Category: Newsletter

Introduction

Telemedicine represents a significant milestone in healthcare, merging traditional practices with modern Information Communication and Electronics (ICE) technologies. This integration has enabled healthcare to reach the unreached, transforming the Indian medical landscape deeply rooted in traditions dating back to Charaka and Susrutha.

Early Beginnings and Milestones

The journey of telemedicine in India began with tele-consultations, tracing back to the inception of telephony 1907.

A significant leap occurred in 1999 when Sri Ramachandra Medical College hosted a video lecture by Dr. Stephen Dretler from Department of Urology, Massachusetts General Hospital and Harvard Medical School Boston, USA, introducing the video format in medical education and. The year 2000 witnessed another landmark event when US President Bill Clinton commissioned the world’s first VSAT-enabled village hospital in Andhra Pradesh.

ISRO’s Pioneering Role

The Indian Space Research Organization (ISRO) played a transformative role in telemedicine’s growth. Although ISRO conducted preliminary experiments in the mid-90s, it was not until 2000 that a special program commenced. This initiative was significantly bolstered in 2001 with the successful link between Chennai’s Apollo Hospital and Apollo rural hospital in Aragonda, Andhra Pradesh.

Formation and Evolution of TSI

The Telemedicine Society of India (TSI) was formally established in 2006, headquartered at the School of Telemedicine and Bioinformatics, SGPGI, Lucknow. TSI’s evolution was marked by collaborations with the Ministry of Electronics and Information Technology (MeitY), various governmental and non-governmental organizations, and research institutes, further propelled by ISRO’s SatCom facility and emerging technologies.

Developments During My Tenure (2019-2023)

As the Honorary Secretary of TSI, I witnessed and contributed to several pivotal developments:

1. Telemedicine Practice Guidelines (TMPG): Issued by MoH&FW in March 2020, TMPG formation led to the creation of working groups that developed a telemedicine curriculum. Approximately 30,000 doctors and stakeholders were trained in various aspects of telemedicine, led by Dr. Sunil Shroff and other esteemed faculties including Ms.Bagmisikha Puhan, Wg Cmdr (Dr) Lavanian Dorairaj (Retd), Mr.Mayank Agarwal, Mr.Manick Rajendran, Dr.Ravi Modalli, Dr. (Gp Capt) Suchitra Mankar, Mr.P Ramkumar and Dr.Ashvini Goyal.

2. Expansion through State Chapters: The formation of 12 state chapters significantly enhanced TSI’s geographical reach and impact on telemedicine activities.

3. Membership Growth: There has been a significant increase in membership across various categories, especially among life members. A key focus is now on increasing student membership, vital for the future of TM in India. This has happened also due to incorporating online payment gateways that was initiated by Mr Maynak Agarwal and implemented by Medindia.

4. Bylaws Amendment: In October 2023, TSI updated its bylaws to reflect the contemporary realities of telemedicine, involving extensive online discussions and legal processes.

5. Manual of Processes and Procedures: Recognizing the need for a dynamic operational structure, TSI embarked on creating a comprehensive manual to serve as a standard operating procedure, complementing the bylaws and providing a more agile framework for TSI’s functioning.

Conclusion

The path ahead for TSI is marked by continuous adaptation and responsiveness to the evolving landscape of telemedicine. Our commitment to governance and improvement is evident in the development of the Manual of Processes and Procedures and our focus on engaging the next generation of telemedicine professionals. As of November 2023, TSI’s membership primarily comprises life members, but we are increasingly focusing on nurturing student membership, crucial for the sustained evolution and success of telemedicine in India.

In a strategic move to enhance the effectiveness of Telemedicine initiatives at the grassroots level, the Telemedicine Society of India (TSI) embarked on a journey to establish state chapters. This initiative began with a criterion that each chapter would be formed in states where at least 20 Life members were enrolled. This approach has proven successful, leading to substantial growth over the years.

By 2018, TSI proudly had eight active state chapters. This number has impressively increased, and as of now, TSI boasts a network of 20 functioning state chapters. This expansion reflects our commitment to making Telemedicine services more accessible and collaborative across various regions.

I have had the privilege of contributing to this growth during my tenure as the Honorary Secretary of TSI. From November 2019 to November 2023, I served two consecutive terms, during which I played a pivotal role in the formation of 12 additional state chapters. This expansion marks a significant milestone in the TSI’s history, showcasing our dedication to spreading the benefits of Telemedicine far and wide.

It is essential for every TSI member to be familiar with these state chapters. Awareness and active participation in chapter activities foster a richer exchange of knowledge and ideas, crucial for the growth and development of Telemedicine practices. Additionally, TSI members are encouraged to attend meetings of these state chapters whenever they visit respective states. Such engagements are not only beneficial for professional growth but also serve as a platform for fostering fellowship and building stronger networks within the TSI community.

Our collective efforts in nurturing these state chapters will undoubtedly propel the reach and impact of Telemedicine across the country, benefiting a larger section of society. I look forward to seeing more members actively engage with their local chapters and contribute to this vital cause. Here is a list of all the new chapters that were formed during my tenure.

1. UP Chapter: February 22, 2020

As most of us are aware; Lucknow, UP is the hometown of TSI and SGPGI is the birthplace of TSI and SGPGI is the birthplace and HQ of TSI. But for some unknown reason UP state chapter came late on board. It was inaugurated on February 22, 2020 and became the 11th state chapter. However again, due to the Corona effects the state chapter couldn’t do much activities and remained in a dormant state.

The chapter was reinvigorated on Nov 02,2022 at Prayagraj and has since conducted good number of programmes and training camps.

At the time of writing this report, I came to know that the chapter was initially formed in 2017 itself but was dormant.

2. Jammu & Kashmir: October 29, 2021

One of the dreams of TSI has been to expand to the frontiers of the nation by reaching out to states like J&K. ISRO’s telemedicine has been in vogue in the state since 2004 with SKIMS, Srinagar as the Super specialty Hospital and at the helm of affairs. Mr. Farooq Ahmed Wani has been a crusader for the successful running of operations across 13 ISRO TM nodes in the state established by ISRO. Again, with his active role the dream of TSI came to a reality with the inauguration of J&K chapter at SKIMS, Srinagar on Oct 29,2021.

Quiet unexpectedly but most pleasantly, the state chapter within a period of 9 months from the formation, came forward to successfully host the mid-term conference of 2022 on Aug 26, 2022 again at the prestigious SKIMS. The participation of several young doctors and particularly students and their presentation of high quality research papers was an added attraction in the mid-term conference.

3. Gujarat Chapter: July 06, 2022

Expanding the TSI in the western zone, the Gujarat chapter was inaugurated on July 06,2022 at Ahmedabad. Incidentally this is the city of DECU, ISRO the national provider and coordinator of ISRO’s SatCom based TM services.

4. Chandigarh Chapter May 16, 2022

Dr. Meenu Singh, the then President-Elect and Professor at PGI Chandigarh completed all the formalities and sent a list of enrolled members and request to recognise the formation of a new state chapter. It is the first chapter to be formed in a Union Territory. She had a dedicated and enthusiastic young team of professional like Dr. Amit Agarwal, Dr. Biman Saikia etc.; and with all their coordination the chapter was inaugurated on 16/05/2022 under the aegis of TSI President Dr. PK Pradhan.

Interestingly during this period of formation Dr. Meenu Singh was appointed as the Executive Director at AIIMS Rishikesh and has attended the function online, by making it a Tele-inauguration of the state chapter.

5. Uttarakhand Chapter: November 10, 2022

The shift to AIIMS, Rishikesh of Dr.Meenu Singh worked as a catalyst for the formation of Uttarakhand Chapter. Uttarakhand chapter was inaugurated at AIIMS Rishikesh on the Nov 10, 2022.

Dr. Ankur Mittal of AIIMS has taken lead role in spreading the importance of TM and value of forming a local TSI chapter. The good news is that the chapter stood as the best chapter as declared at Goa Telemedicon AGM by conducting 12/12 programmes (12 events in 12 months period) on subjects varying from Urology, Oncology and recent annual event on Laparoscopy. As said, conducting online events is not the ultimate aim and goal of TSI or state chapters but is a step in the right direction. This keeps the state unit active and dynamic in moving ahead.

6. Himachal Pradesh Chapter: May 13, 2023

With active support and lead role by Dr. Vikrant Kanwar of AIIMS Bilaspur and wishes of Dr. Vir Singh Negi, Executive Director AIIMS, Bilaspur, the HP chapter was inaugurated on May 13,2023. This is personally special and dear to me as this day was also my birthday. Dr. Vikrant came to Telemedicon2022 at Kochi and joined a parallel meeting with me along with Dr.Arti Pawaria of Haryana and got motivated to form a state chapter. An soon after their formation they magnanimously came forward to host 2024 Telemedicon at HP in Dharamshala (Kangda) in Nov 2024 which was ratified by the 2023 AGM.

7. HARYANA Chapter: March 04, 2023

Similar to HP chapter, the Haryana chapter also came into existence after a meeting at Kochi during the Telemedicon 2022. Dr. Arti Pawaria of Amrita Institute of Medical Sciences (AIMS), Faridabad came to Telemedicon for the first time and was so impressed with the work and potential of her desire to serve the society through Telemedicine. The Haryana chapter was inaugurated on Mar 04,2023. Being close to Delhi which is very much crowded, but also being close to the rural Haryana on the other side, Haryana chapter has a key role to play in reaching healthcare to all in the remote regions and let’s hope for an all-round development of TSI activities through Haryana Chapter.

8. Goa Chapter: Telemedicon 2023 was announced to be held at Goa, initially proposed to be hosted by TSI Maharashtra Chapter under the aegis of Dr. B.S. Ratta. Subsequently TSI Gujarat chapter under the presidentship of Dr. Raj Rawal joined the event as a co-host. Like the tradition to preview the venue and review the arrangements, Mid-term meeting of TSI was held at Goa on July 09,2023. With the help and efforts of Dr. Suraj Bhosle of Goa joining the ongoing efforts by Dr. Ratta and Hony. Secretary TSI; the formation of Goa chapter also gained momentum and became a reality with the inauguration on the same day. Hence, the realisation of Goa Chapter and local team in the field, Telemedicon 2023 was successfully held at Goa during Nov 3-5,2023 in a grand way.

9. Jharkhand Chapter: August 18, 2023

With active support and membership drive by Dr.Maishraj of AIIMS Deogarh, the Jharkhand chapter of TSI was inaugurated on Aug 18, 2023 under the aegis of President TSI Dr. Meenu Singh and Dr. Saurabh Varshney, Director AIIMS.

10. North East Chapter: on November 24, 2023

After J&K, North East (NE) region is treated as the most important and difficult geographic terrain. The group of seven states is considered as a single block by Govt of India. Keeping this in mind, and identifying the difficulty in enrolling the required 20 members from each state, TSI also decided to allow the 20+ members from NE (7 states) to form a NE chapter to start with and gradually progress towards independent state chapters wherever possible. This was communicated to the Ad-hoc committee on Nov 01,2023 as a recognition to form the NE chapter. Subsequently the chapter was inaugurated at the Royal Global University, Guwahati on Nov 24,2023. Many engineering college students were addressed about the evolution and growth of TM and advances in technology aiding the growth of TM. There is a potential to from a student chapter of the university soon and this needs to be taken forward to other states and universities of the region.

NE chapter has also agreed to conduct the 2024 mid-term conference in the North East region and formal request during the inauguration itself as announced by the incoming president.

This leaves West Bengal and Bihar in the east to come up with their own state chapters and the work is in progress with the author’s discussions with potential stakeholders to rope-in the required members and probably holding the 2025 conference at Kolkata perfectly matching the ideal desire of holding national Telemedicine meetings in rotation in North-East-West and South (NEWS) regions. Let’s wish for the same to be realised soon.

We anticipate a surge in dynamic activities under the banner of these chapters, driven by the active involvement of our members, particularly from the younger generation.

The initial steps of hosting online and offline seminars, workshops, and training sessions form the foundational activities of these chapters. However, the next, and indeed more impactful phase of our journey, involves organizing remote and rural camps. These camps will demonstrate the real-world application and benefits of Telemedicine to the unreached, bringing this innovative healthcare approach directly into practice.

As we move forward, our goal is to ensure that the benefits of Telemedicine extend far and wide, reaching even the most remote areas. We envision a future where geography, location, and distance become irrelevant in accessing quality healthcare. With this aspiration, we extend heartfelt wishes for the success of these endeavors and the widespread adoption of Telemedicine, making quality healthcare accessible to all, regardless of their location.

Let us strive together towards this noble goal, ensuring that Telemedicine not only reaches but also positively impacts the unreached and underserved communities.

19th International Conference of Telemedicine Society of India, Telemedicon 2023 and 27th International Conference of ISfTeH was held on 3rd, 4th and 5th November 2023 at Park Regis in Goa. The theme being ‘Emerging Technologies Connecting Indian Healthcare System’ – Presented by Serum Institute of India.

This three day feast of Academics, Scientific Presentations, Fun and Frolic, had so many firsts in the form of Fireside Chat with Mr Devang Mody, CE0 Bajaj Health, First Telemedicon Oration by Dr. Rajendra Pratap Gupta, Founder of Health Parliament & Digital Health Academy, Master Classes by Dr Uma Nambiar, Quiz Competition by Prof. Dr K Ganapathy, Best Hopper to the exhibition arena, State Pavilions by TSI Maharashtra, Goa & Gujarat Chapters, Launch Pad For Saffron Telehealth By Suquino, Healthy Vibes & My DNA, ISfTeH represented in person by President Dr Michele Y Griffith, Prof S Yunkap Kwankam & Dr B K Rana. Highest attended AGM & Valedictory Functions. Telemedicon 2023 saw the first paper based elections in its history. Prof. Dr Meenu Singh presented Telemedicine (Past, Present, and Future) as her Presidential Ovation, Col. Dr Ashwini Goel was felicitated at the same time.

There were 15 sessions on Emerging Technologies, Future Trends In Healthcare And Vaccine Delivery, Government Initiatives, Global Telehealth and Cyber Security, Telemedicine Practices And Challenges, Building Bridges For Better Healthcare, ISfTeH Session, Telemedicine – Back to Space, Innovations, AI 6 Mental Health, Past, Present & Future of Telehealth in India, Platform and Devices, Technology Driven Hospital For Better Patient Care by Mr Behram Khodaiji CE0, Grant Medical Foundation Ruby Hall Clinic, Including a Fireside Chat, panel discussion on Remote Monitoring of Substance Use Disorder (Focussed on adolescents and young adults) by Dr Sreya Chattopadhayay, Mr Jaspal Singh, Director General of Police, Goa, Dr Dheeraj Mehrotra and Tele Ophthalmology Society of India headed by Dr R Kim, in the Serum Hall. Two Master Classes and Two workshops were held by Dr T Senthil and Mr A Kishore Reddy, along with Symposium on surgery in the information age by Dr S K Mishra, Dr Anjali Mishra, Prof. Darwin Caldwell, Prof Rifat Latifi, Mr Rajat Sharma, Dr S K Yadav, Prof Priyanka Bagade 6 Dr B S Ratta. In addition, President /Secretaries of all State Chapters of TSI, Industry Corporate and Institute Member Sessions at the Suquino Hall. Around 50 Technology Partners presented their solutions in healthcare with demos in the industry theatre, Bajaj Hall. Over 50 scientific Papers and Posters were presented at the Google Hall.

The event was Inaugurated by Dr Chandrakant Shetye, MLA and Chairman Infotech Corporation of Goa, in the presence of President TSI Dr Meenu Singh, President ISfTeH Dr Michelle Griffith, and Guest of Honor, Dr Rajendra Pratap Gupta, The Exhibition was inaugrated by Mr Michael Lobo, MLA Goa.

Fun and frolic was at its peak during Dinner Cruise on river Mandovi, Goa with Awards Night for the hidden gems and torchbearers of TSI. Dr T Senthil, Dr Sheila John were crowned as Eyeconic of TSI, Mr A Kishore Reddy the King of Telemedicine Operations, the Digital Medical Eye award went to Mr Ashwin Desai, and Rising Star of TSI was Dr Sanjay Sharma & Prof S Raghavan the Star Engineer of TSI. The Paper Man of TSI undoubtedly was Dr Uma Shankar and the Marathon Man of TSI for holding the fort for four consecutive years went to none other than Dr. Murthy Remilla. The TSI Geek Award was bagged by Mr Repu Daman from the SZchool of Telemedicine and Bioinformatics.

The New-King of TSI Award for painstakingly bringing out TSI News Letter consecutively for three years went to none-other than Dr Sunil Shroff, the incoming Vice President of TSI. Vigyan Guru of TSI went to Dr Uma Nambiar. Dr K Ganapathy was Kaun Banega Telepathy, Quiz Master Award.

Three major sponsors: Serum Institute of India, Bajaj Health 6 Ruby Hall Clinic were conferred the Platinum, Gold 6 Healthcare Partner Award respectively. The rising star of Tele-Radiology of India went to Dr Amit Kharat, CE0 Deeptek, The Star Debutant award for successful launch of their product went to Mr Ravi Amble, Dr V S Hegde for Saffron Telehealth, Mr Srinivas Sardar for Remote Patient Monitoring and Mr Subodh Gupta for launching My DNA. Also for the first time Student Essay Contest was held on the theme subject across India and the Gold Medal went to Dr. Anish Mahashankar Joshi, Silver Medal to Dr Vaibhav Verlekar & Bronze Medal to Dr Arjun Jichkar. The best stall award was presented by Dr R Kim, President TSI 2024 to Serum Institute of India, Mr Dinesh Gundi.

Over 325 delegates attended the meet in Goa, spanning USA, Europe, Asia, length and breadth of India representing ISfTeH, ATA, National Health Authority, Ministry of Health and Family Welfare, CDAC, SAC ISR0, Industry and institutes like AIIMS, AIMS, PGI, SGPGI, Apollo, Sankara Nethralaya, Aravind Eye Care, Narayana Hrudayalaya, represented by Dr Devi Shetty and many others.

Winners of the quiz competition were sent their smart watches as awards and the best paper and podium awards, as cash prizes on behalf of TSI. Podium Winners were Dr Uma Nahar Saikia, Dr Sheila John and winners of poster were Dr AnilChauhan and Dr. Hima Bindu Kotamarthy.

Background:

As most of the members are aware, TSI has started functioning informally from the first Telemedicon Conference at Lucknow in 2001 and has been conducting annual conferences since then. However, the formal registration of the Society took place in May 2006 after a grand Telemedicon2005 at Bangalore under the aegis of ISRO.

Naturally like any society/organisation in its nascent phase of starting the activities, TSI had its simple Constitution & Byelaws registered in May 2006 with the primary objective of: “To promote and encourage development, advancement and research in the science of telemedicine and its associated fields”.

Over a period, many chapters have been formed in different states, many changes have taken place in the healthcare environment in the country, the technological arena across the globe which foretold the necessity to amend the style of operations and functioning of the Society including expansion of the society’s objectives and prescribing guidelines for Day to Day operations. Though some efforts were made in 2017 to go for some amendments, same could not be completed due to some technical reasons and loss of communication from RoS.

Keeping these and some other statutory requirements to align our practices to the written Byelaws and aligning the Byelaws to some of our traditional practices over two decades, TSI has taken up the task of amending the Byelaws to meet the society’s new ambitions, objectives and requirements of all the stakeholders.

This has been carried out through a series of EC meetings, National web meetings and taking as many suggestions and corrections as possible into account culminating in the final approval by Registrar of Society’s approval on Oct 04, 2023. Accordingly, the new Byelaws came into effect immediately and the same was notified to all the TSI members by email and through all WhatsApp groups.

However, it may be noted that this is a never ending process and any dynamic society has to keep its Byelaws and practices updated to meet the aspirations of the members.

Most importantly, in view of the long process and time needed to get any amendments in the Byelaws, it was decided to keep the Byelaws simple to the core and develop a separate TSI manual of Policies and Procedures.

Now, let’s have a glimpse at the major highlights of the changes that have been brought in through the current bye-laws –

1.The objectives have been expanded to embrace new practices and new technologies like:

• “To promote and encourage application of Telemedicine (TM) along with development, advancement and research in the field of Telemedicine/ TeleHealth/eHealth/Digital Health (which terms may be used interchangeably in different contexts) and associated fields; for improvement of overall Healthcare access”
• “To conduct regular scientific meetings, symposia, seminars and on matters related to digital health workshops”
• “To develop, co-ordinate and conduct knowledge and capacity building exchange programmes, with national/international organizations engaged in activities in the field of telemedicine.
• To work towards getting recognized as an accreditation body for Telemedicine/TeleHealth/eHealth etc.
• Spearheading or collaborating in the development of appropriate clinical and industry policies and standards, in view of adoption of and integration with TeleHealth.

2.Tenure of EC: The Tenure of the EC (Governing Body) has been amended to align with our practice as follows and the functions of all the office bearers have been elaborated to bring in more clarity and activity.

a. Immediate past president – One year

b. President – One year

c. President elect – One year

d. Vice-President – One year

e. Hony. Secretary – Two years

f. Jt. Secretary*- Two years

g. Treasurer – Two years

h. All other Executive Members – Two years (total seven in number)

i. COO: As per the terms, tenure and criterion if and when decided by the EC to appoint COO

* In tune with the recommendation of AGM 2021, the post of Jt.Secretary & Treasurer has been split into two separate posts of Jt. Secretary and Treasurer.

3.Membership types and fee: Two new types of Memberships – Associate Member for any non-graduate to become a member like a Life Member (except with the right to contest elections) & Oversees Institutional Members

4.A new clause on Cessation, Termination and Reinstatement/Re-admission has been introduced. Importantly to encourage the participation:

All National TSI Members upto the age 65 years should attend at least one National conference in personal/virtual mode in the previous Five Years, failing which their membership shall be suspended till their next participation in the annual conference

5.State Chapters: Since number of chapters is growing, the need to define their role and responsibilities; like fund generation and sharing percentage, preparing annual report, holding state chapter conferences etc. has been highlighted and decided to elaborate them in the TSI Manual of Policies and Procedures.

6.Auditor: The Executive Committee shall appoint and fix the appointment of an auditor and finalise the fee of the Auditor who shall be a Chartered Accountant at least once in three years.

7.Amendments: Any member of the society may propose amendments to the constitution/Byelaws by writing to the Hony. Secretary minimum 45 days before the GBM, who shall put up to the EC, if the EC approves the required change by majority, this shall be put up the Annual / Special GBM as required. Such amendment(s) may be amended by two-third affirmative votes of members present at the annual assembly, or where such affirmation has been provided via e-mails, facsimile, letter sent by courier or India Post, provided a copy of the proposed change has been circulated to each voting member 30 days in advance of the general body meeting. Such Amendments shall also be in accordance with the Societies Registration Act, 1860.

8.One clause on Fellowship Members though decided to be removed was inadvertently retained in the approved Byelaws and EC has approved to apply for removal of the same. The matter will be put up to the AGM for ratification and immediately after that ROS will be approached to issue a corrigendum.

9.Full version of the Approved Byelaws has been sent to each and every member of the society to registered email and WhatsApp Groups.

10.Request all Members to read, review and suggest any suggestion at any point of time without waiting for AGM or call for special meetings, which will be taken up by EC and put up for necessary processes.

Highlights:

1. MGM Healthcare in Chennai, in partnership with the Telemedicine Society of India (TSI), organized a conference.

2. It delved into the vital topics of “Role of AI in Healthcare” and “Recent NMC Guidelines on Telemedicine.”

3. The conference also marked the launch of the innovative MGM Connect App in the healthcare domain.

MGM Healthcare, Chennai, in association with the Telemedicine Society of India (TSI), successfully organized a highly insightful conference focusing on the “Role of AI in Healthcare” and “Recent NMC Guidelines on Telemedicine”. The event also marked the inauguration of the MGM Connect App, a pioneering initiative in the field of healthcare.

The conference began with a warm Welcome Note delivered by Dr. Sunil Shroff, setting the tone for the day’s discussions. Dr. T Senthil, Honorary Secretary of TSI, then introduced the eminent speakers and highlighted the significance of the topics.

AI in Healthcare – Current Status and Potential

Mr. Saurabh Gupta from KIMS Hospitals, Hyderabad, engaged the audience with an enlightening discussion on the current state of AI technology in healthcare. The session underscored the potential benefits and challenges of integrating AI into healthcare systems.

It also highlighted Niramai , a prominent NGO dedicated to revolutionizing breast cancer detection through innovative technology. Their Thermalytix solution utilizes AI-driven thermal imaging to provide non-invasive, early-stage detection, making screenings more accessible and effective. With a mission to save lives through early detection, Niramai is pioneering a new approach to breast health awareness.

The moderator panel, consisting of Dr. Shreevidya from AHEL, Dr. Selvakumar (Chairman, TSI TN Chapter), and Dr. Ikramullah (Vice President, TSI TN Chapter), facilitated a comprehensive discussion.

The session explored key points such as the rationale behind discussing AI in healthcare

• Definition and components of Artificial Intelligence

• Different types of AI and their applications

• Opportunities and challenges in implementing AI in healthcare

• Notable AI use cases in the Indian healthcare landscape

• Existing obstacles and considerations for adopting AI

A vibrant Question and Answer Session guided by Dr. Masood Ikram provided attendees with a platform to address their queries and seek further clarity on AI in healthcare.

The conference reached another milestone with the Inauguration of the MGM Connect App by Mr. Harish Manian (Group CEO, MGM Healthcare) and Dr. R Kim (President and Elect, TSI). The ceremony was expertly moderated by Mr. D. Satheesh Kumar, Treasurer of TSI TN Chapter.

Panel Discussion: Recent NMC Guidelines for Telemedicine and RMP’s Training

The focus was on the recent NMC guidelines for telemedicine and the necessary training for Registered Medical Practitioners (RMPs).

Under the leadership of Dr. Sunil Shroff (President, TSI TN), Dr. R Kim (President Elect, TSI), Ms. Bagmishika Puhan (Associate Partner, TMT Law Practice, South Delhi), Dr. K Ganpathy (Past President, TSI), and Dr. T Senthil (Hony. Secretary, TSI TN), a comprehensive panel discussion unfolded.

Recent Applications of AI in Healthcare

Dr. Dheeraj Krishna, Head of Telemedicine at Star Health Insurance, introduced the session, paving the way for Ms. Mukta Arora, Founder & CEO of myGleeo. Ms. Arora’s presentation delved into the latest advancements and successful applications of AI in the healthcare industry. She showcased compelling case studies and real-world examples that highlighted the transformative potential of AI.

Moderated by Dr. Sheila John, Dr. Ramakrishnan, and Dr. Thulasi Bai (EC Members – TSI TN), the session provided a platform for in-depth exploration and insightful discussions.

The day concluded with an engaging Question and Answer Session, where Mr. Rajarajan S (COO, MGM Healthcare) led discussions that addressed various queries, concerns, and opinions.

The conference’s essence was captured during the Key Takeaways and Vote of Thanks by Dr. Ananth Pai, Director of Medical Services at MGM Healthcare. His remarks highlighted the knowledge gained and the collaborative spirit that underscored the event.

MGM Healthcare’s conference, in collaboration with TSI, successfully brought together experts, practitioners, and enthusiasts from the healthcare and technology sectors. The event’s focus on AI, telemedicine guidelines, and the inauguration of the MGM Connect App showcased the institution’s commitment to advancing healthcare through innovation and informed discussions.

References :

1. WHO issues first global report on Artificial Intelligence (AI) in health and six guiding principles for its design and use https://www.who.int/news/item/28-06-2021-who-issues-first-global-report-on-ai-in-health-and-six-guiding-principles-for-its-design-and-use

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 !!

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

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]

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.