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.