Tele-Health-Newsletter November 2023

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Telehealth Newsletter

Official Newsletter of Tamil Nadu Chapter of Telemedicine Society of India

What is New?

TELEMEDICON 2023, held in the vibrant state of Goa, has concluded on a high note, leaving a lasting impact on the world of healthcare. This year’s event brought together a diverse range of healthcare professionals, technology experts, policymakers, and innovators to explore the cutting-edge advancements in telemedicine and its transformative potential.

Telemedicon 2023: A Resounding Success in Goa And Many First’s in TSI

Under the astute leadership of Dr.BS Ratta, TELEMEDICON2023 stood out and achieved its objective of showcasing a world class event with rich content, exchange of knowledge, global collaboration and wonderful networking opportunities to push the telemedicine forward in our country.

There were also many firsts during this meeting:
  1. An app helped make this a paperless meeting that was easy to ACCESS and navigate.
  2. Fireside Chats
  3. First Telemedicon Oration
  4. Master Classes
  5. Quiz Competition
  6. Best Hopper to the exhibition arena
  7. Highest attended AGM & Valedictory Functions
  8. TELEMEDICON2023 saw the first paper-based elections in its history for Vice President post.

 

TSI Executive Committee 2023-2025

The new Executive was elected and took office for the next 2 years. The names are listed below

Dr. R. Kim, President
Dr. Meenu Singh, Out Going President
Dr. Prem Nair, President Elect
Dr. Sunil Shroff, Vice President
Dr. Umashankar S., Hony. Secretary
Dr. Krishna Kumar, Treasurer
Mr. D. Satheesh Kumar, Joint Secretary
Dr. Amit Agrawal, Executive Member
Dr. Pawan Gupta, Executive Member
Dr. Raj Raval, Executive Member
Dr. T. Senthil, Executive Member
Dr. Sheila John, Executive Member
Mr. Surendr Singh, Executive Member
Dr. Surya Bali, Executive Member

TELEMEDICON 2023 in Goa achieved its goal of advancing the mission to make quality healthcare accessible to all, transcending geographical boundaries. It served as a catalyst for innovation, collaboration, and policy advocacy in the field of telemedicine.

As we bid farewell to this year’s event, the momentum generated at TELEMEDICON 2023 will continue to drive positive change in healthcare, with the promise of an even brighter future where technology and compassion combine to create healthier and more equitable healthcare systems worldwide. TELEMEDICON2024 is to take place next year at AIIMS, Bilaspur (Himachal Pradesh).

Thank you to all participants, speakers, and organizers for making TELEMEDICON 2023 a resounding success.

Thank You
Dr. Sunil Shroff
Chief Editor
Vice President, TSI

TELEMEDICON 2023: Emerging Technologies Connecting Indian Healthcare System

Dr B S Ratta
Organizing Chairman
TELEMEDICON 2023, Goa

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.

TELEMEDICON 2023 Feedback

 

Dr.Ganapathy: Accolades, acclamations, applauses, admirations approvals, awards, cheers, commendations, encomiums, eulogies, endorsements, honours, ovations, praises, panegyrics, paeans thumbs up icons, tributes all freely flowing in all Whats App Groups, from old and young, from veterans and initiates speak for themselves. With my limited vocabulary I am at a loss for words. I would like to join every member of the TSI in thanking the Telemedicon2023 for a fantabulous event. Rattaji obviously did not behave like a Chairman. He was the First among equals. I am also pleased to see the difference of opinion in the various WA groups over the last week. The hundreds of postings indicate a personal involvement. Dissent is the basis of all democracy. Progress is not through consensus. New blood is essential . No one is indispensable. The outgoing TSI team have done a good job. I am sure the current team will steadily raise the bar. We do not want an incremental growth. It should be a radical transformation. This can only happen with a 100% participation. It is better to have loved and lost than not to have loved at all !!

Dr. Selvakumar: Thanks to dr ratta Speakers were off high quality Introduction of dr Ganapathy for quiz was amazing Time management personally by dr ratta was super Food quality was very tasty and rich started by exacises to reduce my calories Overall the the conference was of 7 star ratting Exhibit showcasing was in par excellent ENTERTAINMENT WAS SUPER WITH FUN THANKS to dr ratta again single man show lessons to be learnt from him how to manage such conferences My sincere thanks and appreciattin to old EC team with spl thsnks to dr murthy for excellent management for the last 4 yrs Welcome to the new EC team ism sure this team will tske to greater heights with leadership of dr kim Members absence was only defect in telelmedicon confrence atl we should have double the attendance Nothing more can be done by the TSI in showcasing yearly event I thsnk all the members who attended for the grouth of TSI the meet with there support.

Dr. Raj Raval, Gujarat Chapter of TSI: On behalf of TSI GUJARAT CHAPTER, I’m thanking Dr.Ratta sir for involving us in organising squad although he knows he was very much able to do own his own. We learnt lot many things from him. He literally took all the pains to deliver wonderful event to us. Contents, New ideas pitching, timings, industries participation, food , cruise….everything were fabulous.

We are also thankful to previous office bearers especially Dr. Murthi Ramilla. He has done tremendous work and is source of inspiration for us. With your guidance so many young aspirants have joined TSI. I’m sure you’ll continue your support to TSI wherever require. 👍👍👍 Thanks once again …

Dr. Satyamurthy: You are incredible Dr.Selva. Nice to see your remarks. Dr.Ratta was the dream boy organiser of utmost sincerity, commitment and recorded his hattrick of conducting 3 TSI conferences with grand finale of taking you all on Cruise ship which I missed. God bless our group young Margadharshaks.
Pavithra

New AI Algorithms for Predicting Sudden Cardiac Death

Dr. Pavithra
Assistant Editor, Medindia.net

In a groundbreaking development, researchers have harnessed the power of artificial intelligence (AI) to potentially predict sudden cardiac death and evaluate an individual’s risk, ushering in the possibility of proactive preventive measures in global health strategies.

Identifying High-Risk Individuals with AI Analysis

Using AI analysis, researchers successfully identified individuals with a risk exceeding 90% of experiencing sudden cardiac death, a group that accounts for over a quarter of all such cases.

Sudden cardiac death stands as a significant public health concern, contributing to 10% to 20% of overall mortality. Traditional approaches have often struggled to pinpoint high-risk individuals, particularly on a personal level, making this discovery profoundly impactful.

Lead author Xavier Jouven, a distinguished professor of cardiology and epidemiology at the Paris Cardiovascular Research Center, Inserm, and the University of Paris in France, introduced an innovative approach that transcends the conventional focus on cardiovascular risk factors. This approach encompasses all medical information available in electronic health records, potentially revolutionizing our understanding and management of sudden cardiac death.

The research findings, set to be presented at the American Heart Association’s Scientific Sessions 2023, represent a monumental stride in cardiac healthcare. The research team leveraged AI to analyze medical information sourced from registries and databases in Paris, France, and Seattle.

They examined 25,000 individuals who had experienced sudden cardiac arrest and 70,000 individuals from the general population. These two groups were meticulously matched based on age, sex, and residential area.

A Wealth of Medical Data

The dataset used for analysis comprised over a million hospital diagnoses and ten million medication prescriptions, spanning medical records up to a decade before each individual’s demise.

Through AI, researchers created nearly 25,000 equations, factoring in personalized health criteria to pinpoint those at a high risk of sudden cardiac death. Each participant in the study received a tailored risk profile that incorporated their medical history, encompassing factors such as treatment for high blood pressure, a history of heart disease, and even mental and behavioral health concerns like alcohol abuse.

This comprehensive analysis can determine factors that either elevate or diminish the risk of sudden cardiac death, specifying a particular percentage and timeframe. For instance, an individual might have an 89% risk of experiencing sudden cardiac death within three months. This level of precision empowers healthcare professionals to proactively address and mitigate these risks.

Professor Jouven underscored the importance of AI in this context, stating, “While doctors have effective treatments such as risk factor correction, targeted medications, and implantable defibrillators, the use of AI is essential to identify a patient’s evolving medical history over the years, which creates a trajectory associated with an increased risk of sudden cardiac death. We hope that by providing patients with a personalized list of risk factors, they can collaborate with their healthcare providers to reduce these factors and ultimately decrease the likelihood of sudden cardiac death.”

In conclusion, the integration of artificial intelligence into healthcare signifies a significant paradigm shift in our approach to addressing and preventing sudden cardiac death. This research opens a promising avenue for personalized risk assessment, enabling individuals and healthcare providers to collaboratively and proactively mitigate the risk of this life-threatening condition.
Krishanga

Diving into Precision: How AI Explores Personalized Cancer Treatment

Dr. Krishanga Srivastava
Associate Editor, Medindia.net

The landscape of cancer treatment is evolving rapidly, propelled by advancements in understanding tumor biology and genetics. As the intricacies of genetic mutations are revealed, the potential for personalized therapies grows.

In a recent study conducted by researchers at Charité – Universitätsmedizin Berlin and Humboldt-Universität zu Berlin, the intersection of artificial intelligence (AI) and cancer treatment was explored. The study specifically investigated whether generative AI tools, exemplified by ChatGPT, could contribute to the complex decision-making processes involved in crafting personalized cancer treatments.

The Complexity of Precision Oncology

Precision oncology, a specialized field within personalized medicine, hinges on the identification and targeting of specific genetic mutations responsible for tumor growth. This approach involves a meticulous analysis of the genetic makeup of tumor tissue, leading to the crafting of individualized treatment recommendations.

The interdisciplinary collaboration at Charité, known as the “molecular tumor board” (MTB), involves experts from pathology, molecular pathology, oncology, human genetics, and bioinformatics. Their collective insights aim to decipher the most promising treatments based on the latest scientific studies, culminating in personalized and effective treatment plans.

The Role of Artificial Intelligence in Treatment Decisions

The researchers, including Dr. Damian Rieke, Prof. Ulf Leser, Xing David Wang, and Dr. Manuela Benary, sought to explore whether AI could streamline and enhance this complex decision-making process.

Published in the journal JAMA Network Open, their study involved using large language models like ChatGPT to scan scientific literature for potential personalized treatment options automatically. However, the results indicated that while AI models could identify treatment options in principle, they fell short compared to the capabilities of human experts.

The researchers created ten molecular tumor profiles for fictitious patients, challenging both a human physician specialist and four AI models to identify personalized treatment options. The outcomes were then presented to the MTB for assessment without disclosing the origin of each recommendation.

The study revealed that, while AI occasionally identified surprisingly good treatment options, it overall performed less effectively than human experts. Challenges such as data protection, privacy, and reproducibility were also highlighted in the context of real-world patient applications.

Despite the current limitations, Dr. Damian Rieke remains optimistic about the potential contributions of AI in medicine. The study demonstrated that as AI models continue to advance, their performance improves. This opens the door to enhanced support for complex diagnostic and treatment processes, with the caveat that human oversight remains essential for result verification and treatment decisions.

Charité’s Commitment to AI in Medicine

The study is part of Charité’s broader initiative to leverage AI in patient care Prof. Felix Balzer, Director of the Institute of Medical Informatics, emphasizes the potential benefits of AI in medicine.

Projects within Charité, such as fall prevention in long-term care and AI-based prognosis following strokes, highlight the institution’s dedication to advancing the intersection of medicine and technology. The ongoing TEF-Health project, led by Prof. Petra Ritter, aims to facilitate the validation and certification of AI and robotics in medical devices.

As the field of oncology continues to embrace the era of precision medicine, the study at Charité sheds light on the evolving role of artificial intelligence in personalized cancer treatment. While AI models may not replace human expertise, their continual improvement suggests a promising future in providing valuable support for complex medical decision-making processes.

The careful integration of AI https://www.medindia.net/medical-quiz/quiz-on-artificial-intelligence.asp into the medical landscape, coupled with human oversight, is key to unlocking new frontiers in patient care and treatment.

“As AI advances, so does its potential to support complex medical decisions. The future lies in the collaboration between technology and human expertise.”

Telemedicine – News from India & Abroad

 

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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 October 2023

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Telehealth Newsletter

Official Newsletter of Tamil Nadu Chapter of Telemedicine Society of India

What is New?

The month of October has been filled with celebrations. The TSI has successfully had its new amendment Bye-laws approved by the Registrars of Societies, addressing some past discrepancies. In the coming month, we will also see the installation of a new council. It’s noteworthy that this council has served for three years instead of the usual two, as specified in the old bye-laws.

We are now gearing up for TELEMEDICON 2023 in Goa, thanks to the efforts of Dr. Ratta and the Goa chapter of TSI. The program has been carefully planned, and we hope for a large turnout. Additionally, we continue to enjoy insightful contributions to our newsletter from Dr. Krishanga and Dr. Pavithra of Medindia.

Thank You
Dr. Sunil Shroff
Chief Editor
EC Member, TSI

TSI Byelaws 2.0
New Byelaws come into effect from Oct 04,2023

Dr. Murthy Remilla
Hony.Secretary TSI

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.
Krishanga

AI with MRI can Recreate your Dreams

Dr. Krishanga Srivastava
Associate Editor, Medindia.net

Highlights:

  1. Stable Diffusion AI re-creates images from brain scans, a breakthrough in visual perception

  2. Incorporating photo captions into the algorithm enhances efficiency and reduces training needs

  3. Potential applications range from understanding animal vision to aiding communication in paralysis

A new AI can create images based on what you dream. Scientists are trying to figure out how our brains translate what we see into mental images.

Now, a type of computer learning called Artificial Intelligence (AI) is improving at replicating this process. A recent study demonstrated that AI can analyze brain scans and generate images that closely resemble what a person saw. This could be used for various purposes, such as studying how different animals perceive the world or even recording dreams and assisting individuals who have limited mobility.

In the past, many labs utilized AI to analyze brain scans and generate images of things people had just seen, like faces or landscapes. This new study utilized a special AI program called Stable Diffusion, developed by a group in Germany and made public in 2022. It operates similarly to other AIs capable of generating images from text.

For this study, scientists in Japan added additional training to the Stable Diffusion program. They associated more words with thousands of photos and observed brain activity when participants viewed those photos during a brain scan study. This enhanced Stable Diffusion’s ability to comprehend the brain.

AI can Access Different Parts of the Brain to Recreate Dreams

The AI program utilizes information from various brain regions responsible for processing visual information, such as the occipital and temporal lobes. The system analyzes brain scans obtained using a specialized machine that indicates which parts of the brain are active.

When people look at a picture, the temporal lobes primarily register the content of the image (such as people or objects), while the occipital lobe mainly processes spatial arrangement, like their positions. This information is recorded in the brain scan, and the AI employs it to generate an image that resembles what the person saw.

In this study, scientists trained an AI algorithm called Stable Diffusion with brain scans from four individuals as they viewed a variety of photos. They reserved some of the scans for later testing, not using them in the training process. The AI initially generates random noise, akin to a TV screen fuzz, and then refines it into a clear image by comparing the person’s brain activity to the patterns learned during training. This results in an image that depicts the content of the photo and its spatial arrangement.

AI might be Good but not the Best

The AI performed well in representing spatial arrangements but struggled with objects like a clock tower. Instead of creating a clock tower, it generated something abstract. To address this, the scientists incorporated keywords from the photo captions. So, if a training photo featured a clock tower, the brain activity pattern would be associated with that object. Consequently, if the same pattern emerged in the testing phase, the AI would include the clock tower in the image. This refinement led to images that closely resembled the originals.

Reference: Brain Recording, Mind-Reading, and Neurotechnology: Ethical Issues from Consumer Devices to Brain-Based Speech Decoding
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7417394/

The AI underwent further testing with additional brain scans from the same individuals, producing accurate images of new subjects like a toy bear or an airplane. However, at present, it can only operate with scans from the individuals who initially trained it. Expanding its capabilities to work with other individuals would necessitate additional training. Nevertheless, this could signify a significant advancement in comprehending how our brains function and in generating images based on our thoughts and dreams.

“With further refinements, this technology could unlock a deeper understanding of our thoughts and dreams, and even shed light on how different species perceive the world.”
Pavithra

Telemedicine Needs Restructuring for Long-Term Sustainability

Dr. Pavithra
Assistant Editor, Medindia.net

Highlights:

  1. The telemedicine, driven by the COVID-19 pandemic, has transformed healthcare in India

  2. A 2023 report by TIFAC projects the Indian telemedicine market to grow significantly, with a 31% CAGR between 2020 and 2025, reaching USD 5.5 billion

  3. India must evolve beyond doctor-patient calls, focusing on holistic, integrated care

The explosion of telemedicine occurred in the last four to five years, with a significant boost provided by the COVID-19 pandemic During the pandemic, teleconsultation platforms offered patients an alternative to in-person visits, helping them avoid the risk of contracting the virus in hospitals.

A Growing Market: Telemedicine in India

As we transition into the post-COVID-19 era, experts in the healthcare industry are noticing a decline in footfalls on telemedicine platforms compared to the peak activity during the pandemic.

While popular companies like Medindia, Practo, MeddiBuddy, MFine, and Lybrate continue to offer teleconsultation services, the landscape is changing.

According to a 2023 report by the Technology, Information Forecasting and Assessment Council (TIFAC), the telemedicine market in India is projected to experience significant growth, with a compound annual growth rate (CAGR) of 31 percent between 2020 and 2025, ultimately reaching a market size of USD 5.5 billion.

The increasing demand for teleconsultations, telepathology, teleradiology, and e-pharmacy services drives this expansion.

While the telemedicine market is poised for growth, independent teleconsultation companies are facing stabilization in their growth rates.

The rapid rise in telemedicine during the pandemic has given way to a more competitive environment, where large healthcare providers have gained the upper hand.

Dr. Vikram Venkateswaran from Deloitte India notes that telemedicine consultations now account for roughly 10 to 25 percent of total consultations at hospitals, with an average of around 10 percent. This plateau suggests that growth for independent teleconsultation services is slowing down.

The Need for an Integrated Telemedicine Approach

Industry critics argue that telemedicine needs to evolve to ensure sustainability and growth. Presently, many teleconsultation platforms primarily offer remote conversations between doctors and patients, lacking integrated care mechanisms that provide substantial value to patients.

Siddharth Srinivasan, CEO of Lupin Digital Health, believes that telemedicine should expand beyond mere doctor-patient calls. Patients should be able to measure their vitals at home, with real-time data accessible to their healthcare providers.

This holistic approach, where technology supports remote monitoring and diagnosis, is the way forward.

Dr. K Ganapathy, Director of Apollo Telemedicine Networking Foundation, emphasizes that despite fluctuations in footfalls, telehealth deployment has considerably increased compared to the pre-pandemic era. Hospitals, in particular, are actively integrating digital platforms to engage with patients, creating unique patient profiles, and offering personalized services.

Challenges in Telemedicine Implementation

While the growth of telemedicine in India is promising, there are still significant challenges to address. One critical concern is the digital divide. Not all patients have access to the necessary technology or a stable internet connection, especially in rural areas. Bridging this gap is essential to ensure equitable access to healthcare services.

Another challenge is data privacy and security. With the increasing reliance on digital platforms, protecting patients’ sensitive medical information becomes paramount. Telemedicine platforms must invest in robust cybersecurity measures and adhere to strict data protection regulations to maintain patient trust.

Additionally, there is a need for standardized protocols and guidelines for telemedicine practices. Establishing clear procedures for virtual consultations, remote monitoring, and prescription management can enhance the quality and consistency of care provided through telemedicine.

Regulatory Framework and Policy Considerations

A robust regulatory framework is imperative to govern telemedicine practices effectively. Policymakers must strike a balance between fostering innovation and safeguarding patient interests. Clear guidelines on licensing, reimbursement, and telemedicine ethics are essential to ensure that the sector operates ethically and efficiently.

Collaboration between the public and private sectors is also crucial. Government initiatives can play a pivotal role in promoting telemedicine adoption, especially in underserved regions. Public-private partnerships can facilitate the development of infrastructure and the deployment of telehealth services to remote areas.

Patient Education and Empowerment

Empowering patients with the knowledge and tools to actively participate in their healthcare is a vital aspect of telemedicine’s success. Educational initiatives can help patients understand how to use telemedicine platforms effectively, monitor their health indicators, and manage chronic conditions from the comfort of their homes.

Moreover, raising awareness about the benefits and limitations of telemedicine can help dispel misconceptions and build trust among patients and healthcare providers alike.

The consensus among experts is that telemedicine must play a more significant role in healthcare beyond consultations.

Dr. Venkateswaran points out that hospitals provide a care continuum, covering preoperative, operative, and post-operative care. While telemedicine platforms offer online consultations, they currently fall short of being an integral part of patient care.

To stay relevant and competitive, teleconsultation platforms are actively diversifying their services, moving beyond consultation-driven revenue models. They are exploring new solutions and interventions throughout the healthcare value chain, from patient engagement to digital outreach.

Emerging Technologies in Telemedicine

The future of telemedicine in India is intertwined with the rapid advancements in healthcare technology. Innovations such as artificial intelligence (AI), machine learning, and the Internet of Things (IoT) are poised to revolutionize how healthcare is delivered remotely.

AI-powered diagnostic tools can assist healthcare providers in making accurate assessments based on patient data and medical history. Similarly, IoT devices like wearable sensors and remote monitoring equipment enable continuous tracking of vital signs, providing real-time feedback to both patients and healthcare professionals.

Furthermore, virtual reality (VR) and augmented reality (AR) technologies hold immense potential in medical education and surgical planning. These immersive technologies can be leveraged to train healthcare professionals and enhance patient understanding of complex medical procedures.

In conclusion, the landscape of telemedicine in India is rapidly evolving, with both opportunities and challenges. The post-pandemic era has forced the industry to reassess its role and capabilities in the healthcare ecosystem.

As telemedicine grows, integrating with traditional healthcare services and providing value beyond consultations will be crucial for its long-term success.

References :

Advances in telemedicine in the 21st century
https://pubmed.ncbi.nlm.nih.gov/15366773/
Krishanga

Turning Data into Diagnosis: AI and ML to Transform PCOS Detection

Dr. Krishanga Srivastava
Associate Editor, Medindia.net

Highlights:

  1. Artificial Intelligence (AI) and Machine Learning (ML) technologies are reshaping the landscape of women’s health

  2. PCOS, a common hormone disorder, often goes undiagnosed or misdiagnosed

  3. Integration of AI/ML into healthcare systems promises early PCOS identification and improved patient care

In the world of medical research, a digital transformation is taking place, set to reshape the landscape of women’s health. This change is powered by the boundless potential of artificial intelligence (AI) and machine learning (ML), casting a bright light on one of the most common yet often misunderstood conditions affecting women globally – Polycystic Ovary Syndrome (PCOS).

Artificial Intelligence and Machine Learning Join Hands to Combat PCOS

Artificial intelligence (AI) and machine learning (ML) have demonstrated notable efficacy in identifying and diagnosing Polycystic Ovary Syndrome (PCOS), the most prevalent hormone disorder affecting women aged 15 to 45.

This conclusion arises from a recent study conducted by the National Institutes of Health (NIH), where researchers systematically analyzed published scientific works employing AI/ML to scrutinize data for diagnosing and categorizing PCOS.

The findings underscore that AI/ML-based programs have shown considerable success in detecting PCOS. Dr. Janet Hall, a senior investigator and endocrinologist at the National Institute of Environmental Health Sciences (NIEHS) and a co-author of the study, emphasized the importance of this discovery, especially considering the widespread issue of under- and misdiagnosed cases of PCOS.

She stated that the effectiveness of AI and machine learning in detecting PCOS surpassed their initial expectations.

Why do Women get PCOS?

PCOS arises from irregular functioning of the ovaries, often accompanied by elevated testosterone levels. This condition can lead to irregular menstrual cycles, acne, excess facial or body hair, and hair thinning.

Additionally, women with PCOS face an elevated risk of developing type 2 diabetes, as well as various sleep, psychological, cardiovascular, and reproductive disorders, including uterine cancer and infertility.

Dr. Skand Shekhar, the senior author of the study, pointed out the diagnostic challenges associated with PCOS due to its overlap with other conditions. He highlighted the potential of integrating AI/ML into electronic health records and clinical settings to enhance the diagnosis and care of women with PCOS.

The study authors proposed amalgamating extensive population-based studies with electronic health data and analyzing common lab tests to pinpoint sensitive biomarkers that can facilitate PCOS diagnosis.

Diagnosis of PCOS relies on established standardized criteria, encompassing clinical features (e.g., acne, excess hair growth, and irregular periods) along with laboratory (e.g., elevated blood testosterone) and radiological findings (e.g., multiple small cysts and increased ovarian volume detected through ovarian ultrasound).

Nevertheless, because some PCOS features may co-occur with other conditions like obesity, diabetes, and cardiometabolic disorders, it often goes undetected.

How Can Artificial Intelligence and Machine Learning Help in PCOS Diagnosis?

AI refers to the utilization of computer-based systems to emulate human intelligence and aid in decision-making or predictions. ML is a subset of AI that focuses on learning from past events and applying that knowledge to future decisions. AI excels at processing extensive and diverse data, including that derived from electronic health records, making it invaluable for diagnosing challenging conditions such as PCOS.

It can aid in the following:

  • Improved Diagnosis: AI is proving to be highly effective in identifying and diagnosing PCOS. It can analyze a wide array of data, including clinical symptoms, hormone levels, and ultrasound images, leading to more accurate and timely diagnoses.

  • Early Intervention: AI enables early detection of PCOS, allowing for timely intervention and management. This is crucial in preventing associated health complications.

  • Personalized Treatment Plans: AI can analyze large datasets to create personalized treatment plans for individuals with PCOS. This tailored approach can lead to more effective outcomes.

  • Reduced Misdiagnoses: Due to its ability to process extensive and diverse data, AI can help mitigate the issue of under and misdiagnosed cases of PCOS, providing relief to many affected women.

  • Integration with Electronic Health Records: AI can be integrated into electronic health records, streamlining the diagnostic process and ensuring that healthcare providers have access to the most up-to-date information for effective patient care.

The researchers conducted a comprehensive review of peer-reviewed studies published over the past 25 years (1997-2022) that utilized AI/ML for PCOS detection. With the assistance of an experienced NIH librarian, they identified potentially eligible studies, ultimately screening 135 studies and incorporating 31 in their analysis.

All the studies were observational and evaluated the application of AI/ML technologies in patient diagnosis, with roughly half of them incorporating ultrasound images. The average age of the participants across the studies was 29.

Of the 10 studies that employed standardized diagnostic criteria for PCOS, detection accuracy ranged from 80% to 90%.

Dr. Skand Shekhar highlighted the study’s key finding, emphasizing the remarkably high performance of AI/ML in detecting PCOS across various diagnostic and classification methods.

The authors underscored the potential of AI/ML-based programs to significantly improve our ability to identify PCOS in women at an early stage, leading to cost savings and reducing the overall burden of PCOS on patients and the healthcare system.

They also noted that subsequent studies with rigorous validation and testing protocols will facilitate the seamless integration of AI/ML for chronic health conditions.

By combining state-of-the-art technology with unwavering human commitment, the diagnosis and treatment of PCOS are no longer shrouded in uncertainty but will be illuminated with exceptional clarity and accuracy.

Reference:

Application of Machine Learning and Artificial Intelligence in the Diagnosis and Classification of Polycystic Ovarian Syndrome: A Systematic Review.
https://www.frontiersin.org/articles/10.3389/fendo.2023.1106625/full

Telemedicine – News from India & Abroad

 

Can AI-Based Detection Prevent Heart-Related Complications?

Researchers at the Smidt Heart Institute at Cedars-Sinai have discovered that an artificial intelligence (AI) algorithm can identify atrial fibrillation…..Readmore

AI in Healthcare: Patients’ Comfort Tied to Familiarity

The degree of patients’ comfort with healthcare facilities employing artificial intelligence (AI) is found to be impacted by their familiarity with AI technology…….. Readmore

The Future of Storytelling With ChatGPT-4
According to two separate studies, OpenAI’s ChatGPT-4 has demonstrated an impressive ability to generate customized personal stories by tapping into stream-of-consciousness…..Reademore

Samsung Galaxy Watch Series Introduces Cutting-Edge Sleep Apnea Detection
Korea’s Ministry of Food and Drug Safety (MFDS) has granted approval for the sleep apnea feature within the Samsung Health Monitor app……Readmore
Click here to Become a Member of Telemedicine Society of India

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 September 2023

Click Here to Download PDF Version

Telehealth Newsletter

Official Newsletter of Tamil Nadu Chapter of Telemedicine Society of India

What is New?

The baton of TN TSI was passed on to Dr. Ikramullah as the new president. We are now close to our annual conference in Goa. Do submit abstracts and make this a unique conference.

This issue has an important article from Dr. Sanjay Sood on the great success of e-Sanjeeveni that has served over 156 million patients free.

Dr. Krishanga’s two articles on AI And ChatGPT provides new insights on use of technology for patient care.

Wish you all happy festivities. 

Thank You
Dr. Sunil Shroff
Chief Editor
EC Member, TSI

Exploring AI in Healthcare: Telemedicine Society of India (TSI) and MGM Healthcare Collaborate for Insightful Conference

Dr. Pavithra
Assistant Editor, Medindia.net

Ms. Preeti Jha,
Senior Manager, Digital Transformation

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
Dr.Sanjay Sood-250px

eSanjeevani – National Telemedicine Service of India completes 150 million teleconsultations

Dr. Sanjay Sood
Project Director – eSanjeevani

 

eSanjeevani is the National Telemedicine Service of Ministry of Health & Family Welfare (MoHFW), Government of India. This state-of-the-art cloud-based telemedicine platform has been indigenously developed, deployed and operationalised by the Centre for Development of Advanced Computing in Mohali.

Owing to its widespread and speedy adoption eSanjeevani has evolved into the world’s largest documented telemedicine implementation in the primary healthcare. eSanjeevani – National Telemedicine Service is testimony to the fact that digital health has come of age in India. eSanjeevani has revolutionised primary healthcare in India by bringing health services to the masses in rural areas and remote communities. This microservices architecture based, population-scale unified telemedicine platform is implemented in two variants:

  1. eSanjeevaniAB-HWC (a provider-to-provider telemedicine platform): this Hub & Spoke based variant provides assisted teleconsultations for patients who walk into Health and Wellness Centres (HWCs). The Community Health Officers in HWCs facilitate teleconsultations for patients and through eSanjeevani connect them to the doctors and medical specialists in hubs established in secondary/tertiary level health facilities or medical colleges.
  2. eSanjeevaniOPD (a patient to provider telemedicine platform): it enables citizens to access health services in the confines of their homes through smartphones or laptops etc.

Website: https://esanjeevani.mohfw.gov.in

Android App: https://play.google.com/store/search?q=esanjeevani+app&c=apps&hl=en-IN

Video Link: https://drive.google.com/file/d/1KYgqxHK_tayLdCprCxvBLoZHg0b2dFWf/view?usp=sharing
Krishanga

Where Do Humans Stand When It Comes to AI in Healthcare?

Dr. Krishanga Srivastava
Associate Editor, Medindia.net

Highlights:

  1. Recent surveys indicate that concerns about the potential negative impacts of AI in healthcare are on the rise, with a majority of respondents expressing more worry than excitement

  2. There is a significant increase in concerns about AI’s impact on patient data privacy within the healthcare sector, highlighting the need for comprehensive data privacy regulations

  3. It’s crucial for healthcare professionals and the public to engage in discussions, promote transparency, and advocate for measures to ensure responsible AI deployment in healthcare

Is Humanity Leading or Lagging in the Age of AI in Healthcare?

In recent times, discussions surrounding the emergence of generative artificial intelligence (AI) capable of producing convincing text and imagery have likely taken place among healthcare professionals, policymakers, and the public. These conversations have often revolved around the potential benefits and concerns associated with this technology. Recent findings indicate that apprehensions about the potential negative impacts of AI in healthcare are beginning to outweigh the enthusiasm for its positive applications.

A recent survey conducted by the Pew Research Center, involving over 11,000 individuals from the healthcare field and the general public, revealed that a majority of respondents express more worry about artificial intelligence in the context of healthcare than excitement. This shift in sentiment coincides with the growing attention devoted to AI’s role in healthcare and medical practices. When compared to previous surveys, Pew notes a significant increase in the percentage of healthcare professionals and the public who are more concerned than excited about AI, rising from 37 percent in 2021 to 52 percent in the most recent survey. (1)

The Level of Concern and Enthusiasm on Specific Healthcare AI Use Cases

When questioned about the adoption of AI by healthcare providers for patient care, approximately half of the respondents expressed uncertainty, while the remainder were evenly divided between those who believed it would be beneficial and those who perceived potential harm. More individuals held the belief that AI could enhance the quality of healthcare delivery by assisting healthcare professionals in diagnosis and treatment decisions. However, opinions may differ when considering specific applications of medical AI, such as the use of triaging algorithms to make critical decisions about patient treatment allocation.

Notably, the survey identified a substantial increase in concerns about AI’s impact on patient data privacy, particularly within the healthcare sector. This aligns with the calls from healthcare practitioners, policy experts, and researchers for comprehensive data privacy regulations to protect patient rights and ensure accountability for organizations utilizing AI in healthcare. As of now, legislative measures addressing privacy and data protection in healthcare AI remain under consideration.

One aspect not directly addressed in the survey is AI’s potential to exacerbate or mitigate healthcare disparities and biases. Evidence spanning several years has shown that AI systems can either perpetuate or alleviate biases based on factors such as race, gender, or socioeconomic status in healthcare outcomes and treatment decisions. However, AI also has the potential to uncover hidden biases within healthcare systems and practices, offering opportunities for improvement.

These findings from Pew raise crucial questions about how individuals involved in healthcare, as well as those who are not directly engaged in AI development, can maintain a sense of autonomy as AI technology becomes increasingly prevalent and influential in the medical field. It underscores the notion that AI often feels like something happening to healthcare practitioners and patients, rather than a tool they actively shape or influence. This sentiment is particularly pronounced in regions outside of China, Europe, and the US. However, even those actively engaged in addressing ethical and human rights issues related to healthcare AI can sometimes feel powerless or discouraged.

Avenues for Healthcare Professionals and the Public to Exert More Control over AI’s Impact on Healthcare

  1. Scrutinize the intentions of individuals discussing the potential of AI in healthcare, especially in the context of superintelligent and artificial general intelligent systems. Fears about these advanced AI concepts can serve the interests of a small group of influential healthcare organizations and tech companies. Focusing on these hypothetical scenarios may overshadow the importance of addressing present-day healthcare AI challenges.

  2. Promote broad conversations about AI’s role in healthcare across the medical community and within society at large. Relying solely on healthcare industry executives and AI developers for guidance on ethical and practical considerations is akin to seeking advice from biased sources. Engaging in discussions at various levels of healthcare and involving diverse perspectives is crucial.

  3. Recognize that historical predictions about the transformative impact of AI in healthcare may not always be accurate. While concerns about potential job displacement in the healthcare sector have arisen due to AI, widespread unemployment has not materialized. Additionally, regulatory measures have the potential to ensure responsible AI deployment while fostering innovation and job creation within the healthcare industry.

  4. Embrace the understanding that comprehending AI’s role in healthcare is a fundamental aspect of healthcare professionals’ and patients’ roles in the 21st century. Educate oneself about the ethical and practical implications of AI in healthcare, and communicate expectations to elected officials and healthcare organizations. Advocate for measures such as transparent disclosure when AI influences healthcare decisions, the option for patients to opt out of automated decision-making, and regular audits or testing of AI systems used in healthcare settings to ensure fairness, accountability, and patient well-being.

In conclusion, the evolving landscape of AI in healthcare demands ongoing ethical scrutiny, collaboration, and advocacy for responsible deployment and patient well-being.

Reference:

Growing public concern about the role of artificial intelligence in daily life
https://www.pewresearch.org/short-reads/2023/08/28/growing-public-concern-about-the-role-of-artificial-intelligence-in-daily-life/

Source: Attributed to Medindia
Krishanga

What 17 Doctors failed to diagnose, ChatGPT’s AI Diagnosed in Minutes

Dr. Krishanga Srivastava
Associate Editor, Medindia.net

Highlights:

  1. After three years of unsuccessful attempts to diagnose her four-year-old son’s persistent pain and growth issues, a mother turned to ChatGPT for assistance
  2. ChatGPT, an artificial intelligence tool, has been increasingly relied upon across various industries for streamlining repetitive tasks and freeing up time for more crucial responsibilities
  3. By sharing her son’s symptoms with ChatGPT, the mother discovered that he was suffering from tethered cord syndrome, a rare neurological condition

For three years, a mother struggled to identify the source of her four-year-old son’s suffering, as his symptoms persisted despite consultations with 17 doctors. Ultimately, she turned to ChatGPT for answers.

The mother decided to seek assistance from ChatGPT in order to pinpoint a diagnosis for her son. She created an account and provided detailed information about his symptoms. The rise of artificial intelligence, exemplified by the tool ChatGPT, has streamlined repetitive tasks across various industries, freeing up time for more pressing priorities.

Growing Reliance on ChatGPT

This growing reliance on the tool was underscored when a woman sought out ChatGPT to diagnose her four-year-old son, who was experiencing both toothaches and stunted growth. Courtney, the mother of the boy known as Alex, expressed her frustration, explaining, “I have to give him Motrin every day, or he has these gigantic meltdowns. If he had Motrin, he was totally fine.”

During the COVID-19 pandemic, Alex began chewing things that caused him pain, prompting Courtney to seek medical attention. Despite visiting numerous doctors, including an emergency room visit, she remained unable to find a solution to her son’s pain and other symptoms.

After some time, she noticed that Alex’s growth had plateaued and consulted a doctor who speculated it might be a post-COVID-19 complication. “He’d grown a little bit. He would lead with his right foot and just bring his left foot along for the ride,” she recalled.

When 17 Doctors Failed to Diagnose, ChatGPT Came in Handy

After consulting 17 doctors, the breakthrough came from an unexpected source. Courtney decided to turn to ChatGPT for insight into her son’s toothache and stunted growth. By sharing the symptoms with ChatGPT, she learned that Alex was suffering from a rare neurological condition called tethered cord syndrome. She then joined a Facebook group consisting of parents whose children also grappled with the same condition.

“I went line by line of everything that was in his MRI notes and plugged it into ChatGPT. I put the note in there about how he wouldn’t sit crisscross applesauce. To me, that was a huge trigger that a structural thing could be wrong,” she recounted.

Courtney scheduled an appointment with a neurosurgeon, expressing her suspicion that her son might have tethered cord syndrome. The doctor examined the MRI and confirmed Alex’s condition. Subsequently, Alex underwent surgery for the condition a few weeks ago.

This case is not the first in which ChatGPT has played a crucial role in diagnosing a medical condition. In March, a Twitter user shared how the AI tool accurately identified a diagnosis for their pet dog when conventional doctors were unable to do so.

Reference:

ChatGPT in medicine: An overview of its applications, advantages, limitations, future prospects, and ethical considerations
https://pubmed.ncbi.nlm.nih.gov/37215063/

Tethered cord syndrome is a condition where the tissue in the spinal cord forms attachments, limiting the movement of the spinal cord and causing abnormal stretching of body parts, according to the American Association of Neurological Surgeons.

To conclude, ChatGPT’s intervention proved invaluable after a prolonged struggle to diagnose a 4-year-old’s pain. This case highlights the potential of AI in healthcare.

Telemedicine – News from India & Abroad

Google’s AI Tool Detects Genetic Mutations With 90% Accuracy

Google’s AlphaMissense AI tool has taken a groundbreaking step in predicting harmful genetic mutations. It achieved a remarkable 90% accuracy rate in identifying missense….. Readmore

AI Takes Up the Dual Role of Predicting and Relieving Hot Flashes

Scientists at the Institute for Applied Life Sciences (IALS) at the University of Massachusetts Amherst, in partnership with Embr Labs, have devised a machine-learning algorithm……. Readmore

A Healthy Dose of ‘AI Learning’ With CDS Algorithm Tools: A Prescription for Doctors

As artificial intelligence systems like ChatGPT become increasingly integrated into everyday healthcare practices, physicians are expected to incorporate these tools……Reademore

“Ring One” : Changing the Game in Health Tech, One Finger at a Time

Muse Wearables, an Indian technology startup, has unveiled a smart ring featuring advanced health tracking capabilities and convenient “on the go payments.”…… Readmore
Click here to Become a Member of Telemedicine Society of India

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 August2023

Click Here to Download PDF Version

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

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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
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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

Click Here to Download PDF Version

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

Click Here to Download PDF Version

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]
Dr. Sunil Shroff Vice President

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
Click here to Become a Member of Telemedicine Society of India

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

Click Here to Download PDF Version

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

Click here to Become a Member of Telemedicine Society of India

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 here – https://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

Click Here to Download PDF Version

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

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 March 2023

Click Here to Download PDF Version

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

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 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

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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