Thousand-mile miracle at work

But though the state thinks telemedicine is the next frontier in public health, Maharashtra’s districts lack a credible network.

Anil Kumar Das (name changed) has only his doctors to thank for his voice. This businessman from Assam has cancer of the vocal chords, but since it is in the early stages, and therefore curable, doctors in his home state were in a dilemma. They first thought Das should undergo surgery as a one-time cure; last week they decided to administer him a three-week radiotherapy course.

It took the doctors at the Brahmaputra Diagnostics and Hospital, Dibrugarh, exactly 10 minutes to arrive at the decision, thanks to a new technology that is revolutionisng healthcare across the country: Telemedicine. Although 3,185 miles away, the doctors could not only consult head and neck specialists at Tata Memorial Hospital (TMH), Mumbai, for a second opinion, but also get Das examined by them online.

From their conference room in Mumbai, surgeon AK D’Cruz and radiologist JP Agarwal only needed to hear Das’ voice to decide that radiotherapy would work in his case. “It was necessary to see the patient and hear him speak before recommending treatment,” said Dr D’Cruz. “Telemedicine made that possible even though Das was far away. The technology saves the patient long, expensive journeys to speciality hospitals just for an examination.”

“Telemedicine makes a mockery of distances,” said Dr Sanjay Bavdekar of King Edward Memorial (KEM) hospital, Mumbai. “In rural India, where healthcare facilities and infrastructure are poor, where people have to travel long distances to reach a doctor, telemedicine has been a boon.”

Telemedicine allows even the poorest sections of society access to better healthcare. Now a cardio patient from the Khasi hills in the Northeast can get the best consultation from Bangalore’s Narayana Hrudalaya, or a tribal from the Chhotanagpur can speak to specialists at TMH.

Even as the state government thinks that telemedicine is the next frontier in public health, Maharashtra’s districts lack any credible network. The state has been slow off the telemedicine block when compared to Tamil Nadu, Andhra Pradesh, Karnataka and much of the Northeast. Despite its reputation as a premier healthcare destination, only a few hospitals in the state are tele-linked. Even some of the big-ticket private hospitals in Mumbai do not know about telemedicine.

In the city, TMH is the only hospital offering telemedicine, that too just for cancer and related ailments. The hospital is connected to 28 medical institutions across the country, including 13 regional cancer centres. It also serves two districts in the state — Derwan, with which it conducts regular teleconferencing, and Barsi, where it offers telepathology, through which patients can send their case profiles to TMH online for examination and consultation by in-house doctors, who then e-mail their recommendations.

Remote centres, however, vouch for the advantages of TMH’s online exchange. “Between 300 and 400 patients have benefited from telemedicine at our hospital,” said Farooq Wani of Srinagar’s Sher-e-Kashmir hospital, the largest in Jammu & Kashmir. “Telemedicine is particularly helpful in the winter, when our state is cut off from the rest of the country.”

It is so during emergencies, too. During the 2005 earthquake in J&K, make-shift telemedicine centres were set up in the affected areas of Kupwara and Uri and patients were treated by tapping into the expertise at the best hospitals in the country.

The link with TMH has helped about 10 per cent of Sher-e-Kashmir’s patients: A considerable number if one considers that this is only cancer-related. At the B Barooah Cancer Institute (BBCI), Guwahati, the exchange with TMH has actually helped educate and embolden doctors to try new kinds of treatment. “We are lagging behind institutes such as TMH in cancer research,” said Dr Ashok Das of the BBCI. “But talking to doctors at TMH has also updated our staff on the latest in this field.” In a few months, KEM will also offer telemedicine following a recent MoU signed between the state and the Indian Space Research Organisation (Isro). The government hospital will get connected to the four district hospitals of Beed, Nandurbar, Sindhudurg and Latur, as well as the BMC-run VN Desai hospital in the city.

“About 45 per cent of patients at KEM come from outside Mumbai, mainly from Sindhudurg,” said Dr Bavdekar, who will head the new venture. “There is a great need for telemedicine facilities in the districts.” The KEM set-up — Isro will supply the bandwidth and necessary equipment free of cost; the hospital will have to chip in with a room — is expected to serve five lakh people in the districts, including the tribal belt of Nandurbar.

Smaller hospitals and clinics in the state are hooked up to telemedicine services from outside — the Ramakrishna Mission and the Air-India hospitals are linked to Sankar Nethralaya in Chennai, while some clinics in and around Pune are connected online with the Apollo Telemedicine Network Foundation, Hyderabad.