Telemedicine or WHIMS: Which solution is superior?

To most people to whom we introduce iKure, WHIMS appears to be telemedicine. Telemedicine has become synonymous with technology in rural healthcare. At times one feels that the whole concept of rural healthcare technology has been overshadowed by the concept of telemedicine. If does have a compelling proposition, but there is immense scope of innovation in delivery models. WHIMS is an attempt at providing an alternate to telemedicine when the costs outweigh the benefits of telemedicine.

The topic of this post asks a question, which approach is better – telemedicine or WHIMS? But the matter of fact is that these solutions can’t be used interchangeably. WHIMS is a low cost collaborative IT platform which enables a rural doctor/health-worker and a city-based specialist doctor to exchange data pertaining to a patient’s health. The model doesn’t demand either of the two sides to be available all the time. The rural doctor places the patient’s data on the cloud server and the city-based doctor accesses it whenever he has time or at a pre-defined time each day or as a response to an SMS sent to his mobile automatically when a case is escalated to him. WHIMS therefore is an extremely flexible collaboration model.

Telemedicine is a better known model which enables a doctor present anywhere in the world to consult a patient in a far-flung remote area through the use to audio-video medium. The consultant can view the patient in front of him and can seek assistance of the doctor present at the rural clinic to examine the patient as per his instructions and can get a feedback instantly. Telemedicine replicates the traditional healthcare model where doctor and patient have to be present simultaneously at a point (physically or virtually). While telemedicine has a huge potential, it puts a constraint on the consultant that he has to be present when the patient is there, or the patient has to be present when the consultant is there in the clinic. Also, telemedicine puts a lot of demand on infrastructure. The network should be able to support a bandwidth that can enable an audio-video communication between the two points. But it can be said that the patient has a lot of assurance because he/she has been ‘seen’ by the doctor and has received an instant consultation from the specialist.

When we designed the hub-and-spoke model for WHIMS, we defined hubs as tertiary, or even secondary, care hospitals and spokes as the rural kiosks which would carry the technology and portable diagnostic bits of the overall network. We also left the scope of a sub-hub, i.e. an intermediary between the hub and the spoke. We imagined the role of telemedicine at the sub-hub level.

Such a scenario can be imagined as the rural clinics serving as the last mile primary care centres which provide generic and specialist consultation using WHIMS. In cases where the consultant needs to have a look at the patient, rather than sending the patient 50-70 Kms. to a tertiary care set-up (hub), we can create an intermediate sub-hub with telemedicine support. So such cases where doctor needs to physically observe the patient, he can request them to visit the sub-hub which would be relatively closer to their villages, say 20 Kms. Upon further consultation, if he feels that the patient needs to travel or if there are any complications, he can ask them to visit the hub hospital, 50-60 Kms. from the village.

As explained above, we see the role of telemedicine as complimentary to WHIMS and both technologies can co-exist in the same network with a common overlap, i.e. patient data. 

Remote Health Monitoring

We have come across data that shows paucity of healthcare professionals and healthcare infrastructure in rural and semi-urban areas of India. We also know that it would take generations for us to remove this disparity. In this kind of scenario, any possible solution should work around constraints and bring in a game-changing proposition.

The constraint here is the scarcity of specialist medical help in rural and remote areas. The healthcare parameters in such areas are extremely poor and the traditional solutions offer little respite. The game-changing proposition we offer is the technology-enabled monitoring system for remote patients.

Wireless Health Incident Monitoring System (WHIMS) is a humble piece of technology which enables a city-based specialist doctor to monitor the health of his patients. A trained health worker or a rural doctor provides the primary care to the patients and records information related to their health in WHIMS’ application. WHIMS can be accessed through internet or through mobiles. Low-cost portable diagnostic devices empower the primary care providers to capture precise health information of the patients and provide it to the consultants. While we do not use any tele-medicine interface, the same can be built into the system.

Remote Health Monitoring has the potential to create a viable scalable healthcare model for rural areas because the scare specialist resources are utilized efficiently. Better care can be delivered to the patients at a fraction of the cost to an urban patient.

While the opportunity is real, we must also realize that this is not the solution in totality. Some percentage of patients will require emergency care and in-patient treatments. In some other cases, high-end diagnostics may be required. Even towns do not have such facilities. Clearly, government’s role in creating such an infrastructure cannot be negated. Public-private partnership (PPP) can also be a model where government supports and encourages private players to create such an infrastructure.

A Fresh Perspective

“Anyone who stops learning is old, whether at twenty or eighty. Anyone who keeps learning stays young. The greatest thing in life is to keep your mind young.” - Henry Ford

The benefit of being a start-up is that you keep learning all the time. The learning itself becomes the joy and the achievement. The knowledge can come from any direction and from anyone. The important thing is to embrace the new knowledge and the new perspectives.

April brought with itself an opportunity for the iKure team to gain new perspectives from four students of management from XIMB (Xavier Institute of Management Bhubaneswar). Arnab Neogi, Vidhi Sharma, Abhiroop Saha and Abhishek Jobanputra joined us for an 8 week summer internship to help us solve a few business puzzles. Since it’s the first time such a batch of management students has joined iKure, and we intend to follow this practice in the near future as well, so we have called their gang as ‘Cohort One’.

After having spent a good fortnight with them, all we can say is that this bunch is fun-loving, ambitious, hard working, intelligent, curious and eager to learn. We have been gaining a very fresh view on how we operate as a team and as an enterprise and we are sure together we will be able to meet their project objectives.

As we progress through the remaining days of their internship, we will have more stories to share about their successes and key inputs. So keep checking this space!

Limitations in scalability of healthcare delivery model and possible solution

It is very common from anyone who has worked in the IT sector to come across the term ‘scalable’. Basically it points to the capability of the technology components – hardware and software – to ramp up as the business demand goes up. The implicit requirement is that this ramp up is achieved in a relatively short period of time (compared to how things used to ‘scale up’ in the past) and without compromising the performance of the system.

In business also most start-ups are faced with this question by prospective investors and clients. Their ideas are great and workable and some are even profitable very quickly. But then comes the question of scalability and replicability. Here the expectation of the potential investors and clients is that the design of the business model should allow it to grow quickly. But the thing I’m pondering over is that are all business models scalable? Is it right to expect every business to be scalable? What if a particular industry dynamics do not allow scalability? Should I be bothered if it seems that my business model is not as scalable as other business models in other industries?

In the previous post, there was a discussion on various factors that contribute towards creation of an urban healthcare delivery system and on efforts of iKURE towards creation of an ecosystem of partner organizations and experts to finally create a rural healthcare delivery system. You can refer to the post here.

Now the question arises – Is our delivery model scalable? Or for that matter, is even the urban healthcare delivery system scalable?

The basic elements of a care delivery system are healthcare providers, namely doctors and nurses, supportive services like diagnostics, pharmacy and blood bank, care setting which comprises of the physical infrastructure of the clinic/hospital, bed capacity & types and the medical equipments installed in the setup and other ancillary functions like purchase & stores, housekeeping, engineering, med gas etc. Let me also add IT to this list of elements of a care delivery system. So as I discussed in the beginning of this article, scalability is not new to IT and this is a tried and tested model in the sector. But can we stretch or scale up other elements of the care delivery system? How reasonable is it to assume that we can create more health professionals like doctors and nurses in a short time without compromising quality? How economically feasible is it to add more beds and clinics and hospitals infrastructure? How easy is it for anyone to ramp up ancillary functions of a hospital, like stores, housekeeping and engineering?

By very nature, healthcare industry is infrastructure-dependent. Apart from that, there’s this issue of lack of qualified medical professionals. So one would wonder that if one doesn’t have enough staff and support services, what is the point in creating more infrastructure. There’s similar challenge in rural healthcare delivery as well. There are statistics that say there are very few doctors serving India’s massive rural population, compared to relatively better availability of doctors in urban areas. Similarly, there are statistics on paucity of health infrastructure in rural areas and most new infra being developed in cities only. The ROI-driven growth definitely will happen in cities and there are customers who can afford and pay for the healthcare infra built in the cities. In this context, the infrastructure and availability of healthcare professionals in rural areas become bottlenecks in scalability of rural healthcare delivery models.

iKURE’s model is trying to address a different kind of challenge. Whatever healthcare facilities are available in the villages are also not upto the quality standards. So on one hard the villager doesn’t have many options and on the other hand, the only option available to him also is not upto the mark. It’s our endeavour to give a better deal to healthcare seekers in rural areas by creating a collaborative platform where a rural doctor can coordinate care delivery with the assistance of a city-based specialist consultant. With the use of low-cost diagnostics and timely advice from the doctors, we can prevent the health of the patient from deteriorating further and escalate the case to a higher centre of care at the right time. All it takes is a basic infrastructure to be put into place. A small patient-examination room with a computer kept close by can become an iKURE kiosk. The health-worker or the doctor needs to be trained in using iKURE’s software. Communication can happen in English or in regional language.

From a scalability point-of-view, we have a key challenge in terms of taking technology to the rural clinics. As a software company, we specialize in the application which meets the requirement. But investments are also required in the digital infrastructure to be put at the kiosk. All this has to be done without increasing the cost of the treatment to the patient otherwise the whole exercise will lose its purpose. In the Salboni project of iKURE, the CSR partner JSW Steel takes care of these costs and even provides branded medicines at no cost. This model is easily replicable if there are corporates whose vision is to see a healthier community in the areas in which they operate. State governments can also leverage this low-cost technology by bringing its health centres under the ambit of such a project.

As a company iKURE has been able to generate sufficient interest and it’s a matter of time when we fulfill our vision. The need really is to associate with partners who are committed to the cause and who understand that scalability in a healthcare delivery system cannot be achieved overnight. The community has to be taken into confidence and their involvement is essential. Investments in infrastructure have to be made with a greater focus on SROI (Social Return on Investment) and monetizing the investments through alternative activities which can be aligned to education, livelihood, financial support, women empowerment, e-governance and many more. Innovation is the key.

Technology-enabled healthcare delivery to under-served market

For the last about 2 years that iKURE has been working on technology solutions for healthcare delivery, we have straddled 2 very different customer segments – rural and urban. And it has surprised us that opportunities for advances in rural healthcare delivery exist through the use of a humble technology platform.

Why I used the term ‘under-served market’ in the title is because I wanted to highlight that rural people also pay out of pocket for their healthcare needs. Their ability to get quality healthcare is limited by Access and Affordability. Most good hospitals are built in urban centres and there also you will witness a huge difference in healthcare facilities available in metros and towns/cities. From my own healthcare experience I have realized that it takes many factors to create a quality healthcare system – Doctors, Nurses, Technicians, Engineers, Billers, Security, Waste Management, Medical Suppliers, Equipment suppliers and maintenance, IT etc. and many other supportive institutions like municipality, banks, electricity dept. among many others. And add to this the problem of high rate of attrition in medical and non-medical staff. So let’s admit that it’s not economically feasible to replicate an urban healthcare delivery system for rural setups in the near future. But rural masses deserve the same standards, yet access is limited because they need to travel a lot to avail of the services of hospitals in the urban setup. Affordability is another issue because one another aspect of the urban healthcare system or a hospital is that it is capital intensive and most of the costs are passed on to the patients. For city-based patients it is within reach because per-capita income level in metros/cities is much higher than those for towns and villages.

In such kind of circumstances, the easiest we can do is to enable patient in a village to seek health services from a city-based consultant without having to travel to the city and at a fraction of a cost of what it would be for a city-based patient. At iKure we leverage this through a hub-and-spoke model. For more information on this, please read the post ‘Health for remotest of areas – the iKure way’.

From our field experiments, we have come to a working model which is supported by Corporate Social Responsibility funds. So while the technology creates Access, the Affordability is taken care of by the CSR grant which subsidizes the treatment costs. It’s heartening to see how such partnerships create difference in the lives of our countrymen.

The scope of this model to radically change the rural healthcare delivery process is immense. Our concept is basically to create a technology platform to enable a rural doctor/health worker to collaborate with a city-based specialist doctor to deliver care to the village-based patient. In this process, we are able to uplift the confidence and credibility of the village-based doctor and significantly improve his decision-making abilities regarding his patients’ treatment. Our health partner also spends their resources in training these health workers/doctors to bring them up to the common communication level with the city-based doctor. The CSR partner funds the medicines, consultations and other health costs for the target community. But as a group, it is our endeavour to make the whole model self-sustaining by letting the community take ownership of the whole system.

As we make progress, we would like to explore opportunities where a fairly good number of spokes or village health centres/clinics are technology-enabled and these are connected to a series of specialized centres to provide quality healthcare to a larger set of population. Many more innovators can leverage this network, for example insurers, pharmaceutical companies, low-cost diagnostic device manufacturers, research institutions etc. As I said in the beginning of this post, there are a number of factors which contribute to make an urban healthcare delivery system. We are in the process of creating an ecosystem of partners and experts who will together create a rural healthcare delivery system which will materialize our vision of delivering quality healthcare services to rural people at a price point affordable to them.

If you share our vision, or you are an innovator passionate about this sector, please contact us at contactus@ikure.in

Hosted in the Cloud: HIS

In IT terminology, SmartKure is the front-end of the integrated medical solution provided by iKure TechSoft. It’s a SAAS model Hospital Information System (HIS). One of our objectives is to build Data Warehouses comprising appropriate health information and accessing tools. SmartKure does exactly that. It consists of an online hosted application to be used by both doctors and patients. Patients can search doctors for better treatment of both generic and crucial diseases. On the other hand, doctors can store patient information and also receive feedbacks. SmartKure also provides a guided appointment system through website login, SMS or phone.

SmartKure consists of a Doctors’ Module, a Patients’ Module and Medico Informatics. The various uses of these modules are:

• Doctors’ Module is used to diagnose patients by doctors. They are also aided in their decision making by the “Guided Diagnosis” feature. The “Guided Diagnosis” is achieved with the help of intelligent data-mining of Medico Informatics, which is the data warehouse of the system. Doctors can also take first hand feedback from patients they have treated. In case of poor feedback the doctor would be alerted and he may speak with the patient and fix the situation. The system will stress more to identify the good doctors among the group rather than pinpoint the not so good doctors.
• The Patients’ Module is used by the patients to search for a more suited doctor, to book appointments, and to provide feedback on their own health as well as their satisfaction with the doctor. A step by step guide will be provided for patients who are not aware which doctor they need to go to for their problem. Patients can search based on specialization, location, feedbacks, fees and availability. Thus, one saves time, money and minimizes wrong medication through this process.
• Other than patient feedback the system will also use data from independent bodies through surveys about the quality of doctors. This will be categorized as critic’s recommendations.
• Patients can easily book appointments in advance, in case the doctor has tied up with the system.
• All the doctors who sign up will need to enter details about their profiles, experience, and expertise in an area and up to last 5 major cases handled. This helps patients in having a better idea about the doctors area of expertise.
• For the not so tech savvy patients, our Tele Agents will facilitate the searches and setup appointments. The system has features for phone and SMS reminders as well, thereby making the process convenient and hassle free.
• The web search will be very light weight since we are using web 2.0 technology and W3C framework.

The diagram below shows two different ways in which a patient can use our service. He/she can directly use the website to search for a suitable doctor and book an appointment. Or, the patient can call iKure’s Tele Agent to do the same for him/her. Similarly, doctors are in touch with the Tele agent for appointments and feedbacks and they also use the hosted application.

Now let’s list out some of the major benefits that SmartKure provides.

(a) Give people more information to make an informed decision in a timely manner while choosing a physician. A patient can avoid misguided advices of friends and relatives. He can search and find the best doctor himself without losing privacy. This will also help treat critical diseases such as Cancer, AIDS, brain tumor where the patients need the best physician quickly.

(b) Help doctors better evaluate the care their practices give and learn new ways to keep patients satisfied. Doctors are required to post up to 5 of their recent best handled cases. Other doctors can use these details in their own practice or just refer the patient to a better doctor themselves.

(c) Give the patients the power to help change the practitioner/hospital by creating a strong and large referral system. We intend to develop SmartKure’s referral system into the largest in India.

(d) Currently, there is no system in place, which can help a doctor to get the first hand information on the effect of medications, as there are new medicines reaching the market every day. The feedback mechanism will act as a data warehouse that can contribute in such research and analysis.

We have been talking a lot about rural empowerment, how does information reach the remote and rural areas then? SmartKure has a different mode of action there. The Rural Coordinator in our health kiosks located at remote locations will be our point of contact for this service and not the patients directly. He can work with the hosted application or even call up a Tele Agent to discuss the situation. The Tele Agent will provide him with details of a suitable doctor and can also fix an appointment if required. The Rural Coordinator then coordinates with the doctor for his patients. The process is illustrated in the diagram below.

Thus we see that SmartKure is an easy to use application with lots of health information for all medical entities and for all types of diseases. For a patient, it is a life saver. Our life is in our hands and we need the right information at the right time to preserve it!!

DgImage - Medical Imaging made easy

DGImage is a cost effective and complete solution designed and developed by iKure TechSoft (P) Ltd. for medical image acquisition and management of hospitals. Medical imaging is the process used to create images of the human body or its parts for clinical purposes. Usually these images are provided to patients in the form of films and scans as a hard copy. DGImage is the technology to work with and store a digital format of these images thereby helping hospitals become more environment-friendly by eliminating the use of paper, films, and minimizing the use of scanners and printers.

A multi pronged product from iKure, DGImage has the following components and functionalities:

Ø Acquisition of Medical images from various modalities like CR, DR, CT, PET, MRI, MI and Ultrasound. These digitized medical images along with relevant information are submitted to the DgImage gateway over TCP/IP network protocol for further processing by DGImage’s Image Processing Engine.

Ø Integration points for non-DICOM compliant modalities: DgImage complies with international standards such as DICOM (Digital Imaging and Communications in Medicine). But it works with non-DICOM compliant image sources as well.

Ø Dicomizes the medical images: In case the images received at the image processing engine are non-DICOM compliant, they are submitted to Dicomizer engine of DGImage, which standardizes the image as per DICOM standards.

Ø Compress and Encrypt the Medical images: The image processing engine uses industry standard algorithms for lossless compression and image encryption before storing them in the DGImage database. This helps hospitals in maintaining both - a high security standard and reduced storage space.

Ø Index and archive the Medical images: Hospitals need a long-term solution for medical image archiving that optimizes on volume, storage capacity and on-demand access. In order to achieve these targets we use the DGImage database with appropriate indexing, which facilitates faster retrieval of images in real time.

Ø Physical Data Backup of medical images: DgImage supports image backup on CDs and other backup media for up to 2 years. After a backup is taken, the images can be deleted from the database to free memory for new patients.

Ø Facilitate external system to query the data from DgImage database: Only authorized personnel are given access to the system.

Ø Integration points with internal and external Information Systems: In general, hospitals have various workflows catering to different healthcare processes. To support these workflows, multiple Information Systems are in place. For an efficient functioning, all these workflows need to work in harmony. DGImage helps to integrate all image related workflow by providing query and retrieval protocols to obtain images from the database in real time.

Ø View and analyze Images using DgImage viewer: DGImage Image Viewer, another component of the DGImage package, supports viewing and analysis of both DICOM and non-DICOM images. The Images can be exported to the most common picture or movie file formats. Dicomizer wizard is integrated with DGImage Image Viewer.

Ø Pre built integration to Smartkure and Medico-Informatics: DGImage has a pre-built integration in place with iKure’s other products - Smartkure and Medico-Informatics. This provides the hospitals with a complete solution integrating all workflows around patient management under a single platform.

Looking at the features of our product one can easily grasp its multi pronged benefits. The image above explains the structure and connectivity of DGImag. The image processing engine is the core component of DGImage. It receives images from the gateway server, processes the image and stores it on the database. It also enables the integration of DGImage with web server, authorization server, external systems, printers, archives, backup media etc. Hence, this product aids all entities of the medical system – Hospitals, Doctors and Patients. Some of its implicit benefits are:

ü Helps patients: The amount of data obtained in a single scan is very extensive. Most of this data is usually discarded when making films. However this data can be saved as digital format and that can save patients time and money, while reducing their exposure to radiation. As their scans are stored on a central storage system, patients need not worry about protecting the films.

ü Helps doctors: The doctors can modify the images (size, contrast, color, resolution, etc) using Image Viewer for better examination. They can also cross-refer the reports over the network to other doctors in real time.

ü Helps Hospitals: DGImage helps hospitals build a centralized Image Information and Management System to fetch, handle, store, analyze and transfer-over-the-network. It also enables hospitals to carry out image handling in a secured way prohibiting any unauthorized access to the hospital's Medical images.

ü Medical tourism and Diagnosis of remote patients: DGImage complies with international standards such as DICOM thus enabling hospitals to exchange more and more information with hospitals across the globe.

ü Adhering to a uniform standard for Medical Image Handling: DICOM is almost universally accepted among both manufacturers of medical imaging equipment, health care institutions and their IT departments. It has emerged as the common protocol for medical image communication world wide.

Medical imaging also finds its use in scientific and industrial applications. It has become a major tool in clinical trials since it enables rapid diagnosis with visualization and quantitative assessment. DGImage can be helpful in streamlining processes in an industry and making it much easier to store, retrieve and analyze data.

Health for remotest of areas – the iKure way

India is a country with a wide variety in almost every field – ranging from food, clothing, language, religion, festivals, to a great divide in academic and socio-economic backgrounds. More than two-thirds of India resides in villages and remote areas cut off from basic medical facilities. Caste divide adds to the existing woes of health services. About 65% of Indian women still deliver at home. There is a growing concern about health inequalities between different social groups. An idea of rural – urban disparity can be obtained from the statistics below:

Statistical Data (per 1000)	Rural	Urban
Hospital Beds	0.2	3.0
Doctors	0.6	3.4
Public Expenditures	Rs. 80,000	Rs. 560,000
Out of Pocket	Rs. 750,000	Rs. 1,150,000
Births Attended	33.5%	73.3%
Full Immunization	37%	61%

One the one hand we have a rural-urban disparity in medical care, and on the other, there is an increase in chronic conditions that need regular patient monitoring. Also, with hospitalization costs skyrocketing, patients are finding it difficult to be admitted in hospitals for a longer period of time. These factors are challenging the health system to find a new approach to health management.
A feasible solution is to remotely monitor patients and admit them only during emergency conditions. Our country needs a reliable and cost-effective remote health care monitoring solution. New technologies have come up that can scan and convert medical reports to digital format. This can be stored on central servers, to be accessed and shared by doctors. Worldwide it has been proved that Remote Monitoring, Telemedicine and Wireless Technologies if combined together, can improve health care delivery manifold.
Our company iKure TechSoft, strives to bring health services and insurance to the neglected section of our society, through an entrepreneurial “kiosk” model. We have tied up with SSE (Society of Social Entrepreneurs, IIT Kharagpur), who in turn is partners with GVL (Global Venture Lab), Finland. Selected entrepreneurs are trained under the TEDP (Technology based Entrepreneurship Development Program) course at IIT Kharagpur. They are given rigorous training in personality development, business calculations and risk management. Kiosks, thus setup by these budding entrepreneurs are the nodal point of telemedicine and remote patient monitoring.
Every ‘health kiosk’ has a Rural Medical Practitioner (RMP) who has been trained by specialists using advanced technology. The RMP helps patients take readings for BP, Blood Sugar, Body Temperature, Electrocardiogram (ECG), Weight, Height, Pulse, etc. These readings are wirelessly logged into the system, as they are all in digital format. Based on the patient’s test results, the RMP can prescribe medicines. His analysis and prescription is also entered into the system. In case of a complicated or confusing case, the patient may need special medical advice. For this he/she is referred by the RMP to a hospital attached (contracted) to the kiosk. Hence, these special health centers called ‘health kiosks’ guide patients in getting better access to doctors without venturing very far from their home.
When a patient is referred to a specialist, his medical history is sent wirelessly to the hospital. This provides the doctor with instant access to the patient’s medical reports and also to the line of treatment followed by the RMPs at the health kiosks. Patients from rural areas usually don’t remember details of their medical history and are not aware of medication they have taken. So, having test results and prescriptions transmitted to the hospital or to specialist, helps reduce consultation time with the new doctor. On the other hand, if the case is not that serious, the RMP can also consult a specialist via phone after transmitting his patient’s details. This further saves the patient travel time, cost and energy.
The new age technology that has made the whole idea work, is a handheld device called WHIMS (Wireless Health Incident Monitoring System) which is currently under the patent process. This is the core device that collects digital data from various health monitoring devices and sends them to the main system. WHIMS provides lot many benefits:

1. As this device enables the patients to be in touch with the health experts around the clock, it brings an emotional security and support to them.
2. The adaptable technology of the device helps it to work with multiple measuring devices, thereby covering all the major chronic diseases that can be remotely monitored.
3. Device has a broad spectrum, from urban to rural areas, from educated to illiterate.
4. It is simple and easy to use.
5. It has a facility to send an auto alert to doctors when the readings are way beyond the acceptable range.

IKure has already setup a functional kiosk at a remote area in Madhyamgram, North 24 parganas, West Bengal. The kiosk has facilities for measuring vital statistics, BP, blood glucose, pulse, etc. and to transmit data to some hospitals in Kolkata. A few other projects are in the setting up phase in Durgapur area of West Bengal.

Along with setting up kiosks, Ikure also aims to bring specialists from other areas such as Vellore, Chennai and Mumbai for complicated and unique cases. The patient’s data will be shared by these specialists & the patients can have a remote consultation with these doctors. In case there is a surgical requirement the specialist can intimate the patient on details of cost, hospitalization tenure etc., so that the patient can travel with all the details in hand. Besides helping the patients the data accumulated at the central monitoring server can also be utilized by various research firms and health agencies for study of new medicines, their effectiveness and for general medical research.

Thus we see that the contributions of Remote Monitoring and Wireless Technologies to health care delivery are 3 fold. Access, especially to under privileged, and to provide better Quality at reduced Cost.

Teleradiology - Ikure initiative

TeleRadiology: Tele Radiology is a branch of Tele Medicine that deals with transmission of digitized radiographic images for interpretation by a specialist. It is one of the fastest-growing areas in health care worldwide. It is one of the most widely deployed uses of telemedicine and also tops the list of outsourced telemedicine services. TeleRadiology helps bring cheaper, faster and high quality radiological services to patients, irrespective of his location. It even helps doctors discuss critical and unique cases across the globe, thereby bringing much needed hope to patients and their families.

iKure proposes to bring forth an affordable and efficient mechanism for teleradiology image management of hospitals in India through its product called DgImage. DgImage complies with international standards such as DICOM (Digital Imaging and Communications in Medicine), thus enabling hospitals to easily interpret each others scans. The digital images are small enough and are easily stored in databases. DgImage coupled with SmartKure (another product from iKure), allows not only doctors but even patients to access their radiology reports from anywhere and at anytime.

Teleradiology helps improve patient care, as it provides access to sub specialists even in remote and underserved areas. The radiographical images taken in rural areas can be sent to hospitals and specialists in the city using WHIMS (a health monitoring product from iKure). Patients do not have to travel far and wide, thereby cutting overall cost of treatment. In a country like India, where the majority still lives in villages, health care is always a challenge. iKure aims to provide them with cheaper and quality healthcare in a self sustaining model.

Some years ago, a study by radiology experts in the US predicted that up to 20% of image interpretation business would soon be provided via teleradiology. Today’s fact is that teleradiology makes up nearly 50% of all telemedicine applications.