The NASSCOM India Leadership Forum, held in Mumbai from February 7-9, provided eHealth the opportunity to interact with many experts, who are working in the field of ICT applications in healthcare. Dr. K. Ganapathy is a luminary known for his pioneering work in teleme-dicine. In an exclusive interview, he shared his experience and wisdom with us.
Taking a hard look at the telemedicine scenario, Ganapathy prefaced his remarks saying, “The most important advance about telemedicine is that it has come to be recognized as the key to healthcare delivery in suburban and rural areas. The realization has dawned that telemedicine, in the near future, can provide a level playing field and act as a great equalizer too.”
According to Dr. Ganapathy there are certain institutes in India whose healthcare standards and facilities are more than a match to the prevailing international standards, but the miserable fact is that their reach is limited to a few metros and elite sections of the society. “As far as healthcare in India goes, it is not a question of standard, it is a question of reach,” he stated.
A vast majority of Indians do not have access to that international standard of healthcare. It is here that telemedicine has a role to play, in bridging this divide in making global healthcare go local. “By definition, telemedicine transcends geographical barriers and makes distance meaningless, that way it is turning geography into history,” he quipped.
Elaborating on the barriers to the spread of telemedicine, the doctor pointed to many lacunae in the system, inhibiting its reach in rural India. Chief among them is the lack of awareness about new technologies, coupled with lots of scepticism towards accepting innovative ideas and technologies (a common feature in any country where literacy levels are relatively low and poverty is widespread), lack of adequate infrastructure in connectivity to transmit images, text, etc. and lack of funds to have access to good medical experts, coupled with the high cost of rare and life-saving medicines.
Despite the roadblocks, Dr. Ganapathy is optimistic of the growth and success of telemedicine in India if collective efforts are in place. “A consortium can achieve much more than individual players working in isolation,” conferred the physician.
Ganapthy called for a national policy on telemedicine to cover accreditation, certification and adherence to uniform standards. He sounded very passionate on a universal health insurance as the remedy to hasten the rate of success for teleconsultation. “Only universal health insurance can ensure that investigations and treatment follow teleconsultation route,” he affirmed.
Ganapathy claims Apollo Hospital to be a pioneer in telemedicine networking in India. “Apollo Telemedicine Networking Foundation is probably the largest and oldest multi-specialty telemedicine network of South Asia. Way back in 2000, Apollo started its telemedicine network in Aragonda village of Andhra Pradesh,” recalled Dr. Ganapathy.
“It was in March 2000 that Bill Clinton, the then President of USA, formally commissioned the world's first VSAT enabled village hospital in Aragonda, kick-starting telemedicine in South Asia”, he added. Since then there has been no looking back. What started off as a proof of concept validation by Apollo for the Indian Space Research Organization (ISRO), has turned out to be a big success story.
Elaborated Ganapati, “So far we have given 2,900 teleconsultations for the poorest of the poor sections in Aragonda and nearby villages. In the past 7 years, Apollo Telemedicine Networking Foundation (ATNF) has set up 95 telemedicine units in India and abroad.” The overseas telemedicine units of ATNF are located in Colombo, Dhaka, Maldives and Lagos among others, giving ATNF an extended reach across South-Asia. “Today, more than 17,000 teleconsultations are under our belt and ATNF has emerged as the largest multi-specialty telemedicine network in South-Asia”, he disclosed.
In the coming months, Apollo is planning a big-ticket telemedicine workshop, covering all the Indian Medical Association conferences across the country to step up awareness among the general practitioners. “This will facilitate more mobilization towards telemedicine,” informed Ganapathy. The doctor also announced that Apollo group will be adding 100 more telemedicine centers.
Noticing a new paradigm shift in favour of telemedicine, at the central level, Ganapathy observed, “There are significant initiatives from the government of India at the telemedicine front. It is a matter of pride that the Indian government has embarked on a mega project to provide teleconsultation to 53 countries in the African Union, for a period of 6 years. The best part is that the project includes tele-education also”. Apollo is an active player in this private-public initiative.
Apollo by itself is spearheading many private-public partnership initiatives in the telemedicine front. “The setting up of the National Task Force on telemedicine, constituting a working committee on telemedicine by the Planning Commission, and formation of a National Institute of Medical Informatics and Telemedicine are steps in the right direction and would boost the growth of telemedicine. Apollo is too pleased to be actively involved in all these projects,” Ganapathy affirmed.
Talking about the recent advances in the domain of telemedicine; both at the national and global levels, the doctor informed, “Many advances are taking place in acquisition, display and transmission of images, audio and text which are the sine qua non in telemedicine. Now homecare telemedicine is a reality. And mobile telemedicine includes the use of PDA. Teleconsultations aboard a ship, aircraft, prisons or a moving ambulance are routine now. Telementoring and Telesurgery with telerobotics are catching up. Even wireless telemedicine in a Wi-Max environment is going to be achieved.”
But technical advances are nothing without sustained advances in R&D. According to this techno-savvy physician, “Serious research in telemedicine is in two areas; research in peripheral medical devices which can be linked to a PC, and research for developing cost-effective transmission of images and audio files, using low bandwidth without losing data and developing of user friendly intuitive software, low cost hardware and so on.”
Dr. Ganapthy conceded, “Social, ethical and legal issues are as important as technical problems,” and added, “there is need for serious research on social issues including factors that hinder the growth and development of telemedicine; and also on issues relating to the acceptability of this technology.”
Ganapathy, who heads the Division of Stereotactic Radiosurgery in Apollo Hospitals, Chennai, ventured into telemedicine in 1999 and has risen in the hierarchy of its apex body; today he is the Joint Secretary and Treasurer of Telemedicine Society of India.He spoke about the mission of the society, as an organization committed to the growth and development of telemedicine in India.
The society has been holding annual conferences and workshops, creating effective platforms for generating awareness and dissemination of information on recent developments in telemedicine. According to Ganapathy, TSI is gearing up to organize training programmes and plans to bring out a journal. According to Dr. Ganapathy, “The TSI now represents India on the board of the IsfTeH (International Society for telemedicine and e Health).”
TSI held its first national conference in Bangalore, in 2005, which was organized by ISRO. The second national conference followed in Delhi in 2006, organized by SGIPGMS Lucknow. The third national conference of Telemedicine Society of India is to be held in Chennai, during 2-4 November 2007, with ATNF as the principal organizer.
Throwing more light on the forthcoming conference, 'TSI Chennai 2007', Dr. Ganapathy said, “The conference in November will cater to the experts as well as to the newcomers. The workshop will be limited to a small number of individuals and there will be hands-on exposure to hardware, software and various peripheral devices, used in telemedicine.”
Participants will also be able to see live teleconsultation from a hospital on wheels. “The deliberations of the conference in November, if implemented, will hopefully enable us to achieve that critical mass required for a successful take off,”he presumed.
The conference is expected to attract the who's who of telemedicine from India. “The delegates would come from the corporate sector, academic institutions, government organizations and ISRO. The vendors of software and hardware, along with manufacturers of peripheral medical devices used in telemedicine will also attend.
Since the IsfTeH conference will take place concurrently, about 40- 50 overseas delegates are also expected. They will include professors from the US-based universities, the UK eHealth association, and representatives from SAARC countries, South- east Asia and the Middle East,” informed Dr. Ganapathy.