Telemedicine in Maldives - PowerPoint Presentation

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Telemedicine in Maldives

Regional Consultation on Telemedicine: Sharing Experience and a way forward

by:

Dr. Mohamed Ali

Dr. Nusaiba Farouk HassanSlide2

Overview

Demography

Evolution of E-Health and Telemedicine

Current Scenario

Strategic Direction

Innovations and applications of eHealth and telemedicine

Strength

Weakness

Opportunity

Threats

The way forwardSlide3
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Demography

An archipelago: 1192 Islands

Inhabited: 200 islands

Population: 360,000

Distribution:

Largest: Over 100,000 in Male’ City

Area: 90,000 sq km ( sea)

Ethinicity

- AsianSlide5
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Slide8
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Slide10

Background

In constitution: The right of every citizen to access good quality health services is protected.

The Government: Constitutionally mandated to realize this right for all.

Guiding Principles;

Recognizing Health as a human right and its universality

Ensuring equitable access to affordable, quality health services based on primary health care approach

Harnessing solidarity for health in all national policies

Ensuring policy development based on facts and scientific evidenceSlide11

Vision

for Health

:

Improving the quality and affordability of health care with a focus on access for all.

Goal for E- Health:

Providing standardized high quality medical services, by using interoperable, compatible, reliable, and scalable E-Health solutions such as telemedicine, HIMS, whereby all residents of Maldives have equal access medical expertise available in the Maldives as well as internal medical care institutes. Slide12

Strengths:

ICT is one of the fastest growing areas in Health

Existing institution based

programmes

/ databases

National ID

Nos

are being entered to independent systems, which can be used as a unique patient identifier

Large potential for M-Health;

extensive use of mobile phones and related devicesSlide13

Major Healthcare initiatives in place:

Online Nutrition and Child Health Surveillance System (ONCHSS)

SEARO Integrated Data Analysis System (SIDAS)

Hospital Information System (HIS)

E-Government Portal for online birth and death registration

Neonatal/Perinatal Database Slide14

E – Health Objectives

Establish an integrated health information System

Improve access and quality of health care given to general public using E-Health

Strengthen the capacity to monitor health indicators and conduct system reviews in a timely manner

Facilitate efficient emergency or disaster management and timely decision making in health emergency situationsSlide15

Specific Strategies

Establishment of a governance structure to deliver the E-Health Strategy

Unique citizen identifiers for a common health services and health insurance

Implementing Telemedicine

Availability of needed health information at a national level in a timely manner

Implement consumables management information system

Begin introduction of more clinical information systems and EPRs

Expand use of M-Health

Invest in computing infrastructure

Access to broad-band services

Adequate communication of E-Health strategies Slide16

Current

Investments, goals and plans:

Patient centered information systems

Electronic Health Record Systems

Telemedicine

Information Databases

Preventive Health Services using Mobiles Slide17

Telemedicine in Maldives

Vision: P

rovide

a telemedicine solution to Maldives which is compatible, scalable, reliable and inter-operable. The objective is to upgrade the quality of health care and minimize the cost of medical care through effective acquisition of relevant clinical information at remote sites. And also to ensure that all residents of Maldives have equal access to high quality health services regardless of their location. Slide18

Telemedicine in Maldives

Objective:

Enable people in islands to use

tele

-consultation and avoid travel and support continuing medical education:

Implemented in II Phases

Aiding agencies

Integrated Human Development Project; World Bank

Khalifa

Bin Al

Nahyan

Foundation; Abu DhabiSlide19

Implementation:

Phase I: Integrated

Human Development Project; World Bank

Telemedicine: 4 Main hubs connected on 5

th

May 2010

Indhira

Gandhi Memorial Hospital – Central

Kulhudhufushi

Regional Hospital - North

Thinadhoo

Regional Hospital – South

B.

Eydhafushi

Hospital Slide20

Phase II

34 New Centres joined Telemedicine Network under Khalifa Bin Zayed Al Nahyan Foundation; Abu Dhabi: 20

th

November 2011

Two components

Telemedicine Kiosk and Equipment

Training Component

70 Nurses

10 Specialists; Biomedical Engineers, Obstetrician

Gynaecologists

,

Paediatricians

, Surgeon and PhysiciansSlide21

4 Referral Hospital and 34 Remote points

Hdh

.

Kulhudhufushi

Regional Hospital

Indira

GandI

Memorail

Hospital

Gdh

.

Thinadhoo

Regional Hospital

S.

Hithadhoo

Regional Hospital Slide22

Current Situation

Sporadic Cases

No designated personnel

Trained staff unavailable to provide service

Insufficient attention to Telemedicine due to inadequate number of Clinicians at referral centers

Expensive equipment under lock and Key

No existing referral system

Use of M-Health; applications like what’s

ap

for case discussion by Clinicians

AIM: Strengthening of existing servicesSlide23

Map ISlide24

Innovations and Applications of E- Health / Telemedicine

Tele-Education

Department of Child Health, IGMH and AIIMS, New Delhi

Dengue Season

2011; CMEs in all 4

Centres

Staff at

Thinadhoo

Regional Hospital had participated in the Workshop on Management of Dengue Cases conducted in association with WHO and QSNICH via

tele

-education 2011

Telemedicine

Potentional

for development

Dermatology

Pathology

Radiology

Orthopaedics

General Medicine /

PaediatricsSlide25

Strengths

High Priority Project for Ministry of Health and Family

Health workers at remote points are motivated to learn and maximize use of Telemedicine

Clinicians at the Referral Centers are committed to attend to cases

Human Resource Development Slide26

Weaknesses

Central

Lack of an Alert System

Unaware of the enhanced equipment availability Remote points

Inadequate number of Clinician to attend to inpatient and outpatient facilities, hence telemedicine is not made a priority

No designated personnel / infrastructure

1:38 Ratio of telemedicine carts; central: peripheries

Peripheral

High turn over of trained staff

Nurses trained under Telemedicine project refuse to go back to the island

Inadequate infrastructure and power supply at HC to support equipment

Unavailability of Medications and Basic investigations

Common

Telemedicine Network has not been integrated with the Hospital

Networks

No networking between focal points

Lack of awareness among doctors about Telemedicine

License for teleconferencing has to be purchased; hindrance for

tele

-education

Lack of awareness among clinical staff and management at the hospitals

Lack of telemedicine trained specialists

Referral centers do not have telemedicine links with Regional

Centres

abroad Slide27

Opportunity

SAARC Telemedicine Project

Collarboration with Regional Centres;

AIIMS

Reduce expenditure on Health insurance referrals to male’ and abroad.

Gain the confidence of the public in the health sectorSlide28

Threats

Remote island losing hope due to failure to attend to cases promptly

Lack of maintenance of equipment may lead to loss of equipment performance

Referral

centres

do no have the necessary consultantsSlide29

Way Forward

Encourage

doctors to utilize telemedicine

To integrate M-health in to the

telemedicine system officially

To train the personnel responsible for the telemedicine and assign roles

To assign personnel to manage the telemedicine equipments and to give responsibility of maintaining them

To assign login responsibilities to the individual doctors, rather than the institute

To include

teleconsultation

in the duty roster

To assign CME points in return to the

tele

-consultation hours spent

To give bonus salary for the cases spent on

tele

-consultation

To give preference to

tele

-radiology

To provide basic equipments to the remote kiosks, like USG machines, ECG machines and X-ray machines and maintain the supply to the basic laboratory investigations

Assign budget for telemedicine

WHO and other NGO’s support to implement these services and to train personnel

In

assigning the login responsibilities, the MOH should assign license to

tele

-medicine

Include

tele

-consultation in National Insurances’ (ASANDA) patient evacuation system, to minimize the cost of improper referral and improper referral diagnosis thus reducing cost of referral system.Slide30

Conclusion

Telemedicine is a great promise to Maldivians to achieve better healthcare without having to travel by highs seas to the nearest referral

centre

, and then inevitably to the capital.

Telemedicine is the alternative route to achieving the best possible treatment rather than referring abroad for issues which can be resolved within the country, hence better utilization of resources. Slide31

Thank You!