Tele-Health-Newsletter August2023

Telehealth Newsletter

Official Newsletter of Tamil Nadu Chapter of Telemedicine Society of India

What is New?

August has been a pivotal month for India’s Telehealth landscape. Here are some noteworthy developments:

1. On 3rd August, the National Medical Commission approved the updated Telemedicine Guidelines as part of the Ethics and Medical Registration Notification.

2. The DIGITAL PERSONAL DATA PROTECTION ACT (DPDP) received Parliament’s nod on 13th August.

3. Despite these advancements, the Indian government remains hesitant to legislate e-pharmacies.

In response to significant opposition from the medical community, primarily concerning the prescription of generic medicines, the Health Minister paused the Ethics and Medical Registration Board Notification. While issues around generic medicines are being addressed, it is anticipated that the telemedicine guidelines will remain intact. We encourage our members to familiarize themselves with the notification. Key topics such as patient consent, the role of healthcare workers, follow-up consultations, and clarity on medication dispensation via tele-consultation have been elaborated upon.

This edition offers a concise overview of the Personal Data Protection Act, an insightful article on the ethics of ChatGPT and an article on patient perspective of Psychiatry, and more.

We cordially invite you to register for TELEMEDICON2023 and eagerly await your abstract submissions.

Thank You
Dr. Sunil Shroff
Chief Editor
President – TN Chapter – TSI

ChatGPT and Ethical Issues

Dr. K. Ganapathy
Distinguished Visiting Professor IIT Kanpur | Distinguished Professor The Tamilnadu Dr MGR Medical University | Emeritus Professor National Academy of Medical Sciences | Adjunct Professor, SIPA Columbia University | Director Apollo Telemedicine Networking Foundation &, Apollo Tele Health Services

ChatGPT (Chat Generative Pre-Trained Transformer) is an AI chatbot developed by OpenAI and launched on November 30, 2022. Eventually ChatGPT could be a major integral component, in a doctor’s training and armamentarium. For this to happen, real time and continuous retraining is mandatory. This implies updating with accurate, reliable, unbiased data from the real world of healthcare. The ability of ChatGPT to think, analyse and behave like a healthcare provider in 2030 would certainly be much more related to the then real world. Understanding the complex relationships between different co existing clinical conditions and different management strategies alone is not enough. Also to be taken into account is the patient’s specific desires and unfortunately his/her socio-economic status. In a publication “When Doctors Use a Chatbot to Improve Their Bedside Manner” the authors point out that doctors were asking ChatGPT to help them communicate with patients in a more compassionate way. In fact, an emotional letter generated by ChatGPT made an insurance provider reconsider the original decision of denying benefits ! Users may also blindly trust ChatGPT due to its incredible capabilities. Potential for bias and discrimination in the initial training material used, in creating ChatGPT, may generate outputs that reflect and perpetuate these biases. This could lead to unfair treatment or negative consequences for specific groups. Regular audits, ongoing monitoring, and adopting fairness-aware, Machine Learning techniques, are necessary. ChatGPT unfortunately may even have the potential to propagate disinformation. Training data is essentially from pre-2021, not taking into account the considerable progress since then. Ethically, even the predominance of whites constituting the ethnic composition of the OpenAI team has been questioned !! Meticulous attention to data privacy, quality and quantity, security, regulations, integration with existing systems and ensuring constant human oversight are bothersome ethical issues. Though ChatGPT can generate human-like text, at present it does not have the ability to think, reason, or understand the context of the information generated. ChatGPT adheres to European Union’s AI ethical guidelines, concentrating on human oversight, technical robustness and safety, privacy and data governance, transparency, diversity and non-discrimination, societal and environmental well-being, and accountability. Healthcare in the next decade could be totally different. New codes of conduct need to be evolved. An AI influenced Hippocratic Oath may well be called “The Robocratic Oath”. Would not deploying AI be considered malpractice? Machines, like humans, can also commit errors. “To err is ChatGPT, to forgive is human”. This would be the adage of the future !!

Vikrant Mittal-Rahul Talwar

Patient’s Perception of Telepsychiatry in India


Dr. Vikrant Mittal
MBBS, MD (Psychiatry), MHA, FACHE, FAPA
Rahul Talwar
BA, MSc. Clinical psychology

Background:

Telepsychiatry services had been growing pre-pandemic but was sporadic and scattered in India. After the COVID-19 pandemic telepsychiatry has led to integration of telepsychiatry services into many clinics and hospitals across India. This has led to a shift in the model of telepsychiatry services toward contemporary views of integrated care (collaborative care model) and transition consultation clinic models (Naik et al., 2020). Dynamic changes in the field affect both clinicians and patients. Psychiatrists and healthcare systems will be better able to customize their approaches in order to respond to the patient’s perceived needs if they are aware of the patient’s perspective on telepsychiatric services.

Progress:

There are various facets of telepsychiatry that have been studied in multiple areas from patient perspective. Few of those are discussed here.

Acceptance: The privacy and easy access to telepsychiatric services have resulted in over 90% of patients reporting “very much” and “high” acceptability of them. However, these reports of satisfaction and acceptability are only in online follow-up sessions. These results indicate the need and effectiveness of transition consultation clinic models. (Das, 2020)

Cost-Effectiveness: Both integrated care (collaborative care model) and transition consultation clinic models of telepsychiatry were found to be economically sustainable in a study by Moirangthem et al. (2017). The same study also states that in comparison to tertiary care facilities and community outreach programs, telepsychiatry implementation cost are anywhere from 4 to 50 times more economically, depending upon individual practitioner’s pricing and other socio-economic determinants. Additional benefits felt by patients and practitioners are an increased frequency of consultations, with a reduced consultation time which also leads to better monitoring of symptoms and drug titration.

Barriers: A practitioner who cannot speak the patient’s language or dialect causes a lot of misinformation and miscommunication between the parties. This causes frustration, and hampers therapeutic alliance. An alternative to this is having an interpreter present within the session. This is generally not preferred by patients. A study showed that instead of conversing with an interpreter, patients preferred to use teleconsultation with a psychiatrist who is located far away and speaks their original tongue, an option made easy through telepsychiatry. (Mucic, 2008)

Age-based perspectives: Children and adolescent populations view technology-assisted consultations as novel and intriguing. They also proved to be more proactive in the telepsychiatry process and appreciated the sense of control that it offers to a patient (Boydell et al., 2010). Furthermore, the parents also reported increased satisfaction as they did not have to skip work to take their child to a clinic. However, patients of geriatric populations reported hesitance to an almost non-modifiable level with respect to telepsychiatry services. (Gardner et al., 2015)

Conclusion:

Patients’ perception towards psychiatry/ psychotherapy may be hesitant in the beginning. Yet it is progressively positive, especially in transition consultation clinic models. It is increasingly used for providing psychological services in disaster areas, rural, semi-urban areas. Thus, this model of providing psychiatry/ psychology services/ practice has the most beneficial effects for both patients and clients.

References:

Boydell, K. M., Volpe, T., & Pignatiello, A. (2010). A qualitative study of young people’s perspectives on receiving psychiatric services via televideo. Journal of the Canadian Academy of Child and Adolescent Psychiatry, 19(1), 5.

Das, S., Manjunatha, N., Kumar, C. N., Math, S. B., & Thirthalli, J. (2020). Tele-psychiatric after care clinic for the continuity of care: A pilot study from an academic hospital. Asian Journal of Psychiatry, 48, 101886.

Gardner, M. R., Jenkins, S. M., O’Neil, D. A., Wood, D. L., Spurrier, B. R., & Pruthi, S. (2015). Perceptions of video-based appointments from the patient’s home: a patient survey. Telemedicine and e-Health, 21(4), 281-285.

Moirangthem, S., Rao, S., Kumar, C. N., Narayana, M., Raviprakash, N., & Math, S. B. (2017). Telepsychiatry as an economically better model for reaching the unreached: A retrospective report from South India. Indian journal of psychological medicine, 39(3), 271-275.

Mucic, D. (2008). International telepsychiatry: a study of patient acceptability. Journal of Telemedicine and Telecare, 14(5), 241-243.

Naik, S. S., Manjunatha, N., Kumar, C. N., Math, S. B., & Moirangthem, S. (2020). Patient’s perspectives of telepsychiatry: the past, present and future. Indian journal of psychological medicine, 42(5_suppl), 102S-107S.

Pavithra

Government Reluctant to Formalize Online Drug Sales

Dr. Pavithra
Assistant Editor, Medindia.net

In a significant setback for the ePharmacy sector, government officials have displayed reluctance in formalizing the online sale of drugs and medications. A meeting between industry representatives and officials, held at the office of the Drugs Controller General of India (DCGI), aimed to address concerns related to the regulation of ePharmacies.

Insiders familiar with the matter have revealed that the government remains unconvinced by the proposals presented by ePharmacy representatives and intends to maintain the current state of affairs. A high-ranking official stated, “The government is not inclined towards endorsing ePharmacies; instead, they wish to maintain the current mode of operation. The government has informed them that the sector will not be formalized in its present structure.”

Prioritizing Safety and Authenticity in ePharmacy Sector

This discussion followed a previous interaction between ePharmacy stakeholders and Health Minister Mansukh Mandaviya earlier this month. The government’s primary objective in regulating online drug sales is centered around mitigating risks such as the circulation of counterfeit medicines, addictive narcotics, and potential national security concerns.

During the meeting with leading ePharmacy entities, Mandaviya expressed reservations about the existing model of online drug sales and stressed the necessity for enhancing the approach to address these concerns. Prominent companies such as Tata 1mg, Netmeds, Amazon, Flipkart, Practo, Apollo, and PharmEasy were among the participants.

To combat illicit online drug sales, the health ministry is reportedly planning to introduce a national portal for ePrescriptions. It is anticipated that doctors will be required to register on this platform to provide online prescriptions, thereby enabling patients to purchase their prescribed medications.

The government’s aim is to discourage the misuse of prescriptions by implementing an ePrescription network for the online sale of drugs and medicines. “The government envisions a Zomato-Swiggy model for medicine delivery, where delivery personnel would collect medicines from physical stores and deliver them to customers.

E-pharmacies can lead to potential drawbacks such as misuse of antibiotics, lack of proper medical recording and potential ethical legal concerns. Earlier this year, the ministry issued notices to 31 firms for selling medicines online without the necessary permissions.

The government’s commitment to regulating the online pharmaceutical sector stems from its dedication to ensuring the safety and authenticity of medications accessible to consumers. However, the potential drawbacks outlined above highlight why some doctors are wary of ePharmacy and its potential impact on patient care and safety.

As deliberations continue between ePharmacy stakeholders and government officials, the future of the online drug sales industry remains uncertain.


dr.shrof-dr.Krishanga

E-Pharmacy: Why Is India Still Waiting to Legalize Its Regulation?

Dr. Krishanga Srivastava
Associate Editor, Medindia.net

Dr. Sunil Shroff
President, Tamil Nadu Telemedicine Society of India | Consultant Urologist & Transplant Surgeon

In a world racing towards digital dominance, where convenience wears the crown and efficiency holds the scepter, the concept of e-pharmacy is seen as the logical next step. However, in a stark demonstration of how the regulatory system struggles to keep pace with ongoing technological advances, the state of the Indian pharmaceutical industry has been in a turmoil carrying the legacy of the past and unable to make the change to embrace the future.

The problem stems from the fairly big underground market of counterfeit medication, ease of purchase of prescription medicines in India and unqualified quacks practicing as doctors.

Is India Compromising the Healthcare Sector?

India’s healthcare sector is subject to complex regulations to ensure the quality and safety of medications. Age old practices refer to the manufacture, sale, and distribution of drugs. But with the rise of online sales, these laws lack any clarity and falter in handling the complexity of e-pharmacies, sending the regulators into a legal spin.

The lack of a clear rulebook has created a series of problems for e-pharmacies. Chief among these are the locations of the search results. Under current legislation, pharmacies must have a physical infrastructure. This stifles innovation for e-pharmacies and stalls their development. It’s like telling a digital virtual object to stay in the physical realm, and they miss what’s really important.

The interstate drug trade is another quagmire. State laws mean that drugs that are legal in one region can be illegal a few miles away. This legal confusion not only confuses consumers but also cripples e-pharmacies in the legal conundrum.

The economic side is equally murky. While some laws only require payment upon shipment, countless online payment methods tend to work outside these limitations. This confusion enhances concerns about liability and consumer safety, putting buyers and sellers in dangerous situations.

Immediate concerns involve the sale of prohibited Schedule H and X drugs. These drugs should be strictly regulated, but e-pharmacies have the danger to open the door for its abuse. The potential for online re-use of a prescription highlights the need for rigorous checks and random audits by oversight committee.

Verifying patient identities is another glitch. The online realm struggles to authenticate prescriptions, risking the sale of prescription drugs without medical oversight. And with no regulations barring sales to minors, the threat to public health multiplies.

Even as the standard rules have been around for years, brick-and-mortar establishments continue to compete with digital entrants. Reports say that delivering drugs home disturbs legitimate concerns and threatens their turf. However, disruption in others sectors too has changed the way business is done and pharmacies should be ready to accept these challenges.

One solution to check for quality and also improve supply chain would be to use bar codes on medication packaging. This could easily be implemented and ease many concerns of patient safety.

While e-pharmacies promise to democratize healthcare, especially in remote locations but the lack of cold-chain logistics if required, can limits accessibility, leaving this section of the population unserved.

It’s time India recognizes tech’s power and the potential of e-pharmacies and this will require a foolproof regulatory framework, not just for progress but also to create access to the last mile. The digital age craves modern solutions, not archaic rules. The government must champion innovation, support technological advances, and find the right balance between regulation and advancement with an overall objective for a safe, efficient, and affordable healthcare for all.

Forecasts have already predicted India’s e-pharmacy sector having touched Rs 25,000 crore in 2022. The urgency for clarity prodded FICCI to push for e-pharmacy regulations, calming stakeholder jitters. Sector specialist Dr. B R Jagashetty insists the government should hasten the finalization of these rules.

E-Pharmacy’s Legal Framework

Few key areas for e-Pharmacies include the following:

  • Only registered pharmacies can sell medicines.

  • Certain drugs need valid prescriptions.

  • Exporting medicines is illegal.

  • Registered practitioners can only sell on prescriptions.

  • Selling prescription drugs to minors is forbidden.

  • The sale of banned drugs is strictly prohibited.

The Flawed Draft of E-Pharmacy Rules

Draft rules from 2018 cover e-pharmacy operations, like registration, distribution, and inspection. But, they’re flawed.

  • They don’t tackle prescription verification or misuse.

  • Privacy and storage concerns loom large.

  • The government’s role in customer data remains hazy.

  • The draft misses the privacy policy display and customer data retention guidelines.

In conclusion, e-pharmacies could reshape healthcare accessibility and affordability. Robust regulations are vital for safety and function. Stricter licensing, verification logos, barcoding, digital data storage, and integration with health schemes would go a long way in making it a safe way forward.

There is an urgent requirement for the government requires to invest more in cleaning up the current state of how the physical pharmacies operate. No pharmacy should dispense drugs without a valid prescription and all counterfeit drug operations need to be stopped.

Given our reliance on e-commerce and events like COVID-19, we require clear e-pharmacy rules. By studying global models, India can regulate e-pharmacies smartly, reaping the benefits while securing public health and accessibility.

But unless the government acts on this draft and indulges in further meaningful deliberations, we will never be able to regularize healthcare and instead of promoting good health in the community, we might end up granting them access to dangerous drugs including narcotics and dangerous prescription drugs.

Source: Medindia.net

Salient Features of the Digital Personal Data Protection Bill, 2023

The Bill provides for the processing of digital personal data in a manner that recognizes both the rights of the individuals to protect their personal data and the need to process such personal data for lawful purposes and for matters connected therewith or incidental thereto.

  1. The Bill protects digital personal data (that is, the data by which a person may be identified) by providing for the following:
    1. The obligations of Data Fiduciaries (that is, persons, companies and government entities who process data) for data processing (that is, collection, storage or any other operation on personal data);
    2. The rights and duties of Data Principals (that is, the person to whom the data relates);and
    3. Financial penalties for breach of rights, duties and obligations.

The Bill also seeks to achieve the following:

  1. Introduce data protection law with minimum disruption while ensuring necessary change in the way Data Fiduciaries process data;
  2. Enhance the Ease of Living and the Ease of Doing Business; and
  3. Enable India’s digital economy and its innovation ecosystem.

 

  • The Bill is based on the following seven principles:
    1. The principle of consented, lawful and transparent use of personal data;
    2. The principle of purpose limitation (use of personal data only for the purpose specified at the time of obtaining consent of the Data Principal);
    3. The principle of data minimisation (collection of only as much personal data as is necessary to serve the specified purpose);
    4. The principle of data accuracy (ensuring data is correct and updated);
    5. The principle of storage limitation (storing data only till it is needed for the specified purpose);
    6. The principle of reasonable security safeguards; and
    7. The principle of accountability (through adjudication of data breaches and breaches of the provisions of the Bill and imposition of penalties for the breaches).
  • The Bill has few other innovative features:
    The Bill is concise and SARAL, that is, Simple, Accessible, Rational &Actionable Law as it—
    1. Uses plain language;
    2. Contains illustrations that make the meaning clear;
    3. contains no provisos (“Provided that…”); and
    4. Has minimal cross-referencing.
  • By using the word “she” instead of “he”, for the first time it acknowledges women in Parliamentary law-making.

 

  • The Bill provides for following rights to the individuals:
      1. The right to access information about personal data processed;
      2. The right to correction and erasure of data;
      3. The right to grievance redressal; and
      4. The right to nominate a person to exercise rights in case of death or incapacity.

For enforcing his/her rights, an affected Data Principal may approach the Data Fiduciary in the first instance. In case he/she is not satisfied, he/she can complain against the Data Fiduciary to the Data Protection Board in a hassle-free manner.

  • The Bill provides for following obligations on the data fiduciary:
    1. To have security safeguards to prevent personal data breach;
    2. To intimate personal data breaches to the affected Data Principal and the Data Protection Board;
    3. To erase personal data when it is no longer needed for the specified purpose;
    4. To erase personal data upon withdrawal of consent;
    5. To have in place grievance redressal system and an officer to respond to queries from Data Principals; and
    6. To fulfill certain additional obligations in respect of Data Fiduciaries notified as Significant Data Fiduciaries, such as appointing a data auditor and conducting periodic Data Protection Impact Assessment to ensure higher degree of data protection.

 

  • The Bill safeguards the personal data of children also.
    1. The Bill allows a Data Fiduciary to process the personal data of children only with parental consent.
    2. The Bill does not permit processing which is detrimental to well-being of children or involves their tracking, behavioural monitoring or targeted advertising.

 

  • The exemptions provided in the Bill are as follows:
    1. For notified agencies, in the interest of security, sovereignty, public order, etc.;
    2. For research, archiving or statistical purposes;
    3. For startups or other notified categories of Data Fiduciaries;
    4. To enforce legal rights and claims;
    5. To perform judicial or regulatory functions;
    6. To prevent, detect, investigate or prosecute offences;
    7. To process in India personal data of non-residents under foreign contract;
    8. For approved merger, demerger etc.; and
    9. To locate defaulters and their financial assets etc.

 

  • The key functions of the Board are as under:
    1. To give directions for remediating or mitigating data breaches;
    2. To inquire into data breaches and complaints and impose financial penalties;
    3. To refer complaints for Alternate Dispute Resolution and to accept Voluntary Undertakings from Data Fiduciaries; and
    4. To advise the Government to block the website, app etc. of a Data Fiduciary who is found to repeatedly breach the provisions of the Bill.
(Posted On: 09 AUG 2023 9:43PM by PIB Delhi)

Telemedicine – News from India & Abroad

Balancing Precision and Missteps in Cancer Treatment Through ChatGPT

ChatGPT’s capacity to suggest evidence-based cancer therapies is restricted, with accurate and erroneous suggestions intertwined in approximately 33% of its responses, posing challenges in error identification….. Readmore

Is Your Age No Longer a Secret to AI?

Scientists from Osaka Metropolitan University have created an advanced artificial intelligence (AI) system that employs chest X-rays to precisely predict a patient’s chronological age…….Readmore

Harnessing Nanotechnology to Help Treat Blindness

Researchers have harnessed nanotechnology to develop a 3D “scaffold” for growing retinal cells, opening up possibilities for new approaches in treating macular degeneration, a prevalent cause of blindness….Reademore

‘Eye-Opening’ Inaccuracy of ChatGpt Discovered Over Its ‘Eye-ronic’ Medical Advice

A cross-sectional study reveals that an AI chatbot, ChatGPT, provided inappropriate and potentially harmful medical advice about vitreoretinal disease in response to patient questions. ….Readmore

TN – TSI invites all the TSI Chapters and Members to submit information on their upcoming Webinar or Events (50 words), News related to Telemedicine (200 words) or short articles (500 words) for the monthly e-newsletter.Guidelines for submission to TN TSI Newsletter-

  • Report can be from 500 to 600 words
  • Report Should be relevant to Telemedicine or Medical Informatics
  • No promotion of self or any product
  • Avoid plagiarism
  • All references should be included
  • Provide any attributions
  • Visuals are welcome including video links
  • Send full authors name, degrees, affiliations along with a passport sized photograph of good resolution. If multiple authors only main author photo to be sent.

Submission may be sent to – tsigrouptn@gmail.com
Editors reserve the rights for accepting and publishing any submitted material.

Editor in Chief – Dr. Sunil Shroff
Editors – Dr. Senthil Tamilarasan & Dr. Sheila John
Technical Partner- https://www.medindia.net

Tele-Health-Newsletter July2023

Telehealth Newsletter

Official Newsletter of Tamil Nadu Chapter of Telemedicine Society of India

What is New?

July, traditionally a monsoon month in India, has experienced intense rains and floods which seem to be becoming a standard event due to climate change.

A significant highlight this month was the launch of the Goa chapter of TSI, An initiative of our former president Dr. B.S. Ratta on the 8th July. Interestingly, the chosen location for this inauguration will also host the upcoming TELEMEDICON 2023 event.

In this issue, the president of Goa chapter explains their vision for the chapter. Part two of Dr. Viamal Wakahlu’s article provides insightful perspectives on Smart Technology. Additionally, I’ve included several intriguing pieces of international press coverage that have been received recently.

Thank You
Dr. Sunil Shroff
Chief Editor
President – TN Chapter – TSI

TELEMEDICINE SOCIETY OF INDIA – GOA STATE CHAPTER

Dr. Devdutt M. Sail
B.A.M.S PG-CRCDM-Clinical Research
Secretary – Goa State – Telemedicine Society of India

The Telemedicine society of India- Goa state chapter was inaugurated on 8th July 2023 by the dignitaries from the National Executive Committee- TSI India marking a new era of E-health and putting Goa on the map of national telemedicine framework.

Our Vision

Telemedicine society of India- Goa State chapter is formed with an aim to inculcate telemedicine as an integral part of health care delivery in present and future.

As our county is evolving is all aspects, healthcare and medical sector is witnessing tremendous growth, India’s national public health policies are accentuating technology and digitalization for efficient, economical, and quality delivery of healthcare, it is pertinent that telemedicine will play an important role to augment traditional medical care, the prime example of this metamorphosis was experienced during COVID-19 pandemic.

Goa as a tourist destination and small state having excellent healthcare network in public and private sector. However it has its own set of challenges to improvise the delivery of healthcare, disparity of human resources in healthcare along floating population of the state and issues of mobility can create gaps in efficient delivery of timely healthcare. If there is a good network of point-of-care telemedicine and E-health hubs, it will help in bridging such gaps and create efficiency.

Overall Objective

Promote and implement all aspects of telemedicine and E-Health among the medical community and general public and to participate and do value addition in state, national and international events in the field of telemedicine.

Our Immediate Goals-

– To strengthen the TSI Goa state chapter by incorporating members of medical fraternity and other professionals.
– To sensitize the general public and medical sector on guidelines governing telemedicine.
– To demonstrate real-world working of telemedicine and E-health tools to benefit the patient and doctors.
– To convince the medical community on importance of telemedicine to augment clinical practice.

Long term Goals-

– To ensure setting up network of telemedicine point-of-care in individual and institutional capacity delivering healthcare to common citizens of the state.
– To contribute towards strengthening the national legislations governing telemedicine and E-health.
– To constitute “Telemedicine Cells” in government and non-government organizations for bringing telemedicine in mainstream.
– To create a digital healthcare map of state of Goa along with online digital platform on boarding local doctors and patients.
– To create and inventory of certified telemedicine tools and platform with qualified and trained manpower to deliver E-health

FOUNDING MEMBERS

A consortium of 25 doctors and professionals from state of Goa have joined hands as the founding members of the chapter, the members are a cohort of diverse background including Oncologist’s, Gynecologists, General Physicians, Surgeon’s, Physio therapist, Dieticians, AYUSH doctors and Engineers.

The current working Committee-
Dr. Suyog Samuel Arawattigi, President
Dr. Shekhar Shivram Salkar, President Elect
Dr. Kedarnath M. Padte, Vice President
Dr. Devdutt M. Sail, Secretary
Dr. Paresh G. Kamat, Joint Secretary
Dr. Babita Angle Prabhudesai, Treasurer

List of other members-
Dr. Shuba Jyothy Bobbili, Executive Committee
Mr. Chinmay Kantak, Executive Committee
Dr. Swati Divyal Pai, Executive Committee
Dr. Anushri Mukhopadhyay, Executive Committee
Lt. Col. Dr. Parag Prabhudesai, Executive Committee
Mr. Sagar Utagi, Executive Committee
Dr. Richard L. Fernandes, Scientific Committee
Dr. Vibhav Verlekar, Scientific Committee
Dr. K. Ramananda Kamath, Scientific Committee
Dr. Akshata Kotharkar, Program Committee
Mr. Michael Fernandes, Fund Raising Committee
Dr. Swarna Pathak, Newsletter Committee
Dr. Mohammed Mazhar Shaikh, Membership Committee
Dr. Keith Allen Fernandes, Membership Committee

Launch of Goa Chapter

(more…)

Tele-Health-Newsletter June2023

Telehealth Newsletter

Official Newsletter of Tamil Nadu Chapter of Telemedicine Society of India

What is New?

This issue features some interesting articles, including one from the Medical Board of Australia discussing the issuance of prescriptions during Telehealth consultations. Another captivating piece titled “Leveraging Emerging Technologies for Healthcare – Smart Health” by our former president Mr. Vimal Wakhlu, delves into employing cutting-edge technologies such as AI, Extended Reality, Blockchain, Big Data Analytics, Quantum Computing, IoT, and 3D Printing to achieve Sustainable Development Goal 3 (SDG-3), which aims to “Ensure healthy lives and promote well-being”. He explores how these technologies can particularly aid India in reducing maternal and infant mortality, as well as combatting communicable and non-communicable diseases.

With AI progressing at a brisk pace, it is imperative to contemplate the fundamental principles and strategies necessary for its regulation in healthcare, to safeguard patient safety without stifling innovation. A concise article sheds light on this topic, pinpointing key considerations and focus areas for regulatory strategies in the healthcare sector.

For those interested in coding, Dr. Sridhar presents an engaging article that guides you through simple steps to get started. Should you encounter any challenges, he’s available for assistance. His infectious zeal may inspire some to begin experimenting and enjoying the process.

Additionally, let’s appreciate that the month of June, named after the Roman goddess Juno. It has brought some respite from heat by the refreshing onset of the rainy season. In fact, for the first time in 62 years the monsoon arrived on the same day both in Delhi and Mumbai.

Thank You
Dr. Sunil Shroff
Chief Editor
President – TN Chapter – TSI

Leveraging Emerging Technologies for Healthcare – Smart Health Part1

Vimal Wakhlu

Good Health and Wellbeing is one of the Sustainable Development Goals(SDGs)- SDG3. SDG-3 of Sustainable Development Goals-SDGs 2030 states- “Ensure healthy lives and promote wellbeing”. The primary objective of SDG3 is to ensure healthy lives and wellbeing for everyone, regardless of age, gender, or socioeconomic status. It aims to address various health challenges, reduce preventable deaths, and promote physical and mental well-being, and in the process envisages:

#1 Reducing maternal mortality and ensuring access to quality maternal and reproductive healthcare services.

#2 Ending preventable deaths of newborns and children under 5 years old, with a focus on tackling major diseases, malnutrition, and providing vaccinations.

#3 Combating major communicable diseases such as HIV/AIDS, malaria, and tuberculosis, as well as non-communicable diseases like cancer and cardiovascular diseases.

#4 Ensuring universal access to healthcare services, including access to essential medicines and vaccines, and strengthening health systems.

#5 Addressing substance abuse, promoting mental health, and providing access to affordable and quality healthcare services for all.

Emerging Technologies like Artificial Intelligence, Extended Reality, Blockchain, Big Data Analytics, Quantum Computing, Internet of Medical Things,3D Printing, Digital Twins, Drones etc. ensure that concepts like Digital Health can be implemented to leap frog the traditional approach, as there is an acute shortage of all resources, including trained health professionals at the global level.

Artificial Intelligence (AI) and data analytics: Healthcare data, including maternal health records can be analyzed, to identify patterns and risk factors associated with maternal mortality and complications, since it varies from place to place. These technologies can help develop predictive models to identify high-risk pregnancies, provide personalized care plans, proactive intervention. (#1)

AI can help analyze disease patterns and environmental factors, to detect outbreaks and anticipate disease trends. Early detection and response to outbreaks can prevent the spread of infectious diseases and enable targeted interventions to protect children’s health. (#2)

AI can also analyze, genetic information and molecular structures, to accelerate drug discovery and development. It can also identify potential drug candidates, optimize treatment regimens, and predict drug responses. This can significantly impact the development of new therapies for communicable and non-communicable diseases, including HIV/AIDS, malaria, cancer, and cardiovascular diseases. (#3).

Data analytics and AI algorithms can also analyze large-scale healthcare data, providing insights for evidence-based decision-making and resource allocation. These technologies can help optimize healthcare delivery. It can also support clinical decision making, risk stratification, and personalized treatment plans, improving health outcomes and efficiency of care. (#4)

Data from online assessments, surveys, and social media can be analyzed to identify individuals at risk of substance abuse or mental health disorders. It can assist in the early identification of symptoms, prompt appropriate interventions, and guide personalized treatment plans. It can also improve the efficiency of mental health screenings and support the scalability of services. (#5)

Telemedicine and telehealth: Prenatal care, postpartum care and advice on reproductive health can be enabled through telemedicine network in rural and remote areas as well. Video consultations, and remote monitoring devices can be helpful in the process. (#1)

Telemedicine platforms can connect healthcare providers with patients in remote guidance, consultations, and follow-up care for both communicable and noncommunicable diseases. (#3)

Telemedicine facilitates access to healthcare services, including primary care, specialist consultations, and follow-up visits. It can reduce travel costs and time, overcome geographical barriers, and improve healthcare access for marginalized populations. (#4)

Teletherapy and online counseling services enable individuals to receive therapy, counseling, and support for substance abuse, addiction, and mental health issues. Teletherapy thus expands access to mental healthcare, especially for those in underserved areas or facing barriers to in-person services.(#5)

Electronic Health Records (EHRs): EHRs can help improve the management of maternal healthcare information in terms of a comprehensive and centralized record of a woman’s medical history, facilitating continuity of care between different healthcare providers, thus leading to informed decision-making, reduced medical errors, and improved coordination during the course of this entire cycle.(#1).

EHRs for children can help in the comprehensive management of vaccination records, growth charts, and medical history, besides improving coordination of care, and enable healthcare providers to identify trends, patterns, and gaps in healthcare delivery. (#2).

EHRs and data analytics can facilitate comprehensive management of patient information, disease surveillance, and research, besides enabling tracking of disease trends, identifying risk factors, and developing targeted interventions for communicable and non-communicable diseases. Data-driven insights can help formulate public health strategies, personalized treatments, and early interventions.(#3)

EHR systems can streamline healthcare delivery, improve coordination of care, enhanced patient safety, besides enabling healthcare providers to access patient information and medical history, reducing duplication of tests, improving medication management, and supporting continuity of care. Also this process can contribute to data collection for health system monitoring, resource allocation, and policy planning. (#4)
(To be continued)

[This article has been first published in Communications Today in June 2023 as
Healthcare 2.0: Unlocking Opportunities with Emerging Technologies]

sunilshroff_200x250

Healthcare’s Digital Custodians: Steering the Course of AI Regulation for a Safer Tomorrow

Dr. Sunil Shroff
President, Tamil Nadu Telemedicine Society of India | Consultant Urologist & Transplant Surgeon

 

 

The advent of Artificial Intelligence (AI) has revolutionized the healthcare industry. Within a short span we now have available predictive analytics using patient data to robotic surgeries. However, alongside the benefits, there are challenges and risks that need to be immediately addressed. The challenge is to determine what are the essential principles and strategies for regulating AI in healthcare to ensure patient safety without inhibiting innovation and development.

AI in healthcare encompasses various applications that include – diagnostic tools, treatment planning, drug discovery, and patient monitoring. These applications can improve healthcare delivery and add tremendous value by enhancing accuracy, efficiency, and personalized care. However, the misuse or malfunction of AI systems could have dire consequences and is scary. It can lead to misdiagnosis, privacy violations, and inequitable healthcare services.

Principles and Strategies for Regulation:

1. Patient Safety and Efficacy: Ensuring patient safety is paramount. Regulatory bodies must require that AI systems in healthcare undergo rigorous testing and validation before deployment. In the US it is proposed that the Food and Drug Administration (FDA), for instance, should assess AI systems in terms of both safety and efficacy, ensuring they meet specific standards before approving them for clinical use. In India, even the healthcare apps have so far no regulations or certification.

2. Data Privacy and Security: Healthcare AI systems often rely on patient data, which is sensitive and personal. The regulation must ensure that AI systems comply with data protection laws, such as the Health Insurance Portability and Accountability Act (HIPAA) in the US, ensuring the confidentiality and security of patient data. Patients should have the right to know how their data is being used and to consent to or opt-out of data sharing. Currently in India we still are awaiting the parliamentary approval of the PDP bill.

3. Discriminatory practices Bias and Fairness: AI systems can inherit biases and this can be unintentional as they would be more inclined to provide results from the data they are trained on and this can lead to discriminatory practices. Hence it is critical to enforce regulations that mandate the use of diverse and representative datasets in the development of AI tools. However currently diverse clean datasets may not be available. AI systems should be continuously monitored for biases, and corrective measures should be taken if any disparities are identified.

4. Transparency: AI systems’ decision-making processes should be transparent and interpretable by healthcare professionals. Doctors must understand how an AI system arrived at a particular diagnosis or recommendation. This aids in fostering trust among healthcare providers and ensures that AI acts as a decision-support tool rather than a decision-maker. For this to be effective doctors would require some training into how AI decision-making processes works.

5. Liability and Accountability: Clearly defining liability in case of AI failures or errors is essential. Regulations must determine who will be held accountable – the AI developers, the healthcare institution, or the individual practitioners. Clear accountability structures can ensure prompt responses to issues and reinforce the responsible deployment of AI in healthcare. This regulations would to an extent also apply for privacy and confidentiality issues, hence could be addressed within the PDI bill or in the IT act.

6. Human Oversight: AI should complement, not replace, human expertise in healthcare. Regulations should mandate the presence of human oversight bodies, particularly in critical decision-making areas. Doctors and medical professionals should have the final say in patient diagnoses and treatments, ensuring that AI recommendations are validated through human judgment. This has been incorporated in the Telemedicine Practice Guidelines from the Ministry of Health.

7. Continuous Monitoring and Post-Market Surveillance: AI systems in healthcare must be subject to ongoing monitoring and post-market surveillance to ensure that they continue to perform safely and effectively in real-world settings. Just like for drugs regulatory frameworks must facilitate the reporting of adverse events and allow for the recall or modification of AI systems that do not meet safety or efficacy standards.

8. Global Collaboration and Harmonization: AI in healthcare is not constrained by borders. International collaboration is essential for sharing best practices and harmonizing regulatory standards. Global organizations, such as the World Health Organization (WHO), can play a significant role in facilitating international dialogue and cooperation on AI regulations in healthcare.

The integration of AI into healthcare holds tremendous promise for improving patient outcomes and healthcare delivery. However, this must be balanced with comprehensive regulations that prioritize patient safety, data privacy, fairness, transparency, human oversight, continuous monitoring, and accountability.

Through thoughtful regulation and global collaboration, we can harness the power of AI applications in healthcare and safeguard all the stakeholders.

Dr_Bodapati_ Sridhar

Coding for fun

Dr. Bodapati Sridhar
Founder and CEO, EdQueries LLP

All of us use software these days. Software is made by writing code and creating stuff and watching others use it is fun. Just like poets enjoy writing poetry and want everyone to hear their poetry. In case you are wondering which coding I am referring to; it is the code used in Software programming; not the codes used in Electronic Medical Records.

But for many it’s a daunting task. Therefore, in this article and a few following ones, I will attempt to make it simple, and fun.

To get started, let’s download Visual Studio Community edition (it’s free!), by clicking this link. You can download it for your Windows laptop or PC as well as for Apple’s Mac. Visual Studio is a very powerful tool and makes coding extremely easy.

To begin with, we will be creating some very simple Console applications. Console is the black screen on which you enter commands. It’s not frequently used these days, but it makes life easy for beginners learning to code for the first time.

Once you have downloaded Visual Studio Community edition, click the “Create a new project” button.

Then, select C# Console App (you can use the Search box to get it)

Click the ‘Next button’ and then give your project a name.

Usually, the first project someone makes is called “Hello World”. It’s a nice convention you may want to follow.

Click ‘Next’ again and finally click the ‘Create’ button.

You should now see something like this:

This statement will write the message specified in double quotes on the Console : Console.WriteLine(“Hello World”)

Click the “Play “ button on tool bar ( the button to the left of the ‘flame’ icon in the image below).

A black screen should load in a moment, with “Hello World “written.

Now, let’s close this black window (this is the ‘Console’).

It’s time we changed the message displayed on the ‘Console’. Close the ‘Console’. Now, in Visual Studio, write your name, instead of “World”; say hello to yourself. I wrote “Hello Sridhar” and clicked the ‘Play’ button again.

Now, the ‘Console’ shows “Hello Sridhar”.

We have successfully written a message to the ‘Console’.

Now, let’s write other messages. Write Console.WriteLine(). Inside the two round brackets, insert double quotes and write some text. Do this three times by writing three different messages using Console.WriteLine(). Each time, you must end the line with a semi-colon. The semi-colon tells your computer that the line of code is complete.

After writing these messages, click the ‘Play’ button again.

If you have successfully displayed more messages on the ‘Console’, then you have written lines of code to display output on the ‘Console’. Congratulations!

We have taken our first baby steps into the world of Software programming.

The words or sentence inside the double quotes can be stored elsewhere, so that the line of code can be re-used multiple times. That storage space we will create is called a ‘Variable’; and if we are storing words or sentences in it, it’s called a ‘string’ type of variable. ‘Variables’ can be of various types. E.g., ‘string’ stores words or sentences while a variable of type ‘int’ stores numbers (‘int’ represents Integers).

Well, let’s try them out.

Let’s start afresh. Create a new project by following the above steps. Give a name to the new project e.g. My Variables

This time delete everything that’ pre-written for you, including the “Hello World” statement.

You should have an empty central area in Visual Studio, like this:

Now, create a “variable of type “’string’ “like this.

string s = “Ice cream”;

Since we are creating a variable of type ‘string’, we must enclose the words or sentence after the = sign in double quotes. After that end the statement with a semi-colon.

Now, you have stored the words inside a ‘variable’ . You have also given a name to the variable. I have name it “s”. But I could have named it anything else. E.g. I could have named it “myFirstVariable”. The code would then look like this:

string myFirstVariable = “Ice cream”;

The ‘variable’, as mentioned above is a storage space. You have given the storage space a name so that you can call it by that name whenever you need it. You have then stored some text inside that storage space. Now, let’s use our variable, by writing this code:

Console.WriteLine(s);

Now, “Play” this code.

You should see your text in the Console window.

Now, let’s change the text we stored in the variable, like this:

‘string’ myFirstVariable = “This is what I want to do today”;

Now, play it again. The Console will display the new text, because you changed what is stored in the variable.

If you have tried all the above steps and successfully displayed messages on the Console, you have taken your first steps into the world of coding.

The language we are used is called “C Sharp”, written as “C #” also. There are various programming languages out there, each with a specific purpose. I have chosen this one, because it comes from Microsoft and it can be used for creating desktop applications, mobile applications, websites, video games and various other types of software. Also, because of Visual Studio and it’s built in “IntelliSense, it’s quite easy to learn.

Common causes of errors: In C-Sharp, capital letters and small letters are considered different things. “String” and “string” are not the same. If you have named the variable as “MyFirstVariable”, but elsewhere in your code, you called it “Myfirstvariable”, then your code won’t work, as you changed capital letters and small letters changed.

Another common source of errors is the semi-colon. Don’t forget to add a semi-colon at the end of each statement.

That’s all for now. As you try out more coding, you will start enjoying it. Try it today. Try writing various other sentences. Create more variables. Keep coding.

(If you get stuck during coding and require help, you can call Dr. Sridhar at 94490 58818. It may be best to send him a message first)

New Telehealth Guidelines issues by Medical Board of Australia for Prescriptions

Updated telehealth guidelines will close the gap that’s sprung up between online prescribing business models and good medical practice.

After consulting the community and profession, the Medical Board of Australia has today issued revised telehealth guidelines that will take effect on 1st September 2023.

Under the updated guidelines:

  • Telehealth consultations will continue as an important feature of healthcare in Australia.

  • Real-time doctor-patient consultations remain key to safe prescribing.

  • Prescribing via questionnaire-based asynchronous web-based tools in the absence of a real-time patient-doctor consultation is not considered good practice.

‘Telehealth is here to stay. It plays an important role in healthcare in Australia and has opened great opportunities to improve access to and delivery of care, including to rural and remote patients and people living with disadvantage,’ Board Chair, Dr Anne Tonkin AO said.

The interaction between a doctor and their patient is an important element in all consultations, including telehealth consultations.’

The standard of care provided in a telehealth consultation must be safe and as far as possible meet the same standards of care as provided in an in-person consultation.

But prescribing or providing healthcare for a patient without a real-time direct consultation, whether in-person, via video or telephone, is not good practice and is not supported by the Board.

The guidelines specify that:

‘This includes asynchronous requests for medication communicated by text, email, live-chat or online that do not take place in the context of a real-time continuous consultation and are based on the patient completing a health questionnaire, when the practitioner has never spoken with the patient.

‘Any practitioner who prescribes for patients in these circumstances must be able to explain how the prescribing and the management of the patient was appropriate and necessary in the circumstances.’

‘A doctor who has not consulted directly with the patient and does not have access to their medical records is unable to exercise good, safe clinical judgement,’ Dr Tonkin said.

Under the guidelines, a patient’s usual medical practitioner, or another health practitioner with access to the patient’s clinical record, can prescribe without a consultation in certain circumstances.

The guidelines allow a patient to consult a doctor for the first time using telehealth and for a doctor to issue new and repeat scripts as part of a telehealth consultation. The Board does not expect a patient to have had an in-person appointment with a doctor before they have a telehealth appointment.

‘Prescribing medication is not a tick and flick exercise. It relies on a doctor’s skill and judgement, having consulted a patient, and recognises that prescription medication can cause harm when not used properly,’ Dr Tonkin said.

The Board carefully considered the feedback from customers of asynchronous prescribing companies who argued that their programs were convenient, including when they couldn’t get GP appointments.

‘But prescribing medication should not occur in isolation,’ Dr Tonkin said.

‘Consultations enable a doctor to ask follow-up questions that help identify the best treatment for a patient, including when they have previously been given a script by another doctor,’ she said.

President Professor Steve Robson of the Australian Medical Association said the MBA revision of the guidelines was necessary to build a sound foundation for telehealth now and into the future.

“The rapid growth of telehealth in recent years spurred on by the Covid-19 pandemic means it is important doctors have clear guidance on its use.

“The guidelines strike the right balance by ensuring telehealth remains accessible for patients, while at the same time discouraging poor models of care that can result in missed or misdiagnosis.

“Telehealth should be seen as an additional tool to assist doctors to provide good medical care to their patients. It should be used to augment and build on the care provided by a traditional face-to-face consultation.

“The guidelines note that while best practice use of telehealth is in the context of a continuing clinical relationship, there are other circumstances where it will be appropriate.

“They also make clear that prescribing in the absence of a real-time patient–doctor consultation for patients with no existing relationship is not appropriate and rarely acceptable.”

One can access these guidelines – https://www.medicalboard.gov.au/Codes-Guidelines-Policies/Telehealth-consultations-with-patients.aspx

Telemedicine – News from India & Abroad

How Does ChatGPT Help Physicians You Pick the Right Imaging Tests?

ChatGPT was found to support the process of clinical decision-making, including when selecting the right radiological imaging tests for Breast cancer screening…. Readmore

How Artificial Intelligence Can Help Predict Cybersickness in VR Users

With the growing use and need of VR technology, being able to effectively predict and prevent cybersickness was crucial, said researchers from Charles Darwin University (CDU) and Torrens University in Australia…..Readmore

Precision in the Future of Medicine Achieved by AI Program

Developed by researchers at NYU Grossman School of Medicine, an AI program analyzes physicians’ notes to accurately predict patients’ risk of death, length of hospital stay, and other crucial care factors…Reademore

The Paradigm Shift Towards AI With Soul

In the modern world, automated systems and artificial intelligence have become essential in our daily lives. However, their pervasive use raises ethical dilemmas for technologists and developers….Readmore

TN – TSI invites all the TSI Chapters and Members to submit information on their upcoming Webinar or Events (50 words), News related to Telemedicine (200 words) or short articles (500 words) for the monthly e-newsletter.Guidelines for submission to TN TSI Newsletter-

  • Report can be from 500 to 600 words
  • Report Should be relevant to Telemedicine or Medical Informatics
  • No promotion of self or any product
  • Avoid plagiarism
  • All references should be included
  • Provide any attributions
  • Visuals are welcome including video links
  • Send full authors name, degrees, affiliations along with a passport sized photograph of good resolution. If multiple authors only main author photo to be sent.

Submission may be sent to – tsigrouptn@gmail.com
Editors reserve the rights for accepting and publishing any submitted material.

Editor in Chief – Dr. Sunil Shroff
Editors – Dr. Senthil Tamilarasan & Dr. Sheila John
Technical Partner- https://www.medindia.net

Tele-Health-Newsletter May2023

Telehealth Newsletter

Official Newsletter of Tamil Nadu Chapter of Telemedicine Society of India

What is New?

The month of May has been very quiet as far as telehealth is concerned. This issue of the newsletter has the least content in the last three years.

I have listed the top AI Top Ten AI Applications in Healthcare, however this is my list, I am sure many of you will have your own favourite ones. Do share them with us.

In many parts of the country the temperature has shot up, do stay indoors and keep yourself well hydrated.

Thank You
Dr. Sunil Shroff
Chief Editor
President – TN Chapter – TSI

Top Ten AI Applications in Healthcare

Dr. Sunil Shroff
President, Tamil Nadu Telemedicine Society of India | Consultant Urologist & Transplant Surgeon

AI’s role in healthcare is rapidly evolving, with new innovations emerging every day. This makes selecting a definitive list of the top ten AI tools a challenging task. However, the chosen tools have demonstrated their effectiveness and reliability in the healthcare sector over time. They’ve been particularly influential in areas such as medical imaging and oncology, enhancing diagnostic accuracy, predicting patient outcomes, and personalizing treatment plans.

1. IBM Watson Health: Watson Health uses AI to analyze large amounts of health data, helping healthcare organizations improve patient care and find efficiencies.

2. Google DeepMind Health: DeepMind uses machine learning and systems neuroscience to build powerful general-purpose learning algorithms into neural networks that mimic the human brain.

3. Aidoc: Aidoc uses AI to provide radiologists with advanced visualizations to aid in interpreting medical images.

4. PathAI: PathAI focuses on pathology. It uses AI to assist pathologists in making faster and more accurate diagnoses.

5. Tempus: Tempus uses AI for precision medicine, particularly in the treatment of cancer. It collects and analyzes vast amounts of clinical and molecular data to support physicians in making real-time, data-driven decisions.

6. Zebra Medical Vision: Zebra uses AI to read medical imaging with the aim of automating the diagnostic process. Its algorithms have been trained to identify various medical conditions.

7. Butterfly Network: Butterfly Network’s iQ and Butterfly Cloud use AI to deliver a handheld, pocket-sized ultrasound tool that connects to a smartphone. It’s designed to make medical imaging accessible to more healthcare professionals.

8. BenevolentAI: BenevolentAI uses AI to enhance the process of drug discovery. It aims to lower costs, increase speed, and improve the success rate for discovering new medicinal compounds.

9. BlueDot: This platform uses AI to track, locate, and conceptualize infectious disease spread. It provides real-time surveillance across the globe.

10. Nuance Communications: Known for their development of clinical speech recognition capabilities, they have advanced tools like Dragon Medical One which assists in clinical documentation by converting speech into text and driving efficiencies within electronic health records.

These are my list but if you have any recommendation to send us your suggestions.

Top Five AI Applications that can be used in Healthcare

Among the current AI applications, I found some that were very easy to use and can be easily applied in healthcare. However many may require subscription. These are listed below:

1. ChatGPT – Provides you ready answers to any health related questions, but do be careful of the references it give you for evidence.

2. Synthesia: This platform uses AI converts text-to-video Software. All you need to do is write the script, choose the presenter, and the AI generates a realistic video with the presenter saying the provided script. I first used Vidnami which was a great application, but this got taken over byt BigDaddy. Vidnami suggested relevant images or clips to the text too. You can try Lumen5 too for the same purpose.

3. Dragon Professional: Known for its dictation software, Dragon is used widely in various sectors, including healthcare for clinical documentation. Other products include Google Speech-to-Text.

4. Wix: Do you want build a website for your practice, you can try this AI tool, it is easy to use.

5. Beautiful.ai: Helps with improving the quality of your presentation by providing you with slides templates and improving your complete presentation

I must confess I did use ChatGPT to check these out and rewrite some of the content.

Murthy-Remilla

Workshop on “Telehealth practice guidelines and latest trends in India”

By Dr. Murthy Remilla



A Hybrid workshop on “Telehealth practice guidelines and latest trends in India” with Inaugural of Telemedicine Society of India (TSI) Himachal Chapter was held at the premises of AIIMS Bilaspur.

The event was inaugurated by the Executive Director of AIIMS Rishikesh cum President, TSI Dr Meenu Singh along with Honorary Secretary of Telemedicine Society of India (TSI), Dr. Murthy Remilla.

The event was initiated by the inaugural Director’s address, conveyed by Dr. Sanjay Vikrant, Dean Academics. He described about the way forward of the AIIMS Bilaspur, to adopt technologies related to Ayushman Bharat Digital Mission (ABDM) and the accomplishments of AIIMS Bilaspur in Digital health domain.

The Chief Guest of the occasion Dr. Meenu Singh presented the Presidential Address. She shared views on Telemedicine practices and other digital health innovations & its importance in the Tele education, telenursing etc. The other Guest speaker Dr. Murthy Remilla threw light on Telemedicine Practice Guidelines issued by Govt. Of India in 2020 & 2022.

The President (Designate) of upcoming TSI Himachal Chapter Dr Vikrant Kanwar expressed gratitude to all the dignitaries and invited guests. He said that the event is indeed a crisp description to know the nitty gritty of the telemedicine trends in the country and this will go a long way in adoption and acceptance of telemedicine and other digital health innovations by healthcare providers and the patients.

The event was attended by AIIMS Faculty, Nursing Officers, Staff, Students and many delegates from all over the Himachal.

AI Can provide Life-Saving Early Diagnosis and Advance the Treatment of Pulmonary Hypertension

(Submitted as Press Release)

Global AI firm Thirona has unveiled LungQ™ AVX, an AI algorithm designed for pulmonary artery-vein phenotyping. Revealed at the ATS 2023 International Conference, the algorithm showed promise in detecting pulmonary vasculature abnormalities from CT scans.

It precisely identifies and quantifies vessel diameters and volumes, essential for accurate and sensitive analysis. Early studies suggest that LungQ™ AVX enables non-invasive detection of arterial and venous changes, potentially facilitating early diagnosis of diseases such as pulmonary hypertension.

The algorithm also aids in diagnosing different vascular diseases and assessing treatment outcomes without requiring contrast-enhanced CT. Leticia Gallardo Estrella, a senior team leader at Thirona, highlights the tool’s potential in early detection and disease management, particularly for rare diseases like pulmonary hypertension (PH).

The insights provided by LungQ™ AVX cannot be subjectively assessed from a CT scan as the eye is not sensitive enough to pick up subtle changes in the dimensions of the pulmonary arteries and veins. AVX could potentially help PH diagnosis by detecting relevant vascular alterations way earlier than they can be picked up by current golden standard of hemodynamic measurements by right-heart catheterization.

Leticia Gallardo Estrella, PhD., Senior Deep Learning Engineering Team Leader at Thirona: “Our expectation is that AV phenotyping will have the most noteworthy benefits in detecting pulmonary hypertension and its subtypes. PH is a rare disease with a very high underdiagnosis rate. Applying AI to help with its early detection can potentially result in slowing the disease progression in PH patients by ensuring they get the best possible treatment sooner.”

“It is an exciting step forward in phenotyping pulmonary vascular disease. AVX is a result of almost a decade of research and development work aimed at finding vascular phenotypes to improve the diagnosis of a multitude of vascular diseases and to identify new potential therapeutic targets. Today, we have several validation studies delivering strong evidence that AVX can potentially transform the way we diagnose and treat uncurable diseases like pulmonary (arterial) hypertension. And more studies are pending.”, says Jean-Paul Charbonnier, PhD., Chief Innovation Officer at Thirona.

References

Boomars, K. A. (2023). Can AI-based Pulmonary Vascular Phenotyping on Chest-CT Detect Volume Shifts in Pulmonary Arterial and Venous Blood Volume in Operable and Non-operable Chronic Thromboembolic Pulmonary Hypertension? In D28. HOW CAN WE DO BETTER: EMERGING DIAGNOSTICS AND THERAPEUTICS IN PULMONARY VASCULAR DISEASE (pp. A6468-A6468). American Thoracic Society.

Maloir, Q., Gallardo Estrella, L., Ernst, B., Louis, R., Charbonnier, J. P., & Guiot, J. (2023). Artificial Intelligence-Based Analysis Differentiates PAH From PH Using Non-Contrast Chest CT Scans. In B56.-OMICS, MACHINES, AND DEVICES IN PULMONARY HYPERTENSION (pp. A3724-A3724). American Thoracic Society.

Maloir, Q., Gallardo Estrella, L., Ernst, B., Louis, R., Charbonnier, J. P., & Guiot, J. (2023). A Step Towards Early Detection of Pulmonary Hypertension on Non-Contrast Chest CT Scans Using Artificial Intelligence. In B56.-OMICS, MACHINES, AND DEVICES IN PULMONARY HYPERTENSION (pp. A3725-A3725). American Thoracic Society.

Telemedicine – News from India & Abroad

Satya Nadella, Sundar Pichai attend emergency meeting on AI at White House as Biden administration works on regulations

Within a matter of months, ChatGPT has gone from a conversational AI being used for writing poetry, college essays and even codes, to being a serious business tool. After a botched attempt to pitch Bard against ChatGPT, Google CEO Sundar Pichai warned about AI’s harmful effects, while Elon Musk called for AI to be paused, while working on his own version. Days after the Godfather of AI warned that the tech can end humanity, US President Joe Biden has urged Pichai and Microsoft CEO Satya Nadella to protect people from risks associated with it…. Readmore

Unlocking the Potential of Apple’s New Tools for Cognitive, Speech, and Vision Accessibility

Apple, the tech giant showed novel software features for cognitive, speech and vision user-friendliness, along with tools for people who are nonspeaking or at risk of losing their ability to speak, that will be available in its devices later this yearAt Apple, we’ve always believed that the best technology is technology built for everyone,” said Tim Cook, Apple’s CEO…..Readmore

Why Is AI Important for Primary Care Patients With Respiratory Symptoms?

A new machine learning model trained with artificial intelligence triaged patients with respiratory symptoms before they visit a primary care clinic. To train the machine learning model, the researchers used only questions that a patient might be asked about before a clinic visit. Information was extracted from 1,500 clinical text notes that included a physician’s interpretation of the patient’s symptoms…Reademore

Are Google Cloud’s AI-Tools the Key to Accelerating Drug Discovery?

Two novel AI-powered life sciences solutions announced by Google Cloud accelerate drug discovery and precision medicine for pharma and biotechnology companies.The tools, target and lead identification suite will help researchers better identify the function of amino acids and predict the structure of proteins; and the multiomics suite will accelerate the discovery and interpretation….Readmore

Tele-Diabetes Course

The Diabetes Telemedicine Practice Course has been put together by experts in the field who have been familiar with this form of practice for many years. This course follows the same level of compliance as available in the document released by the Ministry of Health & Family Welfare, Government of India entitled ‘Telemedicine Practice Guidelines.’

There is a separate online foundation course for all practitioners to familiarise themselves with the’Telemedicine Practice Guidelines.’ The diabetes course goes a step further and helps the diabetes practitioners to understand the requirements for such a practice. You can either take both the courses or just take the diabetes telemedicine course.

Course Directors:

Dr.V. Mohan, Chennai
Dr. Jothydev Kesavadev, Trivandrum
Dr. Sanjay Sharma

Modules:

Module I – Introductory Primer to Tele-Diabetes
Module II – Setting up a Diabetes & Telehealth Practice
Module III – Legal & Ethical Aspects
Module IV – Optional Material

Duration: The total online course duration is for four to six hours

Certification: Proficiency certificate of completion of the course.

Course Delivery: Via Online Platform

To register for the course please click herehttps://tsitn.org/diabetes-telemedicine-practice-course/

TN – TSI invites all the TSI Chapters and Members to submit information on their upcoming Webinar or Events (50 words), News related to Telemedicine (200 words) or short articles (500 words) for the monthly e-newsletter.Guidelines for submission to TN TSI Newsletter-

  • Report can be from 500 to 600 words
  • Report Should be relevant to Telemedicine or Medical Informatics
  • No promotion of self or any product
  • Avoid plagiarism
  • All references should be included
  • Provide any attributions
  • Visuals are welcome including video links
  • Send full authors name, degrees, affiliations along with a passport sized photograph of good resolution. If multiple authors only main author photo to be sent.

Submission may be sent to – tsigrouptn@gmail.com
Editors reserve the rights for accepting and publishing any submitted material.

Editor in Chief – Dr. Sunil Shroff
Editors – Dr. Senthil Tamilarasan & Dr. Sheila John
Technical Partner- https://www.medindia.net

Tele-Health-Newsletter April 2023

Telehealth Newsletter

Official Newsletter of Tamil Nadu Chapter of Telemedicine Society of India

What is New?

April has been a quiet month for TSI and not much has happened except for the 2nd G20 health working committee meeting where India’s Digital Healthcare took the Centre Stage with appreciation from many international delegates about India’s technology adaptation during COVID the pandemic. We carry a report about the event.

Prof. Ganapathy writes about 5G and Healthcare and ChatGPT continues to be in the news. The new tools available now also makes you create your own Avatar – Learn how to make one!

 

 Thank You
Dr. Sunil Shroff
Chief Editor
President – TN Chapter – TSI

2nd G20 Health Working Group Meeting – India’s Digital Healthcare Takes Centre Stage

Dr. Sunil Shroff
President, Tamil Nadu Telemedicine Society of India | Consultant Urologist & Transplant Surgeon

The 2nd Health Working Group meeting under G20 India Presidency will be held during 17th – 19th April, 2023 in Goa. More than 180 delegates from 19 G20 member countries, 10 invited states and 22 International Organizations will be participating.

The 2nd HWG meeting will have thematic discussions on the following three priorities identified under the G20 Health Track:

Priority I: Health Emergencies Prevention, Preparedness and Response (with Focus on One Health & AMR):

Priority II: Strengthening Cooperation in Pharmaceutical Sector with focus on Access and Availability to safe, effective, quality and Affordable Medical Countermeasures (Vaccines, Therapeutics and Diagnostics).

Priority III: Digital Health Innovations and Solutions to Aid Universal Health Coverage and Improve Healthcare Service Delivery”

Luigi d’Aquino, UNICEF India’s health chief, stated that India has recognized digital health as a key priority and has gained significant expertise in creating and implementing digital health programs. He added that the COVID-19 pandemic has highlighted the potential of digital services in enhancing the availability, accessibility, and effectiveness of many healthcare programs.

Despite significant progress, d’Aquino acknowledged that the digital health space is continually evolving and that there are several challenges and opportunities that need to be explored and addressed. However, he noted that the evolving tools, vision, and strategies have made it easier for citizens to access digital health services.

Access Mr. Luigi d’Aquino speech on :

Several cultural programmes infused with flavours of Goan culture have been planned for the event to showcase India’s rich diversity and culture based on Indian philosophy of ‘Atithi Devo Bhava’. Delegates will also be able to experience Goa’s culinary culture, besides enjoying its scenic beauty and generous hospitality.

The Health Track of G20 India Presidency will comprise four Health Working Group (HWG) Meetings and one Health Ministerial Meeting (HMM). India plans to host four side events along with HWG meetings to enrich, supplement and support G20 discussions. A side event on Digital Health will be held on the side-lines of the 2nd meeting of HWG at Goa, 18th – 19th April 2023. The meetings will be held in different locations across the country. This aims to showcase India’s rich and diverse cultures.

India assumed the presidency of the G20 on 1 December, 2022, marking a significant milestone. India is currently part of the G20 Troika comprising Indonesia, India and Brazil marking the first time that the troika is consisting of three developing and emerging economies.

One Earth, One Family, One Future – Vasudhaiva Kutumbakam

Hon’ble Prime Minister Shri Narendra Modi reiterated that G20 India Presidency will be inclusive, action-oriented and decisive. The theme unveiled by Hon’ble Prime Minister: ‘One Earth, One Family, One Future’, based on India’s philosophy of ‘Vasudhaiva Kutumbakam’, is a catchphrase for people across the world to collectively work towards building a healthier post- pandemic world.

As chair of the G20 Presidency, India aims to continue and consolidate health priorities and key takeaways from previous presidencies while highlighting critical areas that require strengthening. India also aims to achieve convergence in discussions across various multilateral fora engaged in health cooperation and work towards integrated action.

5G and Healthcare

Dr. K. Ganapathy
Director Apollo Telemedicine Networking Foundation, Apollo Tele Health Services | Distinguished Visiting Professor IIT Kanpur | Distinguished Professor The Tamilnadu Dr MGR Medical University | Emeritus Professor National Academy of Medical Sciences

5G is the fifth generation of wireless communication technology, promising faster data transfer speeds, lower latency (round trip latency >10 milliseconds), increased network capacity (1 million devices per sq km), 99.999% network reliability and battery life of up to 10 years for IoT devices. There is considerable hype in the media that deployment of 5G will revolutionize healthcare by enabling new medical applications and improving existing ones. Using Edge computing, 5G Data can be processed closer to where it is generated. IoMT devices generate huge amounts of data. Cloud computing can provide necessary infrastructure to process and analyze this data. Faster transmission of data will enable more efficient storage in the cloud. Accessing more bandwidth and computing resources, and providing infrastructure to enable scalability will now be less problematic.

No doubt clarity of images transmitted will be better and the immersive experience in video conferencing will be an all time high. Mammograms, CT, MRI, ultrasound images generate large amounts of data. High-speed transfer and processing will save a few minutes, Onboard cameras, camera-based Headgear, and ‘Body Cams’ for paramedics can transmit patient data to hospitals in real-time using ultra-fast and low latency 5G connected ambulances with medical equipment, patient monitoring applications and telemetry devices can ensure on site excellent pre hospital management. 5G can facilitate real-time control of medical robots, enabling precise and safe interventions in performing complex procedures. 5G enables faster and more efficient data transfer, facilitating clinical trials and drug development, as these require collection of large amounts of data from multiple sources.

The media loves dramatizing “telesurgery” – the use of 5G in enabling remote surgical procedures. The world’s first remote brain surgery using 5G was done in March 2019. Deep Brain Stimulation was done for a Parkinsonian patient, with the surgeon 3000 km away. In India there have been sporadic anecdotal reports of use of 5G in remote interventional procedures, The sceptic would wonder why the patient could not go to where the surgeon is located!!! In May 2021, the Thoracic Surgery Education Group enabled 200 thoracic surgeons to access a virtual environment (VE) wearing a head-mounted display (HMD). Discussions in real-time occurred while observing surgery in a VE. Moving the mouse, every corner of the Operation Theatre (OT) was visible to surgeons from different continents. 3D glasses enabled viewing of High Resolution 3D images. Pathologists can display microscopic images on the large screen of the OT. Surgeon would listen to pathologic findings in real-time & share opinions. 5G assisted Telementoring and telemonitoring is more important, doable and necessary than the media hyped “telesurgery”.

The healthcare “industry” as a whole is generally more conservative in jumping on to the bandwagon, in deploying future ready technology. Interoperability, portability, stakeholder customization, human factors (skills, resistance, distrust, cyber-attacks), legislation and regulations need to be factored in. The adoption of any new technology to a large extent depends on the RoI. Making a product cost effective in turn depends on scalability and mass deployment.

Now that the sales pitch is over, as an old fashioned clinician belonging to the BC era let me ask my favourite question dreaded by MNC’s worldwide SO WHAT? In a Utopia, a clinician, whose primary reason for existence, is to promote good health, postpone illness, reverse, reduce symptoms and signs, and significantly improve health outcome – needs the results of a good, well designed, prospective study where the primary question is “ Did 5G really make a difference? Such a study can be done in India – with global ramifications . The real world is different. If we do not use 5G we are in the Jurassic Park!! Time alone will tell if 5G needs to be an integral part of a hospital’s armamentarium.

Synopsis of invited Talk delivered on 13th April @ Bengaluru in the conference “Science for Scale” on the occasion of the 25th anniversary of IBM Research in India

Create an AI Avatar of Yourself!

Dr. Sunil Shroff
President, Tamil Nadu Telemedicine Society of India | Consultant Urologist & Transplant Surgeon

The boundaries between science fiction and reality are getting blurred. The idea of creating a virtual representation of yourself has long been a concept in science fiction, but with the advancements in AI technology, it has now become a reality. Being in multiple locations at once can now become a reality soon. The power of AI Art Generator Avatar allows you to design your own digital duplicate, creating a virtual being that looks, acts, and even sounds like you. You can either opt for a paid program or go the free route. Use AI programs like Synthesia or Lensa. There are plenty out there and you can experiment with a couple and select.

Step I – Capture your picture

Find the right image where you are looking straight at camera and your face is fully visible. Some platforms can ask more than one image from different angles

Step 2 – Record your voice

Use a AI software like Overdub or ReadLoud that can create a synthetic voice version of your voice, Depending on the software you may need to record 10 to 30 minutes of your voice.

Once this is done leave the program to generate your voice and this may take up to a day.

Once this is done you are ready to go

Step 3 – Merge your Image Avatar to the Voice

You can use D-ID a sophisticated AI tool that can be used to combine an image with a voice to create a realistic digital version video of you speaking.

Once you merge you are ready to go and make your Avatar to read out an article that you may have published or create a chatbot where you personally attend to your customers or make a virtual assistant to perform repetitive tasks. And this is only the start. As technology gets better the possibilities are endless.

Speaking about doppelgangers, it is generally believed that every person has seven look likes scattered across the globe. In fact on social media there was a “Twin Strangers” project to find doppelgangers. With advents of self -Avatars there will be soon even more!.

Did you know that the term Avatar which is so popular comes from Sanskrit: अवतार. It is a concept within Hinduism that in Sanskrit literally means “descent”. It signifies the material appearance or incarnation of a powerful deity, goddess or spirit on Earth. Maybe in the future AI Avatar could be created to save this world!!

Implementation of innovation in healthcare

Khushboo Verma
CEO of vCare Denmark

I am a subject matter expert and entrepreneur from Denmark and recently spoke in TSI’s webinar about implementation of innovation in healthcare.

Bringing any change in healthcare needs great deal of change management. It must be done keeping people, processes, and technology into account.

The lecture was focused on innovation implementation framework which is developed by vCare Denmark using decades of experience with small and large-scale healthcare projects in USA, UK, Finland, Canada and Denmark.

I will be traveling as part of a Danish delegation to India with support from and accompanied by foreign ministry of Denmark. The delegation would be focused on finding co-operations and partnership in relation to vCare Denmark’s project in India. vCare Denmark is coming with a platform to strengthen hospitals, clinics and telemedicine service providers in India and make them interoperable.

The recording of the lecture is available on YouTube link: https://youtube.com/live/WUhnBz56IoM

Making News – TSI Senior Members

 

Prof Ganapathy in discussion with Dr. Mansukh Mandaviya and Dr. Bharti Pawar in G20 Health Working Group meeting at Goa
NRI telemedicine leader Dr. Vijay Prabhakar with our Union Finance Minister - Mrs. Nirmala Sitharaman at Washington DC, USA

Telemedicine – News from India & Abroad

Telemedicine and RPM markets will continue to expand in coming years
The market for telemedicine and remote patient monitoring (RPM) has been rapidly expanding, driven by the COVID-19 pandemic and the need for remote healthcare delivery…. Readmore

Smartwatch Offers Reliable Insight into Parkinson’s Disease Treatment

Digital devices are more sensitive than clinician-dependent rating scales in identifying potential digital measures to assess new treatments for Parkinson’s disease, according to a new study ….Readmore

How Does Computer-Assisted Procedure Classify Ataxia-Related Speech Disturbances?

The newly developed artificial intelligence method identifies the severity of speech disturbances linked to ataxia. Ataxia is a condition where a person lacks coordination during voluntary movement…Reademore

Predicting Alzheimer’s Disease Risk Score Using Artificial Intelligence (AI)

Incorporating genetic risk scores, non-genetic information, and electronic health record data in machine learning models for nearly half a million individuals can rank the risk factors based on their association with the development of Alzheimer’s disease….Readmore

 

Telemedicine Practice Guidelines – A Foundation Course for RMPs by TSI Faculty

To know more about the Telemedicine Foundation Course click on the link below:
https://tsitn.org/tpg-course/

TN – TSI invites all the TSI Chapters and Members to submit information on their upcoming Webinar or Events (50 words), News related to Telemedicine (200 words) or short articles (500 words) for the monthly e-newsletter.Guidelines for submission to TN TSI Newsletter-

  • Report can be from 500 to 600 words
  • Report Should be relevant to Telemedicine or Medical Informatics
  • No promotion of self or any product
  • Avoid plagiarism
  • All references should be included
  • Provide any attributions
  • Visuals are welcome including video links
  • Send full authors name, degrees, affiliations along with a passport sized photograph of good resolution. If multiple authors only main author photo to be sent.

Submission may be sent to – tsigrouptn@gmail.com
Editors reserve the rights for accepting and publishing any submitted material.

Editor in Chief – Dr. Sunil Shroff
Editors – Dr. Senthil Tamilarasan & Dr. Sheila John
Technical Partner- https://www.medindia.net

Tele-Health-Newsletter March 2023

Telehealth Newsletter

Official Newsletter of Tamil Nadu Chapter of Telemedicine Society of India

What is New?

TSI has recently opened its 12th chapter in Haryana, marking another milestone in its growth and expansion.

ChatGPT, an AI language model, has been generating buzz this year with its impressive capabilities. It has been used in this issue to create fascinating AI-related news and articles that are worth checking out for anyone interested in this exciting field.

Furthermore, in this issue, Dr. Vikrant Mittal has contributed an article about the progress of tele-psychiatry in the country. This is an interesting read for anyone interested in mental health and technology.

Last but not least, our past presidents, Dr. B,S. Ratta and Mr. L. Satyamurthy, attended the American Telemedicine Congress, the biggest event in the field. They have compiled all the highlights of the event, so be sure to read and benefit from their insights.

Finally, we would like to wish everyone a Happy Easter!

Thank You
Dr. Sunil Shroff
Chief Editor
President – TN Chapter – TSI

Haryana State Chapter – Telemedicine Society Of India(TSI) Inaugurated at Amrita Hospital, Faridabad

Shruti Saxena
DGM – PR & Communications (North), Amrita Hospital, Faridabad

The newly formed Haryana State Chapter— Telemedicine Society of India (TSI) was inaugurated at Amrita Hospital, Faridabad. Swami Nijamritananda Puri, Administrative Director, Amrita Hospital, Faridabad, lighted the lamp and inaugurated the project.

Delivering the inaugural speech, he said, “Ours is a country where most people do not have access to proper medical care. Though there are several reasons, one of the main reasons is the geographical factor. Launching the Haryana Chapter will help transcend the obstacles and help people denied advanced medical assistance.”

Telemedicine facilitates communication between a doctor and a patient in a remote location with the support of the latest technology. Artificial Intelligence (AI) and Machine Learning support an accurate diagnosis. It includes phone calls, video chats, emails, text messages, and even drone delivery of medicines. Telemedicine is often called telehealth, digital medicine, e-health, or m-health (mobile health). The Haryana Chapter aims to connect patients who need medical help with in-house technical teams using telemedicine and clinics on wheel units.

Dr. Prem Nair, Group Medical Director, Amrita Hospitals & Vice-President National Telemedicine Society of India, said during disasters when all modes of communication are down, satellites establish connectivity with patients within the time described as the golden hour. When the tsunami struck, it was possible to provide healthcare to people in Lakshadweep and Andaman & Nicobar Islands through telemedicine. “This was one of the important milestones for us in telemedicine,” he said, adding, “We have also been successful in mobile telemedicine. We have been able to provide teleconsultation and teleeducation through mobile telemedicine units. We look forward to working with the Telemedicine Society of India and start connecting with local healthcare facilities to support some of the far-flung areas in Northern India substantially.”

Prof Meenu Singh, President of National Telemedicine Society & Director of AIIMS, Rishikesh said, “The government of Haryana started telemedicine Delhi-NCR and Chandigarh many years ago. It is 25 since telemedicine services began in Haryana when Prof. BD Gupta introduced it in 1997. In 2005, the Prime Minister of India started telemedicine along with ISRO and the Department of Education and Technology. It is gratifying to see Amrita collaborating with ISRO and other agencies.”

Stressing the need to bridge the healthcare digital divide, Dr. Puneet Dhar, President, Haryana Telemedicine Chapter said, “About 1.3 billion people in the country fall in the spectrum of the healthcare digital divide. Healthcare infrastructure development is vital to the country’s development, and telemedicine can help. The increasing penetration of smartphones, mobile connectivity, and the internet makes it a game changer. Amrita has been a pioneer in exploring this. During natural disasters, our telemedicine van goes around providing treatment. It proved to be crucial when Covid-19 struck,” he said. He also pointed out the case of start-ups providing online consultation, remote patient monitoring systems, and online pharmacy services that use drones and assist in palliative care.

Unlike the developed world economies, healthcare infrastructure and distribution of the medical fraternity are not uniform in India. A robust, uniform referral system is lacking to directly refer sick patients suffering from specific diseases in remote areas, where tertiary/quaternary is missing. The absence of hospitals/centers/institutes with state- of- art facilities for their treatment further jeopardizes the survival of these sick patients.

The chapter in Haryana is the first step towards making high-quality healthcare accessible to all our citizens. It will help ensure a future where healthcare is no longer a privilege but a fundamental right of every citizen of India. The Chapter is dedicated to hand-hold government/semi-government/private healthcare stakeholders to improve healthcare quality at all levels in Northern India and the rest of the country.

However, some challenges come in implementing telemedicine services in India. The lack of infrastructure, limited internet connectivity, and the shortage of healthcare professionals trained to use telemedicine technologies are some of the challenges that need to be addressed. Hospitals and other conventional healthcare institutions can be crucial in expanding telemedicine services in India. They can provide the necessary infrastructure and technical expertise needed to support telemedicine services. They can also provide the required training for healthcare professionals to use telemedicine technologies effectively.

The TSI’s Haryana Chapter will collaborate with all medical colleges/institutions to provide an in-training for future doctors. It is the 16th state chapter of TSI in India. They will also team up with various stakeholders for quality improvement in all aspects of healthcare- preventive, primary, secondary, and tertiary levels. It is of utmost importance for achieving Millennium Development Goals.

Dr. Kamal Bijlani, Director of E-Learning Research Labs (AERL), is the secretary, and Dr. Tarana Gupta is the treasurer of the Haryana Chapter. Currently, the Society has 45 members.

Dr. Murthy Remilla, Secretary, TSI spoke at the event. Dr. Arti Pawaria, Senior Consultant & Clinical Lead, Department of Paediatric Hepatology, Gastroenterology & Liver Transplantation, Amrita Hospital, Faridabad, Dr. Ashutosh Sharma, Medical Superintendent, Amrita Hospital, and Dr. (Col) B.K. Mishra, Principal, Amrita School of Medicine, Faridabad, graced the occasion.

From L to R - Dr. Kamal Bijlani, Dr Tarana Gupta, Prof. Meenu Singh, Dr. Murthy Remilla, Dr. Prem Nair, Dr. Puneet Dhar
From L to R - Swami Nijamritananda Puri, Dr. Murthy Remilla, Prof. Meenu Singh, Dr. Prem Nair

Meet ChatGPT: Your Intelligent Companion for Endless Conversations!”

Dr. Sunil Shroff
President, Tamil Nadu Telemedicine Society of India | Consultant Urologist & Transplant Surgeon

ChatGPT is an artificial intelligence language model that is designed to interact with us humans through text-based conversations. It uses a machine learning algorithm to generate responses to questions or statements, and its responses are based on the patterns and information it has learned from large amounts of text data.

To put it simply, ChatGPT is like having a conversation with a very knowledgeable and intelligent computer program. It can understand and respond to a wide range of topics, from basic questions about the weather or current events to more complex discussions about science, technology, and philosophy.

ChatGPT is not a physical entity, but rather a software program that operates in the cloud. It is accessible through various chat platforms, such as messaging apps or websites, and can be used by anyone with an internet connection.

Overall, ChatGPT is a powerful tool that can provide information, support, and entertainment to people around the world, and its capabilities continue to improve as its machine learning algorithm evolves and learns from more data.

The impact of ChatGPT on content writing is likely to be significant. With the ability to generate high-quality, human-like responses to text-based conversations, For example, ChatGPT can be used to generate blog posts, news articles, and product descriptions, and can even be used to create entire websites or e-books. However, it’s important to note that ChatGPT is not perfect and still has limitations. While it can generate text that sounds natural and coherent, it can also produce responses that are irrelevant or even nonsensical. Therefore, it’s likely that human writers will still be needed to edit and refine the content generated by ChatGPT.

Furthermore, ChatGPT is not a replacement for human creativity and originality. While it can generate text based on existing patterns and information, it cannot create entirely new ideas or concepts. Therefore, human writers who are able to think critically and creatively will still be valuable in the content writing industry.

Overall, while ChatGPT has the potential to disrupt the content writing industry, it is likely to complement rather than replace human writers. By automating many of the repetitive and time-consuming tasks associated with content creation, ChatGPT can free up human writers to focus on higher-level tasks, such as brainstorming new ideas, developing creative concepts, and refining the quality of the content.

Privacy in Healthcare: Changing Times and Systems

Ms. Bagmisikha Puhan
Associate Partner, TMT Law Practice

In the wake of the recent breach which has been suffered by a leading pharmaceutical company, Sun Pharmaceutical Industries, owing to a ransomware attack – it has become apparent how a sensitive sector like the healthcare does not have enough safeguards in place in terms of data privacy. Fortunately, as a listen entity and in view of the CERT-In Directions notified last year, there was a modicum of an obligation placed squarely on the company to make these disclosures.

However, it is not a sector which can be left fraught with risks, which make the individuals – who could be patients, recipients of transplants, clinical trial participants, surrogates, and several such other individuals, become subject to a harrowing experience at the hands of a person who intends to abuse their data. It is to this end that in addition to the existing policy and standard frameworks which apply to the healthcare framework, only with persuasive value – there be the introduction of an umbrella privacy framework which applies to all and sundry as a mandate.

It has been oft the case that the end user, to whom the information pertains to, either rely on IT, e-commerce, consumer protection laws to somehow build a case for preserving and enforcing their own right to privacy – which is now a fundamental right, in the stead of being presented with a forum which is marked with the dedicated objective of enforcing their rights.

We have already witnessed the turmoil that is being faced by the e-pharmacies in wake of the recent court order, which was covered under the earlier newsletter; it is only imperative now that the draft drugs and cosmetics legislation which came into circulation last year be considered for further discussion and deliberation, to also look at the digital health ecosystem, privacy of the stakeholders anew.

While, as per the regulatory filings Sun was able to clarify that “we proactively isolated our network and initiated the recovery process.” It also went on to clarify that the incident did not impact the company’s core systems and operations. It is important to note that while Sun was able to contain it to impacted assets and not let the core systems suffer, imagine a healthcare organization suffering from a breach with their Health Information Systems being impacted, it will expose entire medical/ health histories of patients to the perpetrators.

Recently, ICMR issued the Ethical Guidelines for Application of Artificial Intelligence in Biomedical Research and Healthcare focusing on all stakeholders, including innovators, developers, technologists, researchers, healthcare professional, Ethics Committees (ECs), Institutions, sponsors, and funding agencies involved in research related to artificial intelligence in biomedical research and healthcare. The preface to the guidelines state that the central goal for AI and ML systems should be to make the platforms available for the benefit of the largest section of common people with safety and highest precision possible. This will also press further the need to have a robust privacy framework. We shall discuss finer details of these Guidelines in the next newsletter.

Vikrant Mittal

Telepsychiatry in India: Brief Review

Dr. Vikrant Mittal MBBS, MD (Psychiatry)
Chief Medical Officer, Oasis Lifecare LLC

Background
Disruptor is a commonly used phrase in international IT & business settings. It specially came into vogue with technology disrupting how business was being done for decades. Similar disruption happened during coronavirus disease (COVID – 19) pandemic in the field of telemedicine in India. Some initial data and perception suggest that depression and anxiety increased in general population after Covid-19. Associated with data from a previous study that reported shortage of psychiatrist in India – only 2 psychiatrists for a population of 10 lakh (1). This has brought increased focus on psychiatry. And this is one of the opportunities where telepsychiatry can help bridge the gap in care and achieve more.

History
Similar to other branches telepsychiatry was also growing as the need arose and with technological advances in cameras, connectivity infrastructure and audio technology. Earliest use of telepsychiatry has been mentioned as a 1961 article on two-way television in group therapy (2). Over the years, telepsychiatry has been studied in different settings – child and adolescent population, adult forensic and correctional psychiatry and in geriatric populations throughout the world. It has shown to be highly effective and improved sustained care even in Schizophrenia and other psychotic disorder patient population (3). Indian data also suggests telepsychiatry is more economical than the present practice of in-person clinical care (4). It is also acceptable and feasible to the general population (5).

Progress
In India, one of the first implementation project was during the devastating 2004 Tsunami calamity mainly in Coastal districts of Tamil Naidu. This was done by an NGO SCARF (The Schizophrenia Research Foundation) (6). They provided psychological support services and training to volunteers.

Over the years mainly various government organizations have led in developing telepsychiatry guidelines for both synchronous and nonsynchronous models. Some of the successful models highlighted by Naskar S et al (2017) are STEP model by SCARF, PGIMER, Ganiyari model and ATP in different states (7).

In reaction to Covid 19 and to utilize virtual medical practice The Telemedicine practice guidelines were released in March 2020 (8). Following it in May 2020 Medical Council of India released the Telemedicine practice guidelines, The Indian Psychiatric Society (IPS) and Telemedicine Society of India (TSI) in collaboration with the National Institute of Mental Health and Neurosciences (NIMHANS) released Telepsychiatry operational guidelines (9). Guidelines outline scope, definitions, norms, protocols, and framework to implement telemedicine services. These guidelines are to help better understand the administrative and legal concerns present in practicing telemedicine. Other highlights of the guidelines are that both synchronous and asynchronous communication modes could be utilized to deliver service. Psychiatrists would be able to consult patients across the country leading to better and equitable access to all parts of the country. The guidelines offer legal protection to all the stakeholders and a higher likelihood of maintaining patient records. The inclusion of research and training in the guidelines would provide the necessary scope to evaluate the telepsychiatry practice (10).

Conclusion
At present there is an estimated huge gap ranging from 75% to 93% (11). Telepsychiatry services provided by both private and public providers would help bridge this gap. Guidelines provide a working framework that will help smooth implementation of programs, easy accessibility of services to all. Guidelines should be updated periodically with inputs from all stakeholders. This would be prudent given the ever-evolving technology, types of stakeholders and patient needs.

References:

  1. Mohandas E. Roadmap to Indian psychiatry. Indian J Psychiatry 2009;51:173-9.

  2. Wittson CL, Affleck DC. Two-way television in group therapy. Mental Hospitals Magazine. 1961 Nov: 22-23.

  3. Dwyer TF. Telepsychiatry: Psychiatric consultation by interactive television. Am J Psychiatry 1973;130:865-9.

  4. Moirangthen S et al. Telepsychiatry as an economically better model for reaching the unreached: A retrospective report from South India. Indian J Psychol Med 2017;39:271-75.

  5. Das S et al. Tele-psychiatric after care clinic for the continuity of care: A pilot study from an academic hospital. Asian J Psychiatry 2020;48:101886.

  6. Thara R, John S, Rao K. Telepsychiatry in Chennai, India: The SCARF experience. Behav Sci Law 2008;26:315-22.

  7. Naskar S et al. Telepsychiatry in India – Where do we stand? A comparative review between global and Indian telepsychiatry programs. Indian J Psychol Med 2017;39:223-42.

  8. Board of Governors in supersession of the Medical Council of India. Telemedicine practice guidelines. 1st ed. India BOD-MCI. India, 2020.

  9. Math SB, Manjunatha N, Kumar CN, et al. Telepsychiatry Operational Guidelines-2020. Bengaluru: NIMHANS.ISBN No: 978-81-945815-29.

  10. Dinakaran D et al. Telemedicine practice guidelines and telepsychiatry operational guidelines, India – Commentary. Indian J Psychol Med. 2020;42(5S):1s-3s.

  11. Gururaj G et al. National Mental Health Survey of India, 2015-16. Prevalence, patterns and outcomes. 2017. Ministry of Health and family Welfare, Government of India.

Conflict of Interest:
Author is partner at USI Health LLP which owns Telepsych website and App.

DrSibanandaMohanty

Glimpses of American Telemedicine Association 2023 Conference, San Antonio, Texas

Satyamurthy Lakkavalli and Bhagwant Singh Ratta
Suquino Telehealth India

Mr. L Satyamurthy and Dr. B S Ratta, our two Past Presidents attended ATA 2023 at San Antonio on 4th, 5th & 6th March 2023.

Brief Report:

  • It was a Teletreat for us to attend and present our Paper. There were over 300 Speakers & 2000 Attendees, spread out by Sessions on Tele Business, Clinical Opportunities, Policy, Research, Technology apart from Special Interest Group (SIG) Meeting, Book Signing by Authors, CEO Spotlight, Deep Dive, Express Theatre talks, Fire side chats, Keynotes, Panel Discussions, Patient Spotlight, Research Oral & Poster Presentations & Workshops.

  • A.I, Remote monitoring, Building and sustaining Tele Networks, Transforming care for rural populations were the highlights.

  • Every delegate, exhibitor was on an APP and he or she could prepare their own planner, see exhibitors & sponsors, including Scientific Program.

  • S.I.G Meetings were held on Telemental health, Ocular Telehealth, Govt relations, Acute & Critical Care Digital transformation, Remote monitory home & community telehealth, Home testing ATA Global Health Collaborative etc.

  • Telehealth, Innovators challenge was another highlight along with the startup conclave.

  • The exhibitors (Over 200) were par excellent and each stall was designed elegantly – The Keynotes, Panel Discussions in the mornings with over 2000 seating capacity and Breakfast/Lunch area were all in one huge hall with exhibitors and one could easily do 10,000 steps a day in that arena. There were over 4 break away groups for rest of the day. The Startup Zone was vibrant and their stalls were classic.

  • All in all it has left an indelible memory to be cherished. The overall program, arrangements, interactions, networking & fun is value for money and strongly recommend our young enthusiasts to take the lead and represent India.

  • Social Program – Casino Night & Welcome reception on Day 1 was a fun filled evening followed by a Paid Dinner on the 2nd night and the last day was by the river in the Hard Rock Café

  • With live music where everyone let them loose and enjoyed.

Telemedicine – News from India & Abroad

AI system can predict cardiovascular risk more accurately than humans

Researchers at the University of Oxford developed an AI system that uses machine learning to predict a person’s risk of developing heart disease and stroke. The AI system was able to produce a personalized risk score for each patient using medical data such as blood tests and lifestyle factors. In a study of over 400,000 patients, the AI system was able to predict cardiovascular risk more accurately than traditional methods used by doctors. The study was published in the journal, The Lancet Digital Health. https://www.thelancet.com

AI system detects early signs of Alzheimer’s disease

Scientists at University College London developed an AI system that can detect early signs of Alzheimer’s disease in brain scans. The AI system uses machine learning to analyze brain scans and identify subtle changes in the brain’s structure that are associated with Alzheimer’s disease. In a study of over 500 patients, the AI system was able to accurately predict which patients would develop Alzheimer’s disease up to six years before symptoms appeared. The study was published in the journal, Radiology. https://pubs.rsna.org

AI technology helps diagnose rare genetic disorders

Researchers at the Children’s Hospital of Philadelphia developed an AI system that can help diagnose rare genetic disorders by analyzing patients’ medical records and DNA sequencing data. The AI system uses machine learning to identify patterns in the data that are associated with specific genetic disorders. In a study of over 1,000 patients, the AI system was able to accurately diagnose rare genetic disorders in a fraction of the time it would take for a team of human doctors to review the same data. The study was published in the journal, Science Translational Medicine. https://stm.sciencemag.org

AI system improves accuracy of breast cancer diagnosis

Scientists at Google Health developed an AI system that can improve the accuracy of breast cancer diagnosis by analyzing mammogram images. The AI system uses machine learning to identify subtle changes in breast tissue that are associated with breast cancer. In a study of over 76,000 mammograms, the AI system was able to reduce the number of false positives and false negatives, which could help improve the accuracy of breast cancer screening. The study was published in the journal, Nature. https://www.nature.com

AI technology helps predict ICU mortality rates

Researchers at the University of Chicago developed an AI system that can predict the mortality rate of patients in intensive care units (ICUs). The AI system uses machine learning to analyze patient data such as vital signs and laboratory results to produce a personalized risk score for each patient. In a study of over 46,000 patients, the AI system was able to predict ICU mortality rates more accurately than traditional methods used by doctors. The study was published in the journal, Critical Care. https://ccforum.biomedcentral.com

Telemedicine Practice Guidelines – A Foundation Course for RMPs by TSI Faculty

To know more about the Telemedicine Foundation Course click on the link below:
https://tsitn.org/tpg-course/

TN – TSI invites all the TSI Chapters and Members to submit information on their upcoming Webinar or Events (50 words), News related to Telemedicine (200 words) or short articles (500 words) for the monthly e-newsletter.Guidelines for submission to TN TSI Newsletter-

  • Report can be from 500 to 600 words
  • Report Should be relevant to Telemedicine or Medical Informatics
  • No promotion of self or any product
  • Avoid plagiarism
  • All references should be included
  • Provide any attributions
  • Visuals are welcome including video links
  • Send full authors name, degrees, affiliations along with a passport sized photograph of good resolution. If multiple authors only main author photo to be sent.

Submission may be sent to – tsigrouptn@gmail.com
Editors reserve the rights for accepting and publishing any submitted material.

Editor in Chief – Dr. Sunil Shroff
Editors – Dr. Senthil Tamilarasan & Dr. Sheila John
Technical Partner- https://www.medindia.net

Tele-Health-Newsletter February 2023

Click Here to Download PDF Version

Telehealth Newsletter

Official Newsletter of Tamil Nadu Chapter of Telemedicine Society of India

What is New?

Since its inception during the COVID period, the e-sanjeevani app has performed 100 million teleconsultations, the prime minister revealed in his Mann Ki Baat programme. This is unquestionably a world record for the most free teleconsultations ever conducted. We’ll wait for a publication to learn more about its accomplishments and difficulties. The clinicians may learn a lot and contribute to the ecosystem’s general expansion.

TN-TSI chapter and KCG College of Technology successfully hosted a CME on telemedicine for engineering students this month. The programme was warmly accepted, and we intend to run more programs in the future. One of our members displayed the mobile lab that provides lab results instantly.

The recent decision from the Gujarat High Court regarding e-pharmacies is covered by our legal expert Bagmisikha. Even though there is uncertainty regarding their legality, e-pharmacies have expanded. There are unlikely to be any quick fixes to resolve issues related to their status.

We are getting ready for the next TELEMEDICON in Goa. Registration is open so do register.

Thank You
Dr. Sunil Shroff
Chief Editor
President – TN Chapter – TSI


 

Faculty Empowerment Program on Telemedicine and Health Care Research

Dr. Thulasi Bai
Professor, KCG College of Technology

 

Faculty Empowerment Program (FEP) on Telemedicine and Health Care Research was organised by KCG College of Technology in association with Telemedicine society of India-TN Chapter (TSI-TN) on 18th February 2023 at Mirza Seminar Theatre. Dr.Thulasi Bai, Professor, Department of ECE coordinated the over all program.

The inauguration started with prayer song at 9.15 AM. The workshop was inaugurated through traditional lighting of Kuthuvillakku by the dignitaries of TSI-TN and KCG College of Technology. Dr. Kavitha Balamurugan, Head, ECE department welcomed the gathering. Dr. Sunil Shroff, Senior Consultant – Urologist, Madras Medical Mission and President – TSI, TN Chapter gave the presidential address. In his speech, he explained the importance of Telemedicine.

Dr. T. Senthil CEO, Welcare Health Systems, Honorary Secretary, TSI-TN briefed about the activities of the TSI-TN and telemedicine in general. Dr. Srinath Yeswanth, Co-Founder, Curehealth Systems, LLP explained his experience with Telemedicine. Dr. Sheila John, Head of Teleophthalmology & E-Learning, Sankara Nethralaya, TSI-TN talked various initiatives taken in the hospital for screening the patients in rural areas through telemedicine.

After the inauguration the following speakers delivered their speech to assure the participants the best experience about the Telemedicine.

The Faculty Empowerment Program was attended by around 150 participants (Students and faculty) which includes external participants, Faculty of Electronics and Communication Engineering, Students of ECE, IT, AI&DS and Mechatronics department. Tele-Pathology van was brought to the campus and the participants had a chance to explore the facilities which was the highlight of the program.

The participants were given certificates and the FEP received good feedback from them. The workshop came to an end by 2.30 PM.

The organising team thank Management of KCG college of Technology and Principal for hosting the FEP and TSI-TN for arranging the eminent speakers for the sessions.

Dignitaries on Stage

Dr. Sunil Shroff, Senior Consultant – Urologist, Madras Medical Mission, Chennai & President – TSI, TN Chapter giving his speech

Dr. T. Senthil, Director & CEO – Welcare Health Systems, &
Hon’ry Secy – TSI, TN chapter delivering inspiring speech
Mr. P. Ravindran, IT Consultant, Arvind Eye Care Systems giving his talk on Tele-ophthalmology

Dr. Srinath Yeswanth, Co-Founder, Curehealth Systems, LLP during his session

Dr. Thulasi Bai thanking the speakers and gathering
Group Photo

 

DCGI issues notice to e-pharmacies for online sale of drugs without a license

Bagmisikha Puhan
Associate Partner, TMT Law Practice

Siddhant Gupta
Associate, TMT Law Practice

The Drug Controller General of India served show cause notices to prominent e – pharmacies earlier this month, for their continued violation of the provisions of the Drugs and Cosmetics Act, 1940 (DC Act). The show cause notice has relied upon the 2018 order of the Hon’ble High Court of Delhi in the matter of Dr. Zaheer Ahmed v. Union of India and Ors., whereby e-pharmacies were injuncted from the online sale of medicines without a due and proper license and were directed to ensure that the same is prohibited forthwith. The DCGI’ action is driven by the complaint forwarded by the All-India Organization of Chemists and Druggists (AIOCD) to multiple government agencies, including the Prime Minister’s Office (PMO), citing blatant abuse and violation of applicable law, and a rise in spurious drugs distribution.

It is interesting to note that while DCGI had forwarded the captioned order for compliance and action by the state drug controllers in 2019, there were no similar actions contemplated in the last 3 years, during the COVID-19 pandemic. E – pharmacies were instrumental in the past years for last mile healthcare delivery, where a considerable size of the demographics was stationed at home and accessibility to efficient and reliable healthcare services was a challenge. In fact, on March 26, 2020, during the lockdown, the Central Government realized that the retail sale of drugs to the doorstep of consumers is essential to meet the requirements of emergency arising out of pandemic COVID-19 and in the public interest, and accordingly notified the prescriptions for regulation of sale and distribution of drugs for their delivery to the consumers.

In addition to the same, the Telemedicine Practice Medicines, 2020 had sought to regularize and regulate the practice of telemedicine and provided nominal guidance to RMPs for their online consultation conduct and provided for necessary compliances to safeguard patient interest. This also provisioned for what happens when the RMP needs to communicate the prescription to a pharmacy, this was also provided within the same. It did seem like there was not just a mere acceptance of this position, but also growing awareness of consumer comfort which was being sought to be achieved by way of this arrangement between online pharmacies, and end users.

With an objective to regulate this market proposition, the amendments which were proposed to the existing regulatory framework by way of introduction of the draft Drugs, Medical Devices and Cosmetics Bill, 2022, which further indicated towards issuance of specific licensing guidelines for e-pharmacies to regulate the online sale of drugs and cosmetics. Furthermore, the draft National Medical Commission Registered Medical Practitioner (Professional Conduct) Regulations, 2022 sought to provide extensive guidance on the online conduct of RMPs, thereby reiterating the government’s intention to rely on digital technology to promote medical accessibility.

Indeed, the Ayushman Bharat Digital Mission (ABDM), the brainchild of the NITI Aayog and Ministry of Health and Family Welfare, further seeks to provide for a federated health information architecture, which will seek to further interoperability, accessibility and portability of health records across public and private healthcare institutions.

The DCGI action could set the Indian pharmaceutical industry on the backfoot again, after spirited efforts have been made by the regulators and industry stakeholders alike, to realign their operations to incorporate a digital component, and provide healthcare services to patients who are bed-ridden, or reliant upon their caregivers, in terms of finding access to the most primitive modes of care delivery. Adoption of technology, specifically the internet, allows for the ecosystem to increase accessibility and affordability of the services which are presented to the end users, bringing healthcare delivery to the last mile. We must afford e-pharmacies similar leeway, and provide them with the necessary guidance and regulation to streamline their operations, and allow the demographic to leverage the countless advantages of such service providers.

What appears to be a disconnect is the fact that the online pharmacies did not necessarily always rely on the large brick-and-mortar pharmacy chains which exist, but turned towards their own warehouses, stores in bringing this service to the last mile. The representation which made its way to the top, seems to be motivated by the lack of opportunities for the existing set-ups, where digital consultation, has paved way for the end users to find consultation, health check-up and drugs/ medicines, all at one point of care on the internet, as opposed to having to visit a doctor in a facility, and then going to another place for seeking their prescription drugs.

A show cause notice seeking information could be the starting point for regulation, however, this should not be considered to be an opportunity to undo the entire online ecosystem which has been created for the benefit of the masses.


Satellite to Block Chain – A new paradigm in Covid care delivery through Telemedicine under India’s Health care Mission “Ayushman Bharat“

Satyamurthy Lakkavalli and Bhagwant Singh Ratta
Suquino Telehealth India

Introduction

“Ayushman Bharat” meaning blessings of longevity for Indians, is a national flagship mission which is a federally funded government health care delivery system launched in the year 2018. It is an umbrella of two major healthcare initiatives namely:

National Health protection scheme (NHPS): This scheme is envisaged to be applicable for over 100 million poor and vulnerable families for providing up to $ 7,000 (USD) per family annually for secondary and tertiary care hospitalization. Benefits of the scheme are portable across the country with cashless benefits from any public or private empanelled hospitals across the country.

Health and Wellness centres (HWC): Under this scheme a whopping $170 million (USD) is allocated for establishment of 1,50,000 HWCs centres to provide comprehensive health care, covering non-communicable diseases and maternal/child healthcare services at primary level.

Ayushman Bharath and Telehealth:

The Telemedicine Program conceptualization, formulation and implementation in India was primarily spearheaded by the Indian Space Research Organization (ISRO) in the year 2001 under Space Technology applications for societal benefits. ISRO marshalled the diverse stakeholders across the country namely the Doctors, Specialist Hospitals, State Governments, Health Administrators, Technologists and Industry into a common platform for ushering Telemedicine service for rural, semi-rural and urban population.

The important factor of providing satellite connectivity without any charge by ISRO was the major boon for many of the rural district and specialty hospitals.

During the period 2002-2010 India had one of the largest Satcom based Telemedicine network by ISRO with 400 Remote/ rural/ district hospitals and 200 Village resource centres in most of 25 States of the country connected to 50 Specialty hospitals/Medical college hospital located in major cities/towns in the country including 20 Mobile units covering the various medical specialties.

More than Million Teleconsultation took place with several lifesaving instances during that period.

This commendable effort by ISRO demonstrated a beneficial change in reaching out to the rural population of India culminating in a federal government recognizing Telemedicine as an important application under National Health Mission (NHM)of the country.

Ayushman Bharat Digital Mission (ABDM)

ABDM scheme launched in 2018 got a fillip to stitch the silos in Indian health care system. Blockchain technology was thought of since it has the potential to revamp the currently existing processes to unlock new sources of efficiency and value, as was seen and evidenced in the pharmaceutical supply chain, verification and approval of fertiliser subsidies, verification of university certificates and transfer of land records in the country.

The ABDM envisages to register every next provider of healthcare in the country on the portal as the first vertical with all the healthcare facilities in government/ private sector including corporate hospitals and diagnostic Labs registered as second vertical. The third vertical being the population registry with every citizen having healthcare ID called ABHA no (Ayushman Bharat Health Account). The last being the software, hardware, medical devices, health IT companies being registered to provide the service for primary care through Wellness clinics and secondary/tertiary care through hospitals across the nation. With the advent of IT solutions like IoT-driven (Internet of Things) intelligent medical devices, personal healthcare apps for Telemedicine, AI for clinical decision making, online pharmacies for convenience and price comparisons, to name a few, have helped fuel the growth of Indian healthcare.

Creating a unique EMR under ABDM

One of the potential solutions that is often missing from the discussion is a portable or intra-operational Electronic Medical Record (EMR). In India, EMRs are primarily a platform to generate billing for the patient as there is low penetration of package pricing (an agreed-to and published price for a defined procedure) and thus most patients pay a-la-carte for the services they consume (doctor’s time, drugs, radiology reports, procedure, etc.). In this scenario there are no incentives to contain costs or stop unnecessary services from being performed and/or billed, as hospitals generate revenues by providing additional diagnostic tests which may not always be clinically appropriate. In addition to the billing aspect of an EMR, an EMR should also provide an electronically formatted patient file which provides a medical history and ensuing patient notes which are written by the doctor, nurse or allied health professional, results of lab tests and radiology imaging reports, as well as pharmacy orders.

It is not just in India, but in high income economies like the U.S, most of the EMRs cannot easily transfer data from one hospital to another. Why this is important, especially for poorer patients availing services as part of the Ayshman Bharath scheme? Many of these targeted patients need to travel for life saving care from rural India to a Tier I or Tier II city for surgery and rehabilitation, yet their private health information does not easily travel with them in an organized manner that would ensure timely and smooth transition for admission at a surgery centre and subsequently the post-surgery follow-up phase.

Block chain and EMR

Blockchain technology adopted has the potential to facilitate a national EMR system and provide the backbone for building a robust and centralized EMR system. Uploading and storing EMR data on a blockchain application could ensure that all stakeholders would benefit from EMR data without disturbing the integrity of the data and the privacy of confidential patient information. A blockchain EMR could store patient data and provide a unique file identification number to each patient, akin to an Indian Aadhar card number (UID) or U.S. Social Security card number, but the file can only be unlocked by a confidential code that is generated by the EMR blockchain system and the access code is known only to the patient. Additionally, since blockchain is a peer-to-peer technology, all users have a copy of the data in the database and unauthorized changes to the data can be flagged and deleted automatically in each user’s database, thus further ensuring data integrity.

Some of the benefits of using a blockchain EMR system could include:

  • Continuum of care resulting in better outcomes
  • Tax payers and Government could track the successful service for greater transparency and understanding as to how services are being utilized and paid for.
  • Insurance companies/trusts could more easily identify payment fraud and automatically disburse payments directly to a hospital’s bank account which is also one of the Government’s objectives (cashless, pre-authorized payment for services rendered)

Block chain adopted for Covid care

Covid brought unprecedented challenges in every walk of life due to which a big shift taking place in the healthcare industry. Government of India responded well by bringing in The Telemedicine Practice Guidelines on the very next day of the National lockdown on 25th March 2020. This opened the Pandora’s box for teleconsultations on Government and private platforms.

With the success of Blockchain technology in various Government sponsored program in India such as Aadhar, the world’s largest unified ID based system (1.2 billion biometrics and as more than 25 million authentications per day) and others like Unified Payments Interface (UPI) 1.3 billion transactions in Dec 2019, e Sign, Digi locker, Goods and Services Tax Network; Ayushman Bharat Digital Health mission (ABDM) with ABHA app, unified health interface and sandbox integration using block chain technology permits online search of health services, teleconsultations, diagnostic tests etc for creation of longitudinal health record . This enables connecting the different silos in the healthcare system and giving equitable and ubiquitous access to healthcare there by drastically reduce out of pocket expenses for the beneficiaries.

Conclusion
ABDM has already taken off and about 240 million e Cards have been issued to beneficiaries with approximate 8 million hospital admissions. It is envisaged that more than 80 per cent of India’s 1.35 billion population will be in the ABHA registry in the foreseeable future. 144787 healthcare facilities have already been registered. ABDM has built in security at different stages to prevent fraud in any chain. This enormous effort of integrating all the stake holders is enormous job by the federal government and hope for a successful fruition of this mega programme benefiting the major population of India in the near future.

Bibliography:

National Health Authority of India
Ministry of Health and Family Welfare, Govt of India
Ministry of Electronics and Information Technology, Govt of India
Digital India
The National Portal of India
Centre for Development of Advanced Computing, Govt of India

Disclaimer: The complete work related to Ayushman Bharath, Covid care and adaptation of block chain is being carried out by the different Ministries and Departments of Govt of India under the advice of NITI Aayog, the Think tank of the Indian Government. The authors have only done the research study from the data available and do not claim any credit or responsibility on the success of this mega project.


Development of a Digital Platform: A Perspective To Advance Space Telepharmacy

Marlise A dos Santos, Juliana Herbert, Ilaria Cinelli, Jose Antonio L Burmann, Vinicius V Soares, Thais Russomano

Abstract:

Goal : Lessons learned from decades of human spaceflight have helped advance the delivery of healthcare in rural and remote areas of the globe. Inclusion of the public in spaceflights is not yet accompanied by technology capable of monitoring their physical and mental health, managing clinical conditions, and rapidly identifying medical emergencies. Tele-pharmacy is a practice prioritizing pharmaco-therapeutic guidance and monitoring to help improve patient quality of life, and can potentially expand the field of space medicine. We seek to advance pharmaceutical care through tele-pharmacy by developing a digital platform.

Objective: This study focuses on the development of a digital platform for tele-assistance and pharmaceutical teleconsulting services that builds on lessons learned in delivering space medicine.

Methods: The platform contains evidence-based information on various drugs grouped by medical specialty, and also records and saves patient appointments. It has specific service protocols for service standardization, including artificial intelligence, to allow agility in services and escalation. All data is protected by privacy and professional ethics guidelines.

Results: The tele-pharmacy platform is ready and currently undergoing testing for ground applications through validation studies in hospitals or medical clinics.

Conclusions: Although developed for use on Earth, this tele-pharmacy platform provides a good example of how terrestrial healthcare knowledge and technology can be transferred to space missions. Read More



Telemedicine – News from India & Abroad

Transforming India’s Healthcare: Digitize Health Records

The gap between healthcare delivery and digitization is narrowing daily. Global health systems have continued to evolve, especially in the area of information technology (IT) penetration. In India, where 1.6 million people die due to poor quality health care, more stakeholders in the health sector are increasingly searching for solutions to address quality . …Readmore

Can Artificial Intelligence Detect COVID-19 by Listening to Cough Sounds?

Cough sounds do not help Artificial Intelligence (AI) technology to predict COVID-19 better, reports a new study.The AI classifiers trained on audio recordings cannot accurately predict whether someone has COVID-19 by analyzing the sound of their coughs, according to the study led by the UK’s Alan Turing Institute…..Readmore

Life-saver: Apple Watch Saves Wearer’s Life From Fatal Internal Bleeding

our watch can be a life-saver.Apple Watch saved the wearer’s life, by alerting him about a racing pulse following a nap, which led to a diagnosis of severe internal bleeding. Apple Watch can Now Detect Heart Blockage in Real Time Can Apple Watch detect heart problems? Yes, an Apple watch can now help in detecting undiagnosed heart blockage. …Readmore

Can Robots Help Children with Learning Disabilities Stay Focused?

Social robots can assist children with learning disabilities, reports a new study.Engineering researchers at the University of Waterloo are successfully using a robot to help keep children with learning disabilities focused on their work. ….Readmore


Click here to Become a Member of Telemedicine Society of India


Telemedicine Practice Guidelines – A Foundation Course for RMPs by TSI Faculty

To know more about the Telemedicine Foundation Course click on the link below:
https://tsitn.org/tpg-course/

TN – TSI invites all the TSI Chapters and Members to submit information on their upcoming Webinar or Events (50 words), News related to Telemedicine (200 words) or short articles (500 words) for the monthly e-newsletter.Guidelines for submission to TN TSI Newsletter-

  • Report can be from 500 to 600 words
  • Report Should be relevant to Telemedicine or Medical Informatics
  • No promotion of self or any product
  • Avoid plagiarism
  • All references should be included
  • Provide any attributions
  • Visuals are welcome including video links
  • Send full authors name, degrees, affiliations along with a passport sized photograph of good resolution. If multiple authors only main author photo to be sent.

Submission may be sent to – tsigrouptn@gmail.com
Editors reserve the rights for accepting and publishing any submitted material.

Editor in Chief – Dr. Sunil Shroff
Editors – Dr. Senthil Tamilarasan & Dr. Sheila John
Technical Partner- https://www.medindia.net

Tele-Health-Newsletter January 2023

Click Here to Download PDF Version

Telehealth Newsletter

Official Newsletter of Tamil Nadu Chapter of Telemedicine Society of India

What is New?

This New Year’s first issue carries very interesting perspectives from different health domains from mental health to how our health will cope in a microgravity environment of space travel. Dr. Smriti Joshi leads the tele-psychology group and has published a paper entitled “Are you ready for the shift?” From In person therapy to telepsychotherapy” in Indian journal of clinical psychology. We congratulate her for her recognition in this field and for being awarded Ethics in tech leader award for 2022.

Practical application of telehealth in saving lives among stroke patients especially in remote locations in Uttarakhand state is covered by Dr. Meenu Singh our president of the society.

Thank You
Dr. Sunil Shroff
Chief Editor
President – TN Chapter – TSI


Telemedicine Workshop for Trauma & Stroke

Dr. Meenu Singh
Executive Director, AIIMS Rishikesh
President, TSI

Head injury is a major cause of mortality and disability in the working population, resulting in more than 200,000 deaths in India every year. The survivors of head injury become dependent on their family members for months to years, resulting in major financial implications for the family. The department of Neurosurgery organized a two-day CME on 20-21 January 2023 for management and triaging of head injury patients. This CME was attended by 18 medical officers from 10 different districts of Uttarakhand state, 10 neurosurgery residents, 20 nurses and 20 BSc nursing students.

There was a dedicated session on telemedicine on 21 January 2023. In this session, Dr Amit Aggarwal, Assistant Professor, Department of Telemedicine from PGIMER Chandigarh discussed ‘Telemedicine Practice Guidelines’. In this lecture, medical officers were explained how to utilize telemedicine, precautions to be taken while using telemedicine and about the need to take informed consent from the patient and their family. This was followed by the talk by Professor Padma Srivastava, Chief, Neurosciences Center, AIIMS Delhi. In her talk, she shared her experience with telemedicine in management of stroke at the grassroot level in the states of Himachal Pradesh, Haryana and Punjab. Prof Padma led multiple state-level projects in these states, very similar to the ones that is being planned by the team led by Dr Nishant Goyal and Dr Jitender Chaturvedi in Uttarakhand. Time is of important in both stroke and head injury and telemedicine can be utilized in preventing loss of crucial transport time. In her talk, Prof Padma explained that they initially trained medical officers in identifying stroke and differentiating ischemic from hemorrhagic stroke on plain CT scans. They were trained regarding managing ischemic stroke with intravenous thrombolysis. Neurologists at AIIMS, Delhi and IGMC, Shimla were available via telemedicine to provide support to these doctors. They protocol was to discuss the clinical condition of the patient and evaluate the CT scans via telemedicine.

This was followed by the talk by Dr Nishant Goyal, Additional Professor, Department of Neurosurgery at AIIMS, Rishikesh. In his talk, Dr Nishant explained what information should be provided by the medical officers to the neurosurgery team at AIIMS Rishikesh while communicating via telemedicine. With the use of telemedicine, medical officers across the state would thus be in touch with Neurosurgery team at AIIMS Rishikesh and would receive support in providing initial treatment and triaging these patients. This will help in preventing unnecessary transfer of many head injury patients, who will be managed and triaged by the medical officers at grass-root level, close to patient’s residence. The same network will be used in following up the patients of head injury, discharged from AIIMS Rishikesh. After this, the medical officers were taken to the telemedicine facility at AIIMS Rishikesh, where they were introduced to e-Sanjeevani, a telemedicine web-portal, developed by the Government of India.


Global Recognition received for Safe Delivery of Tele mental health services following legal and ethical Standards

Dr. Smriti Joshi MBPsS
M.phil Clinical Psychology
Chief Psychologist & Member board of Directors, Wysa

 

 

The WHO estimates that about over 450 million people globally suffer from mental health disorders. It was suggested way back in 1996 that by the year 2020, our world would be reeling under increased health burden due to mental disorders (Murray and Lopez 1996). No one had imagined back then that a pandemic would strike the entire globe leading to not just physical health crisis but also trigger a Tsunami of mental health concerns. The existing gaps in seeking mental health care arising from shortage of mental health professionals, concentration of most mental health professionals in urban areas, stigma around seeking mental health care and loss of access to physical health care facilities due to social isolation guidelines worsened access to mental health care in India and globally.

Telepsychology services existed even before the pandemic but the pandemic forced both service providers and service users realise the power of digital health modalities to access health care services, especially for mental health care. Some countries were better prepared for their health care providers to make this shift from delivering onsite or in person health care services to delivering mental health services via online modalities. These countries already had good practices and standards of care documented and established around how to offer mental health care services at scale, in a legal and ethically safe way, yet this sudden and forced transition was not easy for anyone. Just around the same time, there was a steep increase in demand for remote mental health services not just to bridge the gap that was triggered due to the pandemic but also to provide mental health support at scale to people across the mental health spectrum. Digital mental health innovations saw a rise like never before and a large variety of digital mental health products and services came into being. Mental health professionals were being hired not just to offer therapy but to assist or take lead with ideating, creating products and service platforms that could meet and bridge the demand-supply gap as well as offer innovative ways to assess and manage mental health concerns at a population level and be able to triage if needed. These are new exciting support unities and psychology students and mental health professionals want to feel more prepared to offer these services but also want to learn to do this in a legal and ethically safe way.

When I had made this professional decision to move into telemental health space about 10 years ago, it was my training at the telemental health institute that had given me the confidence to make this transition, to design products and services that were well grounded with evidence based research and using best practices. There’s a clear need for capacity building and training and guidance for mental health professionals aspiring to enter mental health domain in tech space and for other mental health professionals as well to stay updated with this rapidly evolving space. I volunteered as an expert in this field, to help draft the first set of guidelines for offering telepsychology services and conducted webinars and virtual trainings for the psychologist fraternity in India and South east Asia to assist them with this transition from in person services to offering services using online modalities. Also as a lead for ethics in tech team at therapistsintec a not for profit organisation that came into being during the pandemic promoting the development of ethical digital mental health leaders through authentic connections, upskilling, mentoring, training, and inclusion, I along with my co lead Dr. Erika Torres conducted a survey to assess the need-gap analysis being experienced by mental health professionals aspiring to offer services in this space. The survey results indicated the immense need (30.8%) to learn about how to deliver clinical services/interventions via telehealth in an ethical way. About 23% of members expressed that they wanted to know more about legal and ethical issues that a provider/organisation can face when providing their services via online modalities and another 23% expressed their need to learn more about ethics of using ML and AI in mental health or for mental health service delivery.

These results found support in a recent research paper titled ” Ethics in Telehealth: Comparison between Guidelines and Practice-based Experience” , where key findings from their work indicate that there exists a gap in what practitioners or service providers would find helpful as guidelines and the actual content of existing telehealth /tele mental health guidelines globally. It was observed that existing guidelines are more focused on the structural aspects of telehealth whereas the clinician or practitioner focus on behavioural challenges and implications of using telehealth in specific contexts seems to be not addressed.There is a need to identify and collate Practitioner perspectives and create sources for practice based evidence to develop a better or more helpful set of guidelines that address our questions or need to know ethical implications of delivering services via various modalities, with people from different cultural backgrounds , how social determinants are impacting client’s access to these services , what are the challenges of integrating ML and AI in actual service delivery mechanisms and its implications on outcomes. This survey has led to taking more informed steps for “therapistsintech” members and the larger mental health fraternity to support, train and provide mentorship to aspiring members so they can feel more confident and unleash their full potential. I also shared these results and my vision around bridging the gap that exists between published legal & ethical guidelines and challenges clinicians experience while trying to implement these in their practice at the 8th Annual eMHIC Congress and have been invited to contribute to the position statement on ethics in digital mental health being drafted by a special interest group at eMHIC. These efforts were really appreciated by Therapists in Tech community and I was awarded Ethics in tech leader award for 2022.


A Journey Into Space

Prof Thais Russomano, MD, MSc, PhD
InnovaSpace UK (http://InnovaSpace.org)

 

 

Future space missions aim to further the capabilities of space travel by aiming to fly farther and for longer than ever before. The National Aeronautics and Space Administration (NASA) and a number of private space firms (such as Blue Origin, SpaceX, and Virgin Galactic) have already begun the process of getting ready for long-distance, long-duration space exploration. They currently have plans to explore inner solar planets (such as Mars) by the 2030s. Space travel has emerged as a potential new, exciting frontier of commerce, hospitality, medical, and technology in the upcoming years thanks to the development of space tourism. However what are the implications of space travel on our health.

The presence of gravity on Earth has had an integral effect on the development of life over billions of years and has shaped the anatomy and physiology of human beings. Exposure to microgravity has been shown to affect the whole body, causing numerous changes, such as a reduction in heart size and blood volume, disturbances of the neurological system, decreases in bone and muscle mass, and impairment of the immune function. These physiological changes can lead to undesirable health consequences and to operational difficulties, especially in emergency situations.

The paper entitled Human Health During Space Travel: State-of-the-Art Review is an open access article that presents aspects related to the medical selection of astronauts and examines the physiological and psychological reactions of body and mind to the hostile environment of space. We categorized the extraterrestrial environment into exogenous (like space radiation and microgravity) and endogenous (like altering the human circadian rhythm and mental health due to confinement, isolation, immobility, and lack of social interaction) processes and their various effects on human health. In order to enable new paradigms for space health, we analysed potential health risks connected with space flight and how they might be mitigated, as well as how to employ developing artificial intelligence (AI) technologies to further future space health research.

Space is undoubtedly humankind’s final frontier. Fasten your seatbelt, click on the link and enjoy your free journey into space and read how it can affect your health!
https://www.mdpi.com/2073-4409/12/1/40


Virtual healthcare in the new normal

Dr. Nitin Upadhyay
Associate Professor, IT Systems & Analytics, Chairperson MBA, Program Director Executive Program in Digital Finance and Banking, Indian Institute of Management Jammu

 

The use of information communication and technology (ICT) in public administration systems and service delivery has become increasingly crucial in today’s world as governments around the globe invest in upgrading their ICT infrastructures. One of the most promising applications of ICT in public service delivery is telemedicine, which allows patients and doctors to connect remotely, eliminating the barriers of time and distance and reducing healthcare costs. India, in particular, faces a shortage of doctors and nurses, resulting in a significant gap in healthcare services. To address this issue, the Indian government has implemented regulations, policies, and solutions to strengthen telemedicine services.

The National Telemedicine Service – eSanjeevani was launched in 2019 as a doctor-to-doctor telemedicine platform, operationalizing the Ayushman Bharat health insurance scheme. Amidst pandemic, the Indian Ministry of Health and Family Welfare (MoHFW) expanded the capabilities of eSanjeevani, a telemedicine platform, to provide patients with remote access to medical consultations. This e-government healthcare service allows patients to receive medical treatment from the safety of their homes, instead of in-person visits. This new approach to virtual consultations is a revolutionary way for patients to communicate with healthcare professionals and receive medical services.

However, the successful implementation of these services depends on the willingness of healthcare consumers to adopt telemedicine. Our research aimed to understand users’ attitudes and behavioral intentions towards adopting e-government telemedicine services. The research extended the unified model of e-government adoption (UMEGA) by considering factors such as perceived severity, self-efficacy, and political trust.

The study’s findings revealed the significant impact of “facilitating conditions” on both effort expectancy and behavior intention in regards to the adoption of e-government telemedicine systems (EGTMS) such as eSanjeevani. To accomplish this, the government must invest in the development and provision of a favorable ICT ecosystem that supports the implementation and delivery of EGTMS. This includes designing, procuring, and developing a viable technology infrastructure and ICT tools, as well as ensuring the availability of affordable data packages, uninterrupted power supply, internet connectivity, and access. Furthermore, the government can take steps to reduce the learning curve for individuals using the system, such as providing helpdesks and individual training sessions.

Users’ perceptions of risk can have a major impact on their attitudes and decisions to adopt e-government telemedicine systems (EGTMS). In the virtual environment in which e-government services operate, users may encounter various uncertainties and have concerns related to financial, psychological, performance, and security risks. To address these concerns, it is crucial for the government and administrative entities to design and implement robust and secure systems that can help users overcome these risks. Additionally, providing users with training on the proper use of information can help to alleviate any uncertainties they may have.

Telemedicine services such as eSanjeevani can serve as a medium for preventive health behavior, rather than just a medium for consultation services. Therefore, it is important for the government to strategize and roll out appropriate health communication and health literacy programs to mobilize the public and motivate healthcare consumers and professionals to use EGTMS. Overall, the study suggests that government and administrative entities should focus on building a facilitating environment, developing positive attitudes, addressing perceived risks and promoting self-efficacy for increasing adoption of EGTMS.

Telemedicine holds enormous potential to revolutionize healthcare in India and other countries by reducing the gap in healthcare services. However, to ensure the success of telemedicine services, the government must invest in a favorable ICT ecosystem and address the attitudes and perceptions of healthcare consumers.

The details of the original published paper can be accessed through the following link
https://www.sciencedirect.com/science/article/pii/S0740624X22001368


Telemedicine – News from India & Abroad

New Technology and Old Books to Combat Insect-Borne Diseases Says Google

Google is developing a new technology to combat such diseases using decades-old datasets mined by Google Books as insect-borne diseases are affecting the lives of hundreds of millions of people every year. …Readmore

Artificial Intelligence Tool to Predict Lung Cancer Risk

Sybil, the artificial intelligence (AI) tool developed by researchers precisely predicts lung cancer risk for people with or without a significant smoking history. Results are published in the Journal of Clinical Oncology…..Readmore

On-The-Go Cardiac Imaging on Its Way!

Wearable ultrasound device that can assess both the structure and function of the human heart has been developed by engineers and physicians at the University of California San Diego and published in the journal Nature. …Readmore

Early Signs of Alzheimer’s Disease may be Detected With Artificial Intelligence (AI)


OpenAI’s GPT-3 program can identify clues from spontaneous speech that are 80% accurate in predicting the early stages of dementia as demonstrated by the research from Drexel University’s School of Biomedical Engineering, Science and Health Systems, published in the journal PLOS Digital Health ….
Readmore


Click here to Become a Member of Telemedicine Society of India


Telemedicine Practice Guidelines – A Foundation Course for RMPs by TSI Faculty

To know more about the Telemedicine Foundation Course click on the link below:
https://tsitn.org/tpg-course/

TN – TSI invites all the TSI Chapters and Members to submit information on their upcoming Webinar or Events (50 words), News related to Telemedicine (200 words) or short articles (500 words) for the monthly e-newsletter.Guidelines for submission to TN TSI Newsletter-

  • Report can be from 500 to 600 words
  • Report Should be relevant to Telemedicine or Medical Informatics
  • No promotion of self or any product
  • Avoid plagiarism
  • All references should be included
  • Provide any attributions
  • Visuals are welcome including video links
  • Send full authors name, degrees, affiliations along with a passport sized photograph of good resolution. If multiple authors only main author photo to be sent.

Submission may be sent to – tsigrouptn@gmail.com
Editors reserve the rights for accepting and publishing any submitted material.

Editor in Chief – Dr. Sunil Shroff
Editors – Dr. Senthil Tamilarasan & Dr. Sheila John
Technical Partner- https://www.medindia.net

Tele-health-Newsletter December 2022

Click Here to Download PDF Version

Telehealth Newsletter

Official Newsletter of Tamil Nadu Chapter of Telemedicine Society of India

What is New?

A few notable developments that occurred in 2022 are likely to be helpful and have a big impact on telehealth practice. The first was the National Task Force’s submission of Version 2 of Telemedicine Practice Guidelines to the National Medical Commission. And the second – the public debate over the Personal Data Protection Bill and its final submission this month. After this, the bill is likely to be submitted to the parliament for approval. The future course of telehealth will be set by these two significant developments.

There has, however, been also another unsettling development, the expansion of surgical aggregators similar to those in the pharma feild. These aggregators are now offering commission for surgical referrals, which is very worrying trend (See the image). Corporate medicine in India has already resulted in ongoing ethical issues due to a practise known as referral kickbacks used by some of the country’s leading corporate hospitals and diagnostic centres, and now this – perhaps the mother of all kickbacks.

These kickbacks are against the laid ethical norms of NMC Professional Ethical Guidelines. TSI as a society can take a strong stand to condemn these practices before it catches fire and starts corrupting our ecosystem.

As the festivities and the year come to a close, our newsletter team wishes all the TSI members a very happy, peaceful and safe 2023.

Thank You
Dr. Sunil Shroff
Chief Editor
President – TN Chapter – TSI


Uttarakhand Chapter of Telemedicine Society of India, inaugurated at AIIMS, Rishikesh


Dr. Murthy Remilla
Secretary TSI

 

Telemedicine is the new normal for affordable access to best-in-class universal healthcare in a connected and comprehensive healthcare ecosystem linking even the most remote rural populations to District, State, National and International Centres of Healthcare Excellence.

The Telemedicine Society of India (TSI) inaugurated the Uttarakhand State Chapter of the Telemedicine Society of India during a programme organised at AIIMS Rishikesh on December 10,2022. Professor (Dr) Meenu Singh, President (TSI) and Dr.Murthy Remilla, Hony. Secretary (TSI), jointly launched the Uttarakhand (UK) State chapter of the telemedicine society of India.

Dr.Meenu Singh, is currently the executive director of AIIMS Rishikesh, She highlighted the telemedicine option as a significant advantage for hill states with difficult topographical conditions, such as Uttarakhand and Himachal Pradesh. Dr Meenu Singh stated that additional medical and nursing institutions around the nation would soon be linked to this facility. The Base Hospital, Kotdwar and Lal Bahadur National Academy of Administration (LBSNAA) in Mussoorie are currently linked to AIIMS Rishikesh’s telemedicine capability.

TSI Hony.Secretary Dr. Murthy Remilla described the technology-based telemedicine facility as beneficial for strengthening health facilities across the country. He explained that, with a telemedicine facility, the effort is to strengthen health facilities in every village.

Vice president of TSI Uttarakhand, Professor Shalini Rajaram; Dean Academics, Prof Jaya Chaturvedi; Secretary of TSI Uttarakhand State Chapter and HOD of Urology Department AIIMS Rishikesh, Dr Ankur Mittal and Dr Rajan Arora from Govt of UK also addressed the gathering.

The event was attended by the Medical Superintendent, Prof Sanjeev Kumar Mittal; the Additional Medical Superintendent, Prof Anshuman Darbari; the Principal of the College of Nursing, Dr Smriti Arora; Professor of Physiology, Dr Poorvi Kulshrestha, Professor Arup Kumar Mandal; Dr Yogesh Bahurupi, PPS Vineet Kumar, and a host of others. Representatives of various institutions across the country also participated in the programme online.



 


Digital Health Course Launched by IIM Raipur in collaboration with the Digital Health Academy

Dr. Rajendra Pratap Gupta
Programme Chair for the Post-Graduate Certificate Course in Digital Health

Why do we need a course in digital health

Broadly speaking using technology to deliver healthcare is Digital Health, and during COVID-19, all of us have used digital health in some form or the other. Healthcare is adopting technology faster than we can imagine. Online doctor appointments are now widespread, and using mobile apps for doctors’ consultations and management of chronic diseases is now a reality.

The software is now prescribed like a drug (SaaD), and software is now a medical device (SaMD); it is only that some have not used it while others have, and soon the number of people asking for digital therapeutics is going to increase. The age of treating patients with medicines alone is over, now, we would need technology for handling the new-age patient, and that’s why every doctor who is handling a patient will have to use digital health. The role of the doctor is becoming that of an infomediary. Technology is changing the relationship between the doctor and the patient.

The gap between what is happening and what is being taught is huge, and technology does not wait for anyone. Those who use digital health will replace those who don’t; hence, it is important to understand this digital health domain and be prepared so that when the opportunity knocks, people don’t miss it.

This course will help learners secure their organization’s future and medical practice. It will equip clinicians, paramedics, healthcare professionals, and managers to understand the digital health domain and the deployment of digital health tools. Also, now ABDM is incentivizing the adoption of electronic health records, every single provider will need people qualified in digital health to serve the patients under various government schemes and through the use of ABHA number. Also, newer technologies like the metaverse will impact health care. So, such a course will be a basic enabler for existence in the healthcare sector.

Why is this course online ?

Given that working professionals and doctors find it difficult to attend a college or a university to learn about digital health, we created this fully online course with the world’s best faculty teaching digital health from their years of experience in digital health. Also, for digital health, the course should be delivered digitally.

What did it take to build this course ?

The course was developed with over two years of research with the world’s top authorities on Digital Health. The course was designed in consultation with over 60 global leaders across the healthcare domain working in hospitals, the pharmaceutical industry, research & development, med-tech, information technology, regulators, and policymakers spread across the USA, U.K., E.U., South-East Asia, Africa, and after research in over 100 countries on the course’s need and content. The course is a unique blend of the world’s best faculty and use-cases in digital health.

This is the world’s first ‘Certified Digital Health Professional’ (CDHP) course blending the fields of health, technology, and management. The CDHP course has three levels; Basic, Advanced and Professional. This course aims to provide knowledge on theoretical, technological, management, and application aspects of digital health across the continuum of care. The faculty of CDHP™ are the actual practitioners of Digital Health & Management. They are global health technology leaders who have developed and delivered Digital Health. After this course, people will understand the digital health domain and how to deploy digital tools in day-to-day practice and gain a competitive advantage. The learners will get a theoretical, technological, management, and application-level understanding of key digital health tools.

What is the career perspective for those taking this course?

This Post Graduate Certificate Course in the field of Digital health offers people an opportunity to be a formally qualified and trained professional in digital health. This course can help build a career in:

  • Pharmaceutical Industry
  • Hospitals
  • Consulting & Advisory services
  • Chronic Disease Management
  • Medical Devices
  • Information Technology
  • Academics & Research
  • Digitalizing Medical/ Clinical Practice
  • Public Policy & Regulation
  • Digital Health Project Management
  • Marketing & Business Development for Organizations in Digital Health
  • Develop Digital Health Solutions
  • Insurance
  • Entrepreneurs in Digital Health

Who will award the certificate for this course?

The course certificate will be awarded by IIM Raipur & Digital Health Academy, and those successfully completing the course will become the executive alumni of IIM Raipur. Also, the Digital Health Academy will list the learners in the Certified Digital Health Professionals directory.

What is the international recognition for this course?

The course is endorsed by two of the most prominent bodies in Digital Health; International Society for Telemedicine & eHealth , Switzerland, and the European Connected Health Alliance

What are the eligibility criteria for enrolling in this course?

Graduation degree or its equivalent with work experience of minimum of two years . Clinicians and healthcare professionals, and managers can apply.

How many seats are being offered;

200 seats are available for the 2023 cohort.

What is the Fee structure?

For Indian Students: INR 3.6 Lacs plus applicable taxes
For Foreign Students: US$ 7,000
*The above fees include tuition Fees, Material / Notes & Alumni fees.
3 day Contact Program (Optional) at IIM Raipur.

Website for the course : https://web.iimraipur.edu.in/index.php/programmes/pgcpdh/pgcpdh-overview


NHA aims to promote adoption of Ayushman Bharat Digital Mission (ABDM) by offering incentives of up to Rs. 4 crores to hospitals, labs and digital health solution providers

The National Health Authority (NHA) has announced a Digital Health Incentive Scheme (DHIS) for the stakeholders of the digital health ecosystem. The scheme aims to give a further boost to digital health transactions in the country under the Ayushman Bharat Digital Mission (ABDM). The incentives under this scheme would be provided to hospitals and diagnostic labs and also to the providers of digital health solutions such as Hospital/ Health Management Information System (HMIS) and Laboratory Management Information System (LMIS).

Under the DHIS, the eligible health facilities and digital solutions companies shall be able to earn financial incentives of up to Rs. 4 crores based on the number of digital health records they create and link to ABHA (Ayushman Bharat Health Account). This incentive can be availed by the health facilities (hospitals and diagnostic labs) registered with ABDM’s Health Facility Registry (HFR) and fulfilling the eligibility criterion specified under the scheme.

Elaborating on the same, Dr. R. S. Sharma, CEO, NHA said – “We believe that this scheme will encourage more and more healthcare facilities and digital software companies to come forward and join ABDM for providing patient-centric healthcare. Through this financial incentive scheme, we’re encouraging the adoption of digital health. Further, we’re also including solution (HMIS/ LMIS) providers in the incentive scheme so that they handhold other health facilities to come on board and facilitate strengthening of the ecosystem. Incentives have played a catalytic role in driving early adoption of other citizen centric programs such as UPI, notification of TB cases, Janani Suraksha Yojana, etc.”

Important points under ABDM’s Digital Health Incentive Scheme are:

1.Incentives would be provided to the following entities:
a. Health Facilities having 10 or more beds
b. Laboratory/radiology diagnostics centres
c. Digital Solution Companies (entities providing ABDM enabled digital solutions)

2.The incentives shall be provided on the basis of the number of ABHA-linked transactions i.e. the digital health records created and linked to ABHA.

 

Healthcare Facility Base Level Criteria Incentives
Hospitals 50 Transactions per bed per month Rs. 20 per additional transaction above the base level
Diagnostic facilities /Labs 500 Transactions per month Rs. 15 per additional transaction above the base level

3.Digital Solution Companies (DSCs) will be given an incentive of 25% of the incentive amount received by the eligible health facilities using their digital solutions.

4.For the ABHA linked transactions done by facilities not eligible for direct incentives (Clinics/ Small Hospitals/ Health Lockers/ Teleconsultation Platforms etc.), an incentive would be provided to Digital Solution Companies.

Cost Incentives for Digital solution (HMIS and LMIS) Companies
For every Transaction by hospitals/labs using their software and receiving incentives under this policy 25% of the corresponding incentive amount received by the eligible facilities
For other Transactions (including by health lockers, Teleconsultation platforms, small clinics etc.), provided the transactions are more than 200 per month Rs. 5 per Transaction

For public sector facilities, the incentives shall be added to the funds under Rogi Kalyan Samiti. The estimated initial financial outlay of the incentive scheme is Rs. 50 crores for a period of six months starting from 1st January 2023 onwards.

Further, public webinars would be organised by NHA starting from Dec 23, 2022 to provide detailed overview of the scheme. The schedule and link for the webinars will be available on the website https://abdm.gov.in/dhis. Full text of DHIS is available at: https://abdm.gov.in:8081/uploads/Digital_Health_Incentive_Scheme_550e710e09.pdf Read More


Announcement

10th International Conference on Transforming Healthcare Using IT from 13th to 14th February 2023 at New Delhi


Telemedicine – News from India & Abroad

Google to Soon Translate Doctor’s Handwritten Prescription

Google to use artificial intelligence (AI) and machine learning (ML) model to identify and highlight medicines within difficult-to-read handwritten prescriptions.This will act as an assistive technology for digitizinghandwritten medical documents by augmenting the humans in the loop such as …Readmore

Artificial Intelligence may Predict Success of Botox Treatment in Dystonia Patients

With the help of artificial intelligence/AI technology, researchers have designed synthetic DNA that controls the cells’ protein production.How our genes are expressed is a process that is fundamental to the functionality of cells in all living organisms. Simply put, the genetic code in DNA is transcribed ….Readmore

Is Artificial Intelligence Better at Predicting Brain Metastasis Outcomes

An innovative artificial intelligence (AI) technique developed is found to be more effective than the human eye when it comes to predicting therapy outcomes in patients with brain metastases.The new research and technology could eventually lead to more tailored treatment plans and better health …Readmore

Virtual Reality Game Detects Attention Deficit Hyperactivity Disorder

Virtual reality games and machine learning approach were used by researchers to detect attention deficit hyperactivity disorder (ADHD).ADHD is a common attention disorder that affects around six percent of the world’s children. Despite decades of searching for objective markers, ADHD diagnosis ….Readmore

Looking towards the future of telehealth in Medicare, evidence is needed

Throughout the COVID-19 pandemic, telehealth services have played an essential role in maintaining and expanding Americans’ access to their health care. But what comes next to ensure that telehealth can work after the pandemic? What can we learn from those with “hands-on” experience with telehealth from the past two years? https://www.whitehouse.gov/ostp/news-updates/2022/11/10/looking-towards-the-future-of-telehealth-in-medicare-evidence-is-needed/


Click here to Become a Member of Telemedicine Society of India


Telemedicine Practice Guidelines – A Foundation Course for RMPs by TSI Faculty

To know more about the Telemedicine Foundation Course click on the link below:
https://tsitn.org/tpg-course/

TN – TSI invites all the TSI Chapters and Members to submit information on their upcoming Webinar or Events (50 words), News related to Telemedicine (200 words) or short articles (500 words) for the monthly e-newsletter.Guidelines for submission to TN TSI Newsletter-

  • Report can be from 500 to 600 words
  • Report Should be relevant to Telemedicine or Medical Informatics
  • No promotion of self or any product
  • Avoid plagiarism
  • All references should be included
  • Provide any attributions
  • Visuals are welcome including video links
  • Send full authors name, degrees, affiliations along with a passport sized photograph of good resolution. If multiple authors only main author photo to be sent.

Submission may be sent to – tsigrouptn@gmail.com
Editors reserve the rights for accepting and publishing any submitted material.

Editor in Chief – Dr. Sunil Shroff
Editors – Dr. Senthil Tamilarasan & Dr. Sheila John
Technical Partner- https://www.medindia.net

Tele-health-Newsletter November 2022

Click Here to Download PDF Version

Telehealth Newsletter

Official Newsletter of Tamil Nadu Chapter of Telemedicine Society of India

What is New?

The highlight of November 2022 has been the annual national conference at Kochi at Amrita Hospital and a report by Mr. Bijoy with pictures are presented. Kerala has been at the forefront of Telemedicine since the year 2002 and Amrita has an established department that has indeed helped its growth. In fact Amrita had also started a postgraduate course on the subject by Dr. Ajith Babu during the same time.

Last month there was another interesting telehealth event at Delhi organised by Dr. Rajenra Gupta, one of our TSI members. This was entitled – Global Digital Health Summit. There were apparently 1706 registrations but considering the COVID protocol they approved 750. There were 680+ participants from across the globe.

This month the Ministry of Electronics and Information Technology has invited feedback on the draft ‘Digital Personal Data Protection Bill, 2022.’ Our legal expert – Bagmisikha Puhan has sent her expert comments. Do go through the bill and send your feedback to the ministry. The link has been provided.

Thank You
Dr. Sunil Shroff
Chief Editor
President – TN Chapter – TSI


TELEMEDICON2022 at Kochi

M.G. Bijoy
Telemedicon Organizing Secretary,
Kochi

Highlights of 18th International Telemedicine Conference hosted by TSI Kerala Chapter in association with Amrita Hospital.

KOCHI: The three-day 18th international conference, ‘Telemedicon 2022’ of the Telemedicine Society of India with TSI Kerala Chapter, took place at Amrita Hospital in Kochi . Dr. Mohanan Kunnummal, Vice-Chancellor Kerala University of Health Sciences, inaugurated the conference. State IT Secretary Dr. Ratan Khelkar,IAS; Dr. Prem Nair; Group Medical Director, Amrita Hospitals, Chairman Telemedicon 2022 and TSI Kerala Chapter, Dr.P K Pradhan,President,TSI, M.G. Bijoy, Telemedicon Organizing Secretary, TSI Secretary,Dr. Murthy Ramila were among the dignitaries who spoke at the inaugural function. ISRO Chairman S. Somnath conveyed his best wishes through a video message.

Delivering the speech, Dr. Mohanan Kunnummal said that telemedicine has legal protection across the country, and with the shift to 5G, telemedicine will become popular. The advancement of technology and network connectivity will open up even better possibilities in telemedicine. He said that the days are coming when many modern technologies will have a decisive impact on telemedicine. Virtual reality and augmented reality will open up more opportunities for telemedicine. “The new technologies will help create the impression of getting tested sitting next to the patient,” he further added.

Dr. Prem Nair, Chairman of Telemedicon 2022, President of TSI Kerala Chapter, and Group Medical Director of Amrita Hospitals, delivered the introductory speech. He said telemedicine could help bring down the cost of health care. He also noted that 5G connectivity will strengthen the telemedicine system across the country, saving the time it takes to save the lives of critically ill patients and that telemedicine can be used effectively in situations where a wearable device is used.

“We are one of the early adopters of telemedicine in the state of Kerala. It primarily started as a programme to bridge the physical distance between care providers and patients, he said. Now we are making use of state-of-the-art technologies to expand telemedicine services. Our expertise, clinical care, technology research, and social commitment help us deliver technology-enabled care. “When we started our activity in Kerala in 2002, in association with ISRO, we aimed to provide early healthcare services at affordable cost. Today, after 17 years, we provide telemedicine services to 60 national and nine international centers,” he added.

ISRO Chairman S Somnath attended the conference virtually. He explained the steps taken by ISRO in the initial phase of telemedicine. He said that the growth and integration of technologies are very promising. Telemedicine will witness revolutionary changes as connectivity facilities further improve. Telemedicine connectivity can be strengthened, and the services can be expanded in rural areas with the spread of connectivity through satellites. He pointed out that there will be significant changes in healthcare services with the improvement of connectivity between patients and doctors through applications.

Kerala IT Secretary Ratan Kelkar said, “Startups, private entrepreneurs, and technology partners should come forward to promote telemedicine. He also mentioned that greater participation is essential for the sector’s growth as 5G has provided the best background.Also assured all the support for the digital health initiatives in Kerala”

Expert speakers from WHO presented the Telemedicine Guidelines released by WHO and also about advancements in AI.

Govt of India’s Telemedicine platform was detailed by E-Sanjeevani Man Dr.Sanjay Sood.

The Valedictory function was inaugurated by Mr. K.S. Srinivas IAS, Principal Secretary, Tourism. Mentioned about the possibilities of health tourism connecting Telemedicine.


Public Consultation on the draft ‘Digital Personal Data Protection Bill, 2022’

The Ministry of Electronics and Information Technology invites feedback on the draft ‘Digital Personal Data Protection Bill, 2022’.

Ministry of Electronics and Information Technology has been deliberating on various aspects of digital personal data and its protection, and has formulated a draft Bill, titled ‘The Digital Personal Data Protection Bill, 2022’.

The purpose of the draft Bill is to provide for the processing of digital personal data in a manner that recognizes both the right of individuals to protect their personal data and the need to process personal data for lawful purposes, and for matters connected therewith or incidental thereto.

The draft Bill employs plain and simple language to facilitate ease of understanding and is available on Ministry’s website at https://www.meity.gov.in/data-protection-framework, along with an Explanatory note that provides a brief overview of its provisions, which is available at https://www.meity.gov.in/data-protection-framework

The Digital Personal Data Protection Bill frames out the rights and duties of the citizen (Digital Nagrik) on one hand and the obligations to use collected data lawfully of the Data Fiduciary on the other hand.

The bill is based on the following principles around the Data Economy: The Bill will establish the comprehensive legal framework governing digital personal data protection in India. The Bill provides for the processing of digital personal data in a manner that recognizes the right of individuals to protect their personal data, societal rights and the need to process personal data for lawful purposes.

The Ministry has invited feedback from the public on the draft Bill. The submissions will not be disclosed and held in fiduciary capacity, to enable persons submitting feedback to provide the same freely. No public disclosure of the submissions will be made.

The feedback on the draft bill in a chapter wise manner may be submitted on https://innovateindia.mygov.in/digital-data-protection/ by 17 th December 2022.


Special Note About the Digital Personal Data Protection Bill, 2022

Bagmisikha Puhan
Associate Partner, TMT Law Practice

The Ministry of Electronics and Information Technology (MeitY) released the latest iteration of the data protection framework, christened as the Digital Personal Data Protection Bill, 2022 (Bill) for public consultation. At the outset, it appears that the Bill has sought to ease compliance requirements applicable upon start-ups, and has scrapped the erstwhile data localization requirements, which have been a consistent inclusion within the previous iterations issued by MeitY.

The preliminary relevant highlights of the Bill have been captured herein:

  1. The objective of the Bill has been watered down, to remove protection of interest and security of State, and refocuses on the need to process digital personal data in a manner, which recognizes the right to privacy of individuals, who’s data is being processed by an entity.
  2. The qualified title adding “Digital” seems to reflect the association of this Bill, with the slew of policies the Government intends to roll out to achieve a “Digital India”.
  3. The Bill does not scope in non-personal data and has diluted the scope of what would constitute as harm, to an individual for the illegitimate processing of their data.
  4. The definition does not address “loss of reputation”, “loss of employment”, “psychological manipulation”, and has been provided broad stroke indicators for what would constitute as harm under the Bill.
  5. The Bill has extra-territorial application and extends to any businesses which process Indian user data in connection with any profiling of, or activity of offering goods or services to Indian users within the territory of India.
  6. The Bill has rechristened the chapter on Grounds for Processing of Personal Data without Consent from the previous iteration to Deemed Consent, for optics and ease of understanding for the user.
  7. Data fiduciaries are required to notify the Data Protection Board, to be constituted in accordance with this Bill, in the event of a personal data breach; this may create overlap in compliance obligations, as data fiduciaries are required to report personal data breaches to CERT-In as well.
  8. The Bill permits for contractual arrangements with sub-processors as well; and has limited the scope of data principal rights from the previous iteration. The Bill does not provide for a right to be forgotten, right to data portability; this may be intended towards easing the compliance burden on start-ups, as it may necessitate massive technological overhaul to be able to offer such rights to the end users. The Bill further provides a right of grievance redressal to users, as well as a right to nominate an individual to exercise such rights, in the event of the death of the data principal.
  9. Significant Data Fiduciaries, which will notified by the Government basis the volume of data processed, risks, shall be required to appoint a Data Protection Officer as well as an Independent Data Auditor, to review the organization’s compliance with the provisions of the Bill.
  10. The Bill does not provide any references to compliances necessary to transfer data outside India. The Central Government has retained the power to notify such countries where cross border data transfers may be executed, upon an assessment of factors to be specified at a later stage by the Central Government.
  11. The Bill permits entities to make a voluntary undertaking with respect to any compliance requirements, where a proceeding has been initiated before the Data Protection Board. A similar provision was included within the draft Telecommunications Bill, 2022; we surmise that such provisions are intended to reduce dispute resolution proceedings in front of the Board. An appeal against any order of the Board shall lie to the High Court.
  12. The Bill caps the financial penalties for violation of the provisions of this Bill at 500 crore rupees. The Bill further provides for a penalty against a data principal, where the data principal has submitted a frivolous grievance with the Data Protection Board.

Global Digital Health Summit at Delhi

Global Digital Health Summit was held at Vigyan Bhavan, Delhi and was called an action summit. It led to important launches which will pave the way for ‘Digital Health for All by 2028.’ This is envisaged to be critical for the success of India’s journey in digital health. This summit witnessed the following launches:

  • Release of ‘Digital Health For All by 2028’- Declaration by Dr. Jitendra Singh, Hon’ble Union Minister of State, Prime Minister’s Office
  • Launch of the first Women’s Health Guideline with a holistic approach
  • ‘Project Concern- 2028’ for taking Digital Health to pharmacies across India
  • Campaign on ‘Women for Digital Health’

 


Telemedicine – News from India & Abroad

Telehealth Program Helps Reduce Blood Pressure

After 12 weeks of a telehealth support program, with or without support from a dietitian, people with elevated blood pressure saw improvement.A research team led by Alexander Chang, M.D., Geisinger nephrologist enrolled two groups of patients with high blood …Readmore

Artificial Intelligence Tailors DNA For Drug Development

With the help of artificial intelligence/AI technology, researchers have designed synthetic DNA that controls the cells’ protein production.How our genes are expressed is a process that is fundamental to the functionality of cells in all living organisms. Simply put, the genetic code in DNA is transcribed ….Readmore

Artificial Intelligence Tool Predicts Decreased Blood Flow to the Heart

The artificial intelligence tool developed used computed tomography (CT) scans to spot patients at risk of reduced blood flow to the heart.Blockages of the coronary arteries typically occur due to the buildup of fatty plaques. This may restrict blood flow to the heart, causing chest pain, heart attacks …Readmore

Skin-like Electronics Help Monitor Health

A skin-like device developed by researchers does a personalized analysis of the tracked health data while minimizing the need for its wireless transmission. Worn routinely, future wearable electronics could potentially detect possible emerging health problems — such as heart disease, cancer…Readmore


Click here to Become a Member of Telemedicine Society of India


Telemedicine Practice Guidelines – A Foundation Course for RMPs by TSI Faculty

To know more about the Telemedicine Foundation Course click on the link below:
https://tsitn.org/tpg-course/

TN – TSI invites all the TSI Chapters and Members to submit information on their upcoming Webinar or Events (50 words), News related to Telemedicine (200 words) or short articles (500 words) for the monthly e-newsletter.Guidelines for submission to TN TSI Newsletter-

  • Report can be from 500 to 600 words
  • Report Should be relevant to Telemedicine or Medical Informatics
  • No promotion of self or any product
  • Avoid plagiarism
  • All references should be included
  • Provide any attributions
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Editors – Dr. Senthil Tamilarasan & Dr. Sheila John
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