to a great extent without compromising on quality. The solution enables doctors sitting in cities to treat patients in remote locations while not being tied to a studio and can use any device. The patient is not only able to talk to teh doctor and his vital parameters seen by the doctor but the prescription signed by the doctor gets printed at patient's end.

1. Shaping a World of
Health Without
Boundaries
Prakash Kumar
Director, Internet Business Solutions Group
Cisco
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2. Health Infra for North-Eastern States: Shortage
of Medical Specialists
Shortage shown as % of total requirement
States Doctors Surgeon Gyne at CHC Physician Paediatric Total Radiograp
at PHC s at CHC at CHC ians at specialist hers at
CHC s at CHCs CHC
Arunachal 25% 89% 98% 93% 100% 95% 84%
Pradesh
Assam 59% 78% 38% 83% 69% 68% NA
Manipur 0% 100% 100% 100% 100% 100% 25%
Meghalaya 0% 96% 100% 96% 100% 98% 4%
Mizoram 8% 100% 100% 100% 100% 100% 0%
Nagaland 8% 95% 100% 100% 100% 98% 95%
Tripura 0% NA NA NA NA NA 90%
Sikkim 0% 75% 50% 50% 50% 56% 0%
* 2008 figure from MoHFW, GoI http://www.mohfw.nic.in/NRHM/Health_Profile.htm
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3. Can Technology Come to Our Help for
“Health for all”?
 To provide convenient access to
delivery of health care
 To enable GP to Specialist
Consultations
 To optimize scarce specialist
expertise through innovative service
delivery models
 To improve patient satisfaction
Tele-Medicine:
•Tried since last one decade
•Doctors have to go to a Tele-Medicine Studio
•Mere video conferencing will not suffice
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4. Can we have a Solution
 Where doctor/specialist can provide service from OPD, his
office room, clinic, home (wherever s/he is without any need to
go to a studio)
 Where Doctor could use desktop PC or laptop or a tablet
 Which uses a mix of high-definition video conferencing, contact
centre, and medical device integration to virtualize the
clinician-patient encounter.
 Where patient comes to a location convenient to him/her - a
booth/room in a medical centre, CSC.
 Where a consultation is set up with a remote doctor with the
requisite skills and patient preferences (e.g. gender, ethnicity,
language etc) by click of a mouse.
 Where quality of video adjusts with bandwidth
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5. Can we have a Solution
 Where Doctor is able to see the vital parameters of the
patient and talk to him/her
 Where Doctor is able to write prescription which can be
printed with doctor’s signature on the patient side
 Where patient HER gets generated and the system is
able to integrate with HIS/Appointment scheduler etc
 Which also manages inventory of drugs and
equipments along with their AMC
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6. Cisco HealthPresence Solution
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7. Cisco Connected Health:
Three Solution Portfolios. One Secure Foundation.
Cisco Medical-Grade Network
Care-at-a-Distance Compliance and Continuing Health
and Clinical Medical Device Education and
Workflow Management Business
Collaboration
End-to-End Solutions That Address Critical
Healthcare Challenges
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8. Solution Architecture – WAN approach through Internet
INTE
Doctor RNE Remote Clinic
T
Doctor Remote Clinic
Firewall
VPN Internet Router
CUPS
CUCM
PUB
Remote Clinic
IPCC
Telemedicine EMR
Center
UC Cluster
Data Center
Broadband connectivity
Doctor VPN tunnel
Remote Clinic
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9. Cisco Care-at-a-Distance Solutions
Begin with a Portfolio of Video Solutions for Telehealth
Enable remote clinical Collaboration and Care with an end-to-end
portfolio of video and collaboration solutions
Desktop Video Mobile Telehealth
Immersive Care Team Consultations with Carts for Basic
Collaboration Endpoint Flexibility Consults and Exams
Conference-
Desktop Mobile Carts
Style
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10. Cisco HealthPresence 2.1
An advanced visual collaboration solution for Telehealth
Enable remote clinical Collaboration and Care with an
end-to-end portfolio of video and collaboration solutions
Personalized Doctor Portable Solution Bring the Patient’s Care
Consult from Remote Addressing Team, Vital Information
Location Bandwidth and Health Record 2 to
Constraints 1 the Point of Need
Immersive Deployment Informed
Experience Flexibility Decision Making
1
Third-party medical devices available only directly from its manufacturer and resellers. Not
available in all countries; 2 Requires integration with EMR
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11. Key Features - Medical Devices Integration
 Digital ECG
 Electronic Stethoscope
 Temperature Welch Allyn Spot Vital Signs
Lxi (Blood Pressure,
 Spirometer Temperature, Pulse Rate,
(ECG, NiBP, Electronic, Pulse Oximetry)
 Glucose Meter Stethoscope, Temperature
Reader, Heart Rate Reader,
 Pulse Oximeter Pulse Rate Reader)
 Heart Rate
 NiBP
 ENT Scope
 Gen examination camera AMD-2500
General AMD-3700
Telephonic AMD-2015
3M Examination ENT Scope
Camera 1 Stethoscope
Stethoscope
An architectural approach to integrating high definition
video, audio, medical devices and collaboration tools
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12. Example: Appointment Scheduling
Open EMR Medical Scheduler
EDCS-962042 (7/11)
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13. Cisco HealthPresence:
Teleradiology Integration
Access to RadSpa tool from Telerad Technologies clinical collaboration
EDCS-962042 (7/11)
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14. Prescription Management Capability
 Ability to prescribe medicines online through
ePrescription form
 Easy and intuitive prescription form allows the doctors
to quickly complete the task, reducing the risk of errors
 Database of medicines/drugs, dosages, etc. for quick
lookup
 Integration with Mobile eNotes Taker gives the flexibility
for the specialists to write the prescription by hand
 Handwritten prescriptions scanned and stored with the
patient record
 Ability to print prescription at the remote location
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15. Cisco HealthPresence– Solution Snapshot
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16. Cisco HealthPresence– Solution Snapshot
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17. Cisco HealthPresence– Solution Snapshot
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18. Cisco HealthPresence - Solution Snapshot
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19. Cisco HealthPresence - Solution Snapshot
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20. Cisco HealthConnect - Solution Snapshot
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21. Multi-Point Consultation
 Patients can be referred to
other doctors, no matter
where they are to have
patient-GP-Specialist
conference, on the fly
 Cisco HealthPresence on a
mobile cart allows the
remote specialist to consult
with patients at their bedside
Patient
Exp Film
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22. Other Usage (apart from Tele-Consultation)
 Training of staff who need not leave PHC or CHC
 Continuing Education (Refresher courses for
doctors/ANMs/ASHA etc)
 Tele-radiology
 Tele-monitoring
 Psychiatric consultation
 Administration (inventory management of medicines,
vaccines, medical equipments etc)
 Creation of EHR
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23. Business Models
 (1) Where government buys the platform and runs and
operates it.
 (2) Government buys Telemedicine as a service where
service provider brings platform, connectivity, end
equipment and trained paramedic for each center
(2A) Doctors provided by State Government Health Department.
(2B) Doctors provided by the Service provider
 SLAs could be worked out
 Payment on monthly basis based on uptime, SLA etc.
Keeping in view huge investment some upfront
payment may be required.
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25. Experience
 Cisco Health Presence is deployed in 20 Primary
Health Centers (PHC) across 2 states (Karnataka
and Madhya Pradesh)
 2100+ remote consultations in less than a year
 Solution Reach – 16 Lakh people
 Solution is operational from -Nov - Dec 2011
 Central Site i.e. Data Centre is at Cisco Bangalore
 Doctors are provided by State’s District Hospital
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