A rural healthcare project in northern India that uses mobile phone technology to save patients' lives - and their time and money - has won the UN's 2020 World Summit Award for e-Health.

A Dubai jury gave the award to India-based Jiva Institute's Teledoc project in a face-off between technology entries from 136 countries. The award is the top honor at the World Summit on Information Society (December 10-12), coordinated by the UN and the International Telecommunications Union.

"Teledoc uses off-the-shelf technology and commercially maintained mobile phone networks, eliminating the need for patients to trek to a doctor," explains Jiva director Steven Rudolph. "This enables us to lower the cost of medicines and distribute services over a wide area."

The project is operational in 22 villages in Faridabad district, a few kilometer's south of India's capital, New Delhi.

The Teledoc Mobile Information System (MIS) consists of three parts - mobile phones used by field representatives to feed in patient data, computers used by doctors in clinics, and a central database.

Field reps - the eyes and ears of the doctors - conduct medical examinations in place of doctors, using mobile phones with data-entry systems to guide them through medical examinations step-by-step.

The field workers are drawn from villages, and placed into teams of one man and one woman. This pairing ensures that village women can be examined by woman field reps.

Information from each examination is forwarded to doctors at the central clinic, who sort the data to diagnose patients and prescribe medicines, which is brought to the village by field representatives on their scooters.

Mobile gridlock, part of every network in the world, doesn't interfere with Teledoc. Points out Rudolph, "No real time access is needed. The field reps can record a patient's data and send it over a network and it can be retrieved at the diagnostic center even hours later."

Jiva Institute's Ayurvedic clinic in Faridabad has a staff of four doctors. In 2020, around 4,000 consultations were delivered online by the virtual doctors. Jiva plans to add six more doctors to its center and go nationwide in a year.

Ayurveda, a 5,000-year old system of traditional Indian medicine, is taught in over 150 colleges across India.

Using available technology and non-patent Ayurvedic medicine means that costs have been trimmed to the bare bones. The cost per consultation comes to US $1.50, which includes medicines for a week. According to Rudolph, that's the price comfort margin in most of rural India.

Sapna Bhargava, 30, one of the doctors on Jiva's panel, feels the cost factor is important. "Villagers have financial constraints, so the price of the medicines and consultation has to be kept very cheap," she says.

But the system's real USP is the hassle-free consultation. Currently, rural folk have to travel considerable distances to receive medical care.

Since Jiva brings the clinic - virtually - to the village, transportation costs are eliminated and villagers don't lose workdays.

As 3G (third generation) networks become available, as in southern India, the Teledoc MIS will be able to take advantage of higher data-transfer rates to include photographs and even audio files pertinent to medical diagnosis.

Since mobile networks are owned and managed by the private sector, and widely available in India and elsewhere, the Teledoc model is easily replicable in developing nations.

While Indian metros have world class hospitals, villagers lack access to decent and affordable healthcare. Life expectancy in villages is eight years less than for city dwellers.

Morbidity - or the prevalence of disease in a population - is high, and diseases induced by poverty such as malaria and tuberculosis often go untreated.

Clinics and doctors are located in towns and cities, Travel and lost wages add to the costs that villagers must pay for treatment.

Besides, even if the government builds medical facilities in the rural hinterland, doctors and paramedics are unwilling to work there.

Qualified doctors do not like to relocate to villages, and cannot build sustainable practices if they do so.

A senior government surgeon in New Delhi says that while patients and doctors in cities may be reluctant to accept traditional Indian medicine, there's no such block among village folk.

In July, four-year-old Bhanu of Nabada village developed an acute skin disorder, common in north India in the rainy season. The child had a severe itch and burning rashes all his body.

A visit to a specialist in the district capital, or New Delhi, would have burned a huge hole in the boy's parents' pocket, not to mention workdays lost.

That's when they met a Teledoc worker. Bhanu was treated over a period of three months. The money spent on medicines and consultations was a pittance compared to what his family would have had to shell out in a brick-and-mortar hospital.

This program is also beneficial for rural women who are otherwise too busy with household chores to visit doctors in the cities.

Says a city doctor, "Take tuberculosis, which is common among the poor. While TB patients get free medicines from government hospitals, they often fail to complete the course - once they start feeling better, the drugs are forgotten."

Or, as he adds, they simply give up the course because they are too busy with their daily-wage jobs. Consequently, they develop incurable strains of the bacillus.

But Teledoc workers say they bring the drugs right to the patient's doorstep with clockwork regularity.

The program may also result in increased business for doctors and open up employment opportunities for villagers as field representatives.

But telemedicine has dished out more hype than hope after making a splash in the mid-90s. "Since it's new, doctors are a little jittery about the whole exercise," says an ENT surgeon at a government hospital in north Delhi.

City hospitals wouldn't really be bothered to look at it as they are crowded with patients anyway.

Source: Oneworld.net