Tag: TSI Tamil Nadu

The World Health Organization (WHO) has long been a guiding force in global health initiatives, striving to ensure that every individual has access to the highest standards of healthcare. A significant step towards achieving this vision is the Federated Digital ID for Sustainable Development (FIDES), which seeks to revolutionize the way healthcare is delivered, tracked, and improved upon, using digital identity systems and health data.

WHO FIDES: A Vision for the Future

The WHO FIDES initiative is designed to support the 2030 Sustainable Development Goals (SDGs) by improving the integration of health data across borders, creating robust digital identities for individuals, and fostering more equitable access to healthcare services. FIDES aims to bridge gaps in healthcare, ensuring that marginalized and vulnerable populations are not left behind in the pursuit of universal health coverage.

The vision of WHO FIDES is clear: a world where every individual can securely access their health data, regardless of location, fostering improved health outcomes and greater trust in global health systems. This is achieved through interoperability between systems, data privacy safeguards, and a user-centered approach that empowers patients and health workers alike.

Mission: Transforming Health Systems

The mission of the WHO FIDES project is multifaceted:

1. Data Integration and Accessibility: To create an integrated and scalable digital identity system that allows health data to be securely accessed and shared across borders, improving the efficiency of care.
2. Equitable Access: To close the gap between different regions and communities, ensuring equal access to health services for all, especially those in underserved areas.
3. Sustainability: To establish systems that are not only effective in the short term but are sustainable in the long run, contributing to the health sector’s resilience in addressing global challenges, such as pandemics and health crises.
4. Interoperability: To create systems that communicate across various health platforms, ensuring that data is shared seamlessly and securely.
5. Empowerment of Individuals: To ensure individuals have control over their own health data, promoting agency and informed decision-making in healthcare.

My Involvement
With my strong background in digital health, telemedicine, data privacy, and healthcare innovation, WHO wanted me to play a role in FIDES. And help in driving forward the project’s mission of equitable healthcare access through digital innovation.

I have always worked for health equity by advocating for vulnerable populations in global health policy forums. My membership in WHO FIDES focuses on ensuring that digital identity systems prioritize patient confidentiality, while also facilitating the efficient exchange of health data to improve patient outcomes.

WHO FIDES continues to explore innovative approaches to digital health, from telemedicine to digital health wallets, ensuring that all individuals have access to the care they need, wherever they are in the world.

Conclusion

The WHO FIDES initiative stands as a pivotal force in transforming healthcare delivery through the power of digital identity and data integration. With a mission aligned with the Sustainable Development Goals and a vision of accessible, equitable healthcare for all, FIDES is shaping the future of health systems globally.

It ensures in merging multiple powerful voices in health care into a single voice under the banner of WHO fides whom everyone can trust.

Conference on “Digital Health & Telemedicine” Overview

The conference on “Digital Health & Telemedicine” aimed to explore the evolving landscape of healthcare technology, focusing on the integration of digital health solutions and telemedicine practices. The primary objectives were to educate healthcare professionals on the latest trends, share innovative approaches in telemedicine, and discuss the challenges and opportunities associated with digital health. This event was particularly significant in the post-pandemic era, where telemedicine has become an essential component of healthcare delivery.

Venue and Organization

The conference was held in association with the Tamil Nadu Dr. MGR Medical University, where all government and private medical colleges and hospitals in Tamil Nadu are affiliated, except for some deemed universities. This collaboration ensured extensive outreach, particularly within the government sector. Special recognition goes to Dr. K. Selvakumar, Past President of TSI & Visiting Professor of the university, and Dr. Sunil Shroff, currently Vice President of TSI, who served as conveners. Their close ties with the university’s Vice Chancellor were instrumental in organizing the event.

The conference took place on Friday, August 2, 2024, at the Silver Jubilee Auditorium of The Tamil Nadu Dr. M.G.R. Medical University, Chennai. This was the third time the TSI Tamil Nadu Chapter collaborated with the university to host an event on its premises. Nodal officers in telemedicine from various medical colleges and district hospitals participated, both in-person and online. Directors from Medical Education, Rural Health, and Public Health departments also participated, chairing several sessions.

Inaugural Ceremony

The event commenced with the traditional Thamizh Thai Vazhthu and the lighting of the lamp (Kuthuvilakku), followed by a welcome address by Dr. P. Arumugam, Registrar (FAC) of the university. Dr. Sunil Shroff introduced the conference’s aims, while Dr. K. Narayanasamy, Vice-Chancellor of The Tamil Nadu Dr. M.G.R. Medical University, delivered the Inaugural Address, highlighting the university’s vision for digital health and telemedicine in Tamil Nadu.

Dr. Kim Ramasamy, President of TSI, was the Guest of Honour and delivered the Presidential Address. Dr. H. Ikramulla, President of TSI, Tamil Nadu Chapter, delivered the Keynote Address, emphasizing the importance of telemedicine in modern healthcare.

The event featured seven scientific sessions:

1. Session I: Telemedicine Application
   – Focused on the university’s vision for digital health, remote patient monitoring, and the integration of payment gateways and digital signatures in telemedicine. Esteemed speakers shared valuable insights.
2. Session II: Telemedicine Growth & Practice
   – Covered the impact of COVID-19 on telemedicine and best practices for establishing virtual clinics, with contributions from Dr. Subramaniam Swaminathan and Dr. Sunil Shroff.
3. Session III: Telemedicine Setup & Remote Monitoring Devices
   – Discussions centered on network connectivity, video conferencing, wearables, and other critical devices. Experts like Mr. Ashwin Desai and PadmaShri Dr. S. Natarajan offered their perspectives.
4. Session IV: Evaluation of Telemedicine & NMC Guidelines
   – Explored the global landscape of telemedicine, its history in India, and associated legal issues. Renowned speakers Dr. K. Ganapathy, Dr. R. Kim, and Dr. Sunil Shroff provided authoritative lectures.
5. Session V: Telemedicine in Specialties
   – Highlighted telemedicine’s application in various specialties, including Tele-Dermatology, Tele-Cardiology, and Tele-Surgery, with contributions from Dr. P. Manokar, Dr. Sanjay Sharma, and Dr. Murthy Remilla of ISRO.
6. Session VI: Tele-Dentistry & Revenue Models in Telemedicine
   – Featured discussions on Tele-Dentistry by the Dean of Sri Ramachandra Dental College and a successful revenue model in Tele-Ophthalmology presented by Dr. T. Senthil.
7. Session VII: Tele-Education
   – The final session explored telemedicine’s role in education, including tele-mentoring and mobile telemedicine vans, with insights from leaders like Dr. Chavan Kalidas, Dean of ESI Medical College, and Dr. Sheila John.

Outcomes

The conference successfully met its objectives, fostering a deeper understanding of digital health and telemedicine among participants. Key outcomes included:

– Increased awareness of telemedicine’s role in improving healthcare accessibility and efficiency.

– Identification of best practices for implementing telemedicine in various specialties.

– Enhanced collaboration among healthcare professionals, fostering an environment of innovation and shared learning.

Innovative Approaches

The conference showcased several innovative approaches, including:

– Telemedicine in Specialties: Sessions focused on telemedicine applications in cardiology, dermatology, and other specialties, providing practical insights into the specialized use of telehealth.

– Tele-Education: Discussions on using telemedicine for uniform teaching practices and examinations highlighted its potential to revolutionize medical education.

The event concluded with a group photo and a vote of thanks by Dr. S.T. Radhiga, Professor & Head of the Department of Medical Education & Curriculum Development at the university.

Conclusion

The one-day conference on “Digital Health & Telemedicine” was a resounding success, providing a platform for healthcare professionals to explore the future of healthcare through technology. The event not only met its objectives but also set the stage for ongoing innovation and collaboration within the field of telemedicine.

1968 : I entered Medical School 56 years ago. Trained in the 20th century, in the BC era my generation would today be considered to belong to the Neanderthal Age.

I injected air into the brain and dyed directly into the Carotid Artery to see if there was any displacement of ventricles or blood vessels in the brain – a surrogate marker for a possible “Space Occupying Lesion”. Tuberculoma and Cysticercosis (growths due to TB and parasites) were as common as benign and malignant brain tumors. Getting the patient’s consent for surgery was a one-sided conversation.

No questions were asked. Such was the faith and trust reposed in the surgeon. The role of the patient and the family in the decision-making process was minimal. We could not share our responsibility with anyone.

I was Amicus curiae and the Devil’s Advocate rolled into one. We entered the brains of our patients even before the surgery, trying to understand what he/she and their families would want, and took a surrogate decision on their behalf, in their interests.

2024: Tomorrow the Digital Health we will be practicing will be 5P (Predictive, Personalized, Precision, Participatory, and Preventive) medicine with AI as a major component. As 80% of the 41 Zetabytes (410 trillion GB) of digital information currently available is unstructured AI will detect patterns and trends, which our gray matter is unable to decipher.

Powerful AI techniques are unlocking clinically relevant information, hidden in massive amounts of data. Wanting to be future-ready and ahead of the curve, are we turning a Nelson’s eye and forgetting our past?

After all, it is NI (Natural, Native) Intelligence that led to the birth of AI. In a world where algorithms make diagnoses, wearables track vital signs, and robots are remotely controlled, to perform surgical procedures, will clinicians of the last century become an endangered species?

Technology today is working overtime to guarantee patient safety and quality improvement. There is already a marked shift in using technology to promote good health. In the next two decades the necessity to diagnose and treat established diseases will significantly reduce. There will be no chapter on “Complications”.

Genomics, radiomics, and specialties hardly existing today will replace many disciplines. The increasing use of a Digital Twin of a patient will enable accurate assessment and a preliminary “ in silico” trial.

We need to remind ourselves that technology is a means to an end, not an end by itself. Proactive measures need to be taken to ensure that increasing the use of technology does not lead to depersonalization and dehumanization.

Sir William Osler’s observations 150 years ago “ — the good physician treats the disease, the great physician treats the patient who has the disease”

“—–Patients don’t care how much you know until they know how much you care”

“—Listen, listen, listen he is telling you the diagnosis” is even more relevant today. The world has turned upside down. Very soon a clinician who does not use AI in his/ her armamentarium would appear to have come from another planet!

Terms such as “ trust” and TLC (Tender Loving Care) espoused by my teachers, may soon disappear. Once new technologies roll over you, if you are not part of the steamroller, you are part of the road. The writing is on the wall!

The ultimate disruption will be when what today is termed AI will become ANI, not perhaps in my lifetime but certainly in the lifetime of my children.

The A in AI after all stands for Augmenting, Amplifying, Accelerating, Assisting, and Analyzing in an Ambient milieu.

A smart empathetic clinician using ANI will become smarter. A mediocre clinician using ANI will not necessarily become smarter. The Hippocratic Oath may have to be replaced with a Robocratic Oath.

After all “To err is ChatGPT, to forgive is human !!”

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The Telemedicine Society of India, Himachal Chapter, proudly hosted a Continuing Medical Education (CME) event focused on “Telemedicine in Himalayas: Bridging Gaps and Creating Opportunities.” This event aimed to explore the transformative impact of telemedicine in remote Himalayan regions, addressing challenges and unlocking new possibilities in healthcare delivery.

We delved into the intricacies of how telemedicine can revolutionize healthcare in one of the most remote and challenging terrains on earth. We discussed the remarkable potential of telemedicine to bridge geographical gaps, enhance access to medical expertise, and ultimately improve health outcomes for the communities in these remote areas.

Our discussions reinforced the importance of collaboration, innovation, and unwavering commitment to this cause.

Let us continue to work together, leveraging the insights and strategies we have shared, to bring about a healthcare revolution in the Himalayas. By doing so, we can ensure that even the most remote communities receive the care they need and deserve.

I thank all the participants for your dedication, and your passion for advancing healthcare through telemedicine. Together, we can bridge the gaps and create new opportunities for a healthier, more connected Himalayan region.

It is often forgotten that instant access to healthcare is critical in remote isolated locations and areas. Interestingly a phenomenal amount of money and resources are being spent to keep humans on board the ISS (International Space Station) orbiting 400 km above the earth. Health issues of all the 280 humans from 23 countries who have been living in the ISS for the last 24 years ( periods varying from few weeks to several months ) have been addressed and managed.

Air travel today is no longer a luxury. In India, 4.17 lakh passengers board 2891 flights every day. No doubt In Flight Medical Emergencies occur rarely – 7 per 10,000 passengers leading to unscheduled landing (1 for 1 million passengers). Unnecessary diversion causes flight hazards, inconveniences, ↑fuel ↑costs.

Provision of In Flight Emergency Medical Services could therefore be a tremendous value addition. 15 years ago in my enthusiasm as a Telemedicine evangelist I made presentations to the CMO’s of three airlines including the then progressive Jet Airways and even the Director General of Civil Aviation. Perhaps the credibility of the institution which I was associated with and my personal credentials enabled a hearing!! Permission could not be obtained to include Telemedicine equipment in aircrafts for pilot studies. Attempts to do pilot projects on ships also did not materialise then.

It was therefore gratifying to learn that today much water has flown under the bridge (pun intended!). International Labour Organisation (ILO) & Maritime Labour Convention states “—–provide seafarers with medical care as nearly as possible equivalent to care on shore, and to ensure that medical advice by radio or satellite communication to ships at sea is available at any hour of the day or night”. Every ILO signatory nation is bound to have a prearranged system for wireless medical advice available to ships of all nationalities, round the clock and free of charge, also known as Telemedical Assistance Services(TMAS). This network ensures communication through marine radio, email, telephone or fax and in more recent times, via real-time video calls.

The author thanks the Tamilnadu Chapter of the TSI and Amet University for the opportunity given to revive an important topic, not in the main stream of Telehealth.

SNOMED CT stands for Systematized Medical Nomenclature for Medicine–Clinical Terminology and is a clinical terminology system that provides a standardized and scientifically validated way of representing clinical information captured by clinicians.

SNOMED CT is a special type of medical coding system called terminology system where the meaning of a term is coded instead of the term itself. It is a controlled medical vocabulary containing standard terms and that codes the concept definition (meaning) of a term. This definition is a formal logical representation of the information that is always necessarily true about its meaning.

This information representing the meaning is modelled as a set of interrelated triples, which encodes it in a structured format thereby making it machine-interpretable. Being always necessarily true under all circumstances, the meaning is interpreted exactly the same way everywhere each and every time.

The information model is made up of the three entities: subject, predicate and object (hence called semantic triples) that are represent the concept’s relationships.

The SNOMED concept model mandates that at least one of the triples must have the concept as the subject, the relationship “is a” as the predicate, and another concept as the object which represents a broader definition.

This makes the subject concept a finer representation or subtype of the object concept. There can be any number of additional triples that are either subtype relationships or attribute relationships, which have different relationship types as predicates.

Example: Appendicitis is coded by its concept definition. Note the three distinct components of each line – together they form the “triple”.

1. “Appendicitis” “Is a” “Disorder of appendix”

2. “Appendicitis” “Is a” “Inflammation of large intestine”

3. “Appendicitis” “Finding site” “Appendix”

4. “Appendicitis” “Associated morphology” “Inflammatory morphology”

This makes the concept of “Appendicitis” to be a finer version of the “Disorder of appendix” concept (there can be other subtype finer concepts of this like “Appendicular abscess”, “Intussusception of appendix”, “Appendicular neoplasm”, etc.) and of “Inflammation of large intestine” concept (whose other subtype finer concepts would be “Colitis”, “Crohn’s disease”, “Proctitis”, etc.). Incidentally, “Appendicitis” concept has several subtype finer concepts such as “Acute appendicitis”, “Chronic appendicitis”, “Atypical appendicitis”, and more.

As is clearly evident from above, all of the four assertions are always necessarily true of the meaning of “Appendicitis” irrespective of any other consideration.

Combining the above, as per SNOMED CT Expression Constraint Language (ECL), the unique language used to express the concept definition is as follows:

=== 18526009 |Disorder of appendix (disorder)| + 302168000 |Inflammation of large intestine (disorder)| : { 363698007 |Finding site (attribute)| = 66754008 |Appendix structure (body structure)|, 116676008 |Associated morphology (attribute)| = 409774005 |Inflammatory morphology (morphologic abnormality)| }

From the above it is evident that the individual components of the triples are in codes making the entire definition machine-interpretable.

Every concept definition is assigned a unique machine-processable identifier.

Example: Code for Appendicitis is 74400008.

Every concept is assigned a unique human-readable official name that explains the concept in a non-vague manner, which is called Fully Specified Name, or FSN, that has the concept’s domain enclosed in parentheses as a suffix to help disambiguate it.

Example: FSN for Appendicitis is Appendicitis (disorder).

All terms synonymous with a concept’s definition is assigned the same concept code.

Example: Inflamación aguda del apéndice [Spanish], Appendicite [French], blindedarmontsteking [Dutch], Appendicit [Swedish] – all have the same code 74400008.

SNOMED CT also permits the coding of terms without matching concept definitions in a standardised manner, post-facto, for machine-processability and machine-interpretability of user specific or local terms.

The concepts can be constrained, extended, or mapped to other code systems as required. All of the resultant codes will be standards-compliant, making the code system very flexible and customisable.

Example:

1. Myalgia relieved by analgesic === 706955002 |Pain relieved by analgesic (finding)| : 363698007 |Finding site (attribute)| = 127954009 |Skeletal muscle structure (body structure)|

2. operable tumour === 128303001 |Surgical removal (procedure)| : 363700003 |Direct morphology| = 108369006 |Neoplasm (morphologic abnormality)|

3. GC fair === 162669003 |Patient’s condition satisfactory (finding)|

The relationships of the concept definition can be used for in-depth query and its machine-interpretability makes all SNOMED coded information Artificial Intelligence (AI) and Machine Learning (ML) ready – imparts “intelligence”.

Example: Appendicitis has many “is a subtypes” of its own and it itself “is a subtype” of others. These relationships as well as its attribute relationships (assertions # 3 & 4 in the above example) can be used to do semantic search or to generate custom cohorts on-demand or trigger automated follow on action using preset rules like “for all concepts having inflammatory morphology as associated morphology prescribe antibiotics”. Since the code is sufficient for this, on user entry, the required action can be performed by the machine without any further action by the user.

In conclusion, SNOMED CT can be said to be a dictionary of healthcare for machines to “understand” human understandable terms.

Artificial Intelligence (AI) is revolutionizing the way we live, work, and interact with the world. From voice-activated assistants to self-driving cars, AI technologies are increasingly becoming a part of our daily lives. But as AI becomes more prevalent, so does the jargon surrounding it. To bridge the gap between complex AI concepts and everyday understanding, here’s a guide to some of the most common AI terms. This list will help demystify the language of AI, making it more accessible to everyone curious about how these technologies work and their impact on our future.

AI Terms

1. Artificial Intelligence (AI): AI is like a computer brain that can think, learn, and make decisions similar to humans. It can solve problems, recognize speech, and even drive cars without human help.

2. Machine Learning (ML): A subset of AI, machine learning is when computers learn from data without being explicitly programmed. It’s like teaching a computer to improve at a task by learning from its mistakes and successes.

3. Deep Learning: This is a more advanced type of machine learning involving neural networks with many layers. It’s akin to teaching a computer to think and understand the world in a way that mimics the human brain.

4. Neural Network: Inspired by the human brain, a neural network is a series of algorithms that tries to recognize underlying relationships in a set of data through a process that mimics the way the human brain operates.

5. Natural Language Processing (NLP): This technology helps computers understand, interpret, and respond to human language in a valuable way. It’s what powers chatbots and virtual assistants to understand and reply to your questions.

6. Algorithm: In AI, an algorithm is a set of rules or instructions given to an AI system to help it learn from data. It’s like a recipe that the computer follows to make decisions or predictions.

7. Data Mining: This process involves exploring and analyzing large blocks of information to glean meaningful patterns, trends, and relationships. It’s like sifting through a mountain of data to find valuable nuggets of information.

8. Supervised Learning: A type of machine learning where the computer is taught using data that is already labeled. It’s similar to learning with a teacher who provides you with the correct answers for study examples.

9. Unsupervised Learning: Unlike supervised learning, unsupervised learning involves training a machine using information that is neither classified nor labeled. The machine tries to identify patterns and relationships in the data on its own, like learning without a teacher to guide you.

10. Token: In the context of AI, especially in natural language processing, a token is typically a word or piece of text that the machine uses to understand and generate language. It’s like breaking down a sentence into individual pieces to better understand its meaning.

Just as a calf likes to suckle, so too does the cow like to be suckled !! The greatest incentive for conference organisers to persist in their efforts, is the attendance and the feedback. 13 years ago when Dr Sangita Reddy mooted the idea of a conference on “ Transforming Healthcare with IT” we realised that we were too far ahead of the time. A conference on a then non existing subject required considerable conviction ! 200 hundred years ago Victor Hugo had remarked “ Nothing can stop an idea whose time has come”. THIT 2024 has proved that. Last week we reached that critical mass essential for a successful take off. 1667 registrants – young and old, converted and to be converted had an opportunity to directly listen to 67 speakers https://www.transformhealth-it.org/wp-content/uploads/2021/05/11thTHIT-2024_-Agenda.pdf (combined experience of more than 1600 years !!) from 8 different countries.

Cutting Edge topics discussed included Climate change &Telehealth, panel discussions on Bench to Bedside, Healthcare in Outer space, Digital Personal Data Protection Bill, AI deployment, changing trends in technology, Innovations in Digital health etc. It was wonderful to see national and global authorities adhere to the 720 seconds given to them – after all when you have mastered your subject you can communicate the essence as a Take Home Message. Time management was incredible. More than 1000 virtual attendees logged in to partake in 20 hours of unadulterated wisdom. We deliberately had no parallel sessions. Opportunity to display ePosters was also available.

Visits to 31 stalls enabled the attendees to see, touch, feel and understand that what appeared like science fiction, was indeed a cost effective customised available reality ! In keeping with the times everything was App based including a Quiz program and Treasure Hunt . Of course a QR code was essential for plates for lunch !. Large number of contestants for the 8 awards and for the 36 hour Solvathon marathon held in conjunction with IITACB indicates that THIT has truly arrived. This would not have been possible but for a fantabulous set of volunteers who did not want to follow high standards. They believed in setting them ! We no longer strive to achieve world class. We want the world to strive to achieve India class !! A big thank you again to the core committee of Dr Sangita Reddy, Vikram Thaploo. Dr Sujoy kar, Dr Sai Praveen Haranath, Ashokkan and Aashish Kumar Jain.

Introduction

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

Early Beginnings and Milestones

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

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

ISRO’s Pioneering Role

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

Formation and Evolution of TSI

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

Developments During My Tenure (2019-2023)

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

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

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

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

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

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

Conclusion

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

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

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

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

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

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

1. UP Chapter: February 22, 2020

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

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

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

2. Jammu & Kashmir: October 29, 2021

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

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

3. Gujarat Chapter: July 06, 2022

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

4. Chandigarh Chapter May 16, 2022

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

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

5. Uttarakhand Chapter: November 10, 2022

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

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

6. Himachal Pradesh Chapter: May 13, 2023

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

7. HARYANA Chapter: March 04, 2023

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

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

9. Jharkhand Chapter: August 18, 2023

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

10. North East Chapter: on November 24, 2023

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

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

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

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

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

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

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