Telemedicine Based Limb Care Clinics
We are an NGO implementing Telemedicine systems and other technology tools. These help widen the reach and decrease the cost of healthcare provision.
About You
About You
About Your Organization
Organization Name
Society for Administration of Telemedicine and Healthcare Informatics
Organization Website
Organization Country
India, DL, New Delhi
Country where this project is creating social impact
India, GA, Panaji
Is your organization a
Non‐profit/NGO/citizen sector organization
How long has your organization been operating?
More than 5 years
Has the organization received awards or honors? Please tell us about them
Our work on telemedicine has been published in a peer reviewed book see http://www.igi-global.com/reference/details.asp?ID=8260&v=tableOfContents
Our work on treatment of Filariasis has also been published - see http://www.ijps.org/text.asp?2009/42/1/22/53008
Many presentations made on our work across the globe e.g. Global Ehealth 2006 (New Delhi), EAsia(2007) Kuala Lumpur, HIMSS ME 2009(Bahrain), APAMI2009 (Hiroshima), Medinfo 2010 (Capetown), ESL Warsaw(2011), VAICON 2012 (Kochi) etc
References - Please provide two references with a two-sentence biography, email address, and phone number for each
1. Dr B S Bedi, Formerly Incharge of Telemedicine in Department of IT, Union Ministry of Information Technology and Communications. Currently retired but working as consultant with CDAC. bedi11@yahoo.com phone +91 9868243335
2. Dr Yuri Dias-Amborcar, Addional Professor of Surgery heading the Plastic Surgery unit under the Dept of Surgery at Goa Medical College, Bambolim, Goa, gmc.plastsurg@yahoo.co.in ph +91 9890065826
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Innovation
Select the stage that best applies to your solution
Start-Up (a pilot that has just begun operating)
How long have you been in operation?
Operating for more than 5 years
The Need: What problem are you trying to solve?
Lymphoedema is the 4th highest cause of morbidity in the world with over 20 million (50% of global load) in India. It is treatable but lack of knowledge of how to treat leads to neglect leading to loss of work, depression and even suicide. Care is possible but knowledge lacking. The care is prolonged but can easily be adopted in the required massive scale through an injection of Telemedicine technology. Filariasis, cancer trauma and vein diseases are the main causes
We did a project for Filariasis along with the Government of Tamilnadu between 1997- 2000 wherein our model was shown to be a working. However, telemedicine did not exist then. Constant retraining had been a problem. Clinics run by us at New Delhi(including AIIMS) as well as Maharashtra /Goa have shown viability of the idea.
The Solution: What is your solution? Be specific!
We are doing the orientation, training and providing a support system for Rural healthcare practitioners so that care is possible near the patients home. A profit sharing model has been created so that it also helps income generation as well as decrease the cost of care. Equipment and consumables to make this care possible is being provided through a wide array of agencies including Funding organizations ( e.g Rotary), companies operating in the area as part of their CSR as well as the government - e.g. in Goa. In rural Maharashtra, we have an MOU with SPANCO wherein their CSCs give us the IT infrastructure platform and our methods give them and the local entrepreneurs value addition. Thus 90 - 95% of the care will be possible locally. A support system of Surgeons is being created in the surrounding areas who will do tele consultations, prescribe antibiotics and also operate on the patients as per need thus providing the remaining 5-10% of care.
Thus sustainability is assured.
The Model: Walk us through a specific example of how your solution makes a difference; include your primary activities
Treating lymphoedema has been demonstrated to be possible and also desirable. This was based on a 1981 thesis at AIIMS wherein imported pumps and garments were used for therapy. Since the 90s, indigenous equipment was made available at far lower cost. Our results have been largely successful (ref-Ind J Plast Surg. 2009;42:22-30) and even emulated on a mass scale in Tamilnadu. Concomitant mass therapy program of DEC for Filariasis resulted in a fall in incidence in a few selected districts eg Kanyakumari but then, with change of staff and little maintenance, discontinued and the mass therapy program started failing.
The current project follows a public/private approach wherein the equipment in the form of pumps and customized garments have to be supplied alongside mass training of para medical workers and local healthcare staff on the hows and whys of using such treatment modalities. This includes leg washing, antibiotics, exercise methods, bandaging techniques etc. Regular follow up is the key which is now possible through telemedicine.
For Maharastra, SATHI has a collaboration with SPANCO to provide these facilities in the high endemicity villages where they have setup IT based Village Resource Centres (VRCs). SATHI provides training to local healthcare personnel and arrange teleconsultation with lymphologists. Our earnings are through consultancy and supply of equipment/bandages.
A test camp has been done at Shirgaon Village in Sindhudurg district. In Goa, the state government has elicited interest and shall be a partner. Plans for Tamilnadu and Odisha are afoot.
The Marketplace: Who are your peers and competitors? Identify others also working to address the needs you are and what differentiates you from them. What challenges could these players pose to your success or growth?
Starting from our own centre in 1995, now at other places too, we have showcased the results. We are already running a counselling centre at AIIMS and have done camps at hospitals in Vasai (rural Mumbai) as well as at Goa Medical College. The Goa government is looking to provide centres at three places. Our earnings are through consultancy. and supply of equipment/bandages.
Currently proper treatment is not being provided by anybody as the knowledge that it is treatable is lacking. In our case there is no competition and the market is so big that we would rather be happy to have it.
Once working it can be a win win for all but the initial outcomes and results have to be showcased to the stakeholders by small injection of funds. This competition can help us to reach out to millions.
This Entry is about (Issues)
Social Impact
Founding Story: We want to hear about your "Aha!" moment. Share the story of where and when the founder(s) saw this solution's potential to change the world.
A thesis was done at AIIMS in 1981 on this topic. It was realized then that treatment of this problem is possible. Subsequent events took many years. Growth in technology provided better solutions. Important ones being improved care techniques, as well as introduction of Telemedicine.
India is committed to eliminate Filariasis by 2015. While a control program has been started with mass administration of DEC, the results so far show that despite the control, the problem of Lymphedema persists. A morbidity control program has been initiated, but according to us, is incomplete. Authorities in Goa at least have come around to this view as they have managed to control Filariasis, but not Lymphedema. They plan to start centres in 3 places - but Goa is a very small part of India.
Over the years, improved results at our own clinic as well as at AIIMS and the camps we did, reinforced that Lymphedema is treatable and neglect by the Healthcare providers and patients is not justified.
Please describe the goal of your initiative; outline what you are trying to achieve
There are millions of sufferers of Lymphoedema. They can be better managed. Most care is possible locally but nearly life long. Knowledge of such a possibility is lacking among the patients, as well as healthcare providers. We are hoping to spread this simple knowledge that it is possible to treat the problem and very simply too. Treatment can largely be given near the patients home.
Another complicating factor is that Penicillin, the mainstay of antibiotic therapy is not so widely used, and rather feared, due a possibility of reactions. We believe and have shown this fear to be unjustified. So simple community based care supported by Telemedicine can help over 20 million sufferers of this problem in India. It is leading to depression, suicides as well as loss of earning capabilities.
What has been the impact of your solution to date?
The need is in millions but we have as yet reached only a few thousand. But wherever we have reached, the message that Lymphedema is a treatable malady - no different for Diabetes - has been imparted. Besides patients that visit us directly, the places where we have managed to create an impact is at
1) AIIMS - India's premier Institution where we are running a counselling centre
2) Goa. We did a 3 day workshop at Goa Medical College which was filmed for wider publicity by Prudent Media at the behest of the Directorate of Health Services. They now plan to start 3 dedicated centres in Goa and have asked us for help.
3) In Maharashtra, we have done two camps - one at a Cardinal Gracias Hospital in Vasai and the other in village Shirgaon in Sindhudurg district. There the impact so far is less than hoped for, as it is a private initiative with only slight support from NGOs. We are looking for an initial funding support till the outcomes are visible so that it becomes self sustaining.
What is your projected impact over the next five years?
Lymphoedema needs be recognized as a problem no different from diabetes ie it is lifelong problem but controllable.
We hope that Elephentiasis- the severe form resulting form neglect is not seen at all. Possible if the problem is detected and managed in the early stages. Lymphedema exists in many western countries from cancer and trauma etc despite them not having Filariasis. Experts there, agree that, since the patients gets advice and counselling early, it helps to stop progression.
Even if we manage to control filariasis, the approach we are advocating will remain important. Incidence of Lymphoedema in India is now increasing due to the same other causes.
Patients are there but make lifestyle adjustments & take treatment in early stages to remain healthy and active.
Winning entries present a strong plan for how they will achieve and track growth. Identify your six-month milestone for growing your impact
An avg of 2-3 meetings per mth After Maharashtra and Goa - January was in Kochi & Delhi. Next Tamilnadu.
Identify three major tasks you will have to complete to reach your six-month milestone
Task 1
Talk with Fund raisers for provision of initial seed capital and pilots. Rotary has shown interest and supported but more reqd
Task 2
Concentrate on Maharashtra as well as Goa as these have shown interest and these can be replicated elsewhere
Task 3
Test the Private model as finally it is the community who needs to care for themselves and should not be dependent on the govt.
Now think bigger! Identify your 12-month impact milestone
The needs is in millions and hence the goals are too big to think of where to stop working. We need many more partners.
Identify three major tasks you will have to complete to reach your 12-month milestone
Task 1
Get the government to understand that Penicillin is an important drug and it should be decontrolled and made available.
Task 2
Expand to Kerala and Tamilnadu - discussions have started.
Task 3
Start working in Odisha, east UP, Bihar etc
Sustainability
Tell us about your partnerships
In Goa, it is being run by STATE GOVT. A profit sharing model has been created in Maharashtra, we have managed to get donations of the equipment (from our commercial arm- AMLA MEDIQUIP) and the bandage kits (from ROTARY as well as SPANCO - which also runs the CSCs).
The local entrepreneurs are supposed to get the connectivity and charge for the care they provide.
Local surgeons are being invited to help and charge for their services. Finally MOUs are created and are going to be between the various partners themselves. After helping each place to start, we can move on to other places.
Are you currently targeting other specific populations, locations, or markets for your innovation? If so, where and why?
We are targeting affected populations in Bihar, eastern UP, Odisha,, Tamilnadu, Kerala currently but hope to expand wherever it occurs. Additional places include temple Towns (e.g. Deoghar) and where Rice field workers and fishermen are present. We are also targeting Cancer and trauma hospitals as well as health practioners working in lymphoedema affected populations. We orient them about the disease, cleaning, antibiotics, use of pump and compression bandages and the daily self-care routine.
Problems manifest especially during the Monsoon season, so we do more orientation activities then.
What type of operating environment and internal organizational factors make your innovation successful?
All of us are equal despite having an organizational structure of president, secretary etc. Since we are not directly paying anything beyond whatever earnings we garner, we respect a members right to participate or not in a particular project. We have been fortunate to find the right persons, who do give their time and effort once a commitment is provided.
We also do respect the individuals right to benefit in some means from the work that he or she is doing for the organization.
We have had a string of successes e.g. the post tsunami project (See www.sathi.org) despite being a small organization. So far most of us have spent from their own pocket and thankfully success in many of the efforts have compensated the personal investment for the few attempts which did not work out.
Please elaborate on any needs or offers you have mentioned above and/or suggest categories of support that aren't specified within the list
Use of Telemedicne technology in healthcare has so far not been appreciated as a possible changemaker. Past efforts were mostly investment heavy and promoted by the vendors with a top heavy approach. Probably they were also before time but failures have been glaring. Our own projects however have showcased that it works but a different bottom up approach is required. We can help others.
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 | 15 weeks agoShashi Gogia updated this Competition Entry. |
| 15 weeks agoShashi Gogia updated this Competition Entry. |
| 15 weeks agoShashi Gogia updated this Competition Entry. |
| 15 weeks agoShashi Gogia updated this Competition Entry. |
| 15 weeks agoShashi Gogia submitted this idea. |
