高血压英文ppt精品课件prospects and promises of telemedicine and telehealth in

Prospects and Promises of Tele-medicine and Tele- health in Nepal Amod K. Pokhrel UC Berkeley US-Nepal Technology Development Conference Tele-medicine or telehealth u Tele-medicine or tele-health - health care carried out at a distance u Tele-health is use of Information Communication Technology (ICT) to protect and promote public health WHO u Tele-medicine is the incorporation of ICT into curative medicine-WHO u E-mail based telemedicine has been proven to be one of the efficient way to deliver health care to patients u The home telehealth and remote and remote patients monitoring market is currently close to US $ 6 billion in USA and growing Current Health Care Challenges u About 86% of households are situated in the countryside u Access to medical facility is such that only 29% of the poor people can reach a health facility with in half an hour u The public sector has 1; One doctor for every 18,500 inhabitants One nurse for 4000 people One village health care worker for 6000 people One maternal and child health care worker for 7500 people One dermatologist for 0.5 million people One Ophthalmologist for 0.25 million people Doctors and specialists are city centered Specialists visit is prohibitive to many people 1 Towards pro poor health planning WHO/SED/CMH/04.07 Prospects and Promises of tele- medicine and tele-health in Nepal u Provides opportunity to extend preventive and curative services u Help serve millions of underserved people in rural areas u Avoid patients time (including travel time) to specialist clinic visit u Allow specialists to handle more patients Prioritizing tele-medicine and tele- health program in Nepal u Success of telemedicine and telehealth programs starts with: The understanding of needs and wants of people Review of available technology Cost-effectiveness of available technology and Identification of champion or cheerleaders Burden of Disease in Nepal Top 10 morbidity by hospital visits1, causes of deaths2 and DALYs3 for all ages in Nepal Rank Morbidity Mortality DALYs (Disability Adjusted Life Years) 1 2 3 4 5 6 7 8 9 10 Skin diseases Diarrhea diseases Intestinal worms Acute Respiratory Infection (ARI) Pyrexia of unknown origin Gastritis Ear infection Chronic bronchitis Anemia Abdominal pain Perinatal conditions Lower respiratory infections Ischaemic heart disease Diarrhea disease Cerebrovascular disease COPD Hypertensive heart disease Tuberculosis Measles Road traffic accidents Infectious and parasitic disease Perinatal conditions Neuropsychiatry conditions Ischaemic heart disease Unintentional injuries Respiratory infection Maternal conditions Nutritional deficiencies Sense organ disease Intentional injuries 1 Ministry of Health, Government of Nepal, 2002. 2 Mortality Country Fact Sheet 2006. WHO 3 Calculation of author based on DALYs information available /healthinfo/statistics/bodgbddeathdalyestimates.xls Current application of telemedicine in Nepal u First electronic resources for health care providers introduced in 1995 u Nepali health care professionals currently uses: HINARI -Health InterNetwork Access to Research Initiative INSAP - International Network for the Availability of Scientific Publications Pub-Med - MEDLINE and PreMedline searches by the National Library of Medicine Foreign medical journals are still prohibitive to many Nepalese healthcare Professionals u Local medical journals: Kathmandu University Medical Journal, a quarterly, peer reviewed electronic journal (Kathmandu University) Nepal Journal of Neuroscience Neuroscience Forum u Lack of web resource for organized health care information in local Nepali language u Organization like Healthy Nepal () trying to promote the idea of organized health care information in local Nepali language Case I: Healthy Nepal Initiative A Health Portal to view local health related events, news, articles, R&D papers Who wanted to keep electronic records online and retrieve them as and when needed? Self organizing heath related records for future use NRN who need to access their relatives, parents medical records in Nepal A Healthy Nepal Team and Medical Knowledge Management Group in USA and Nepal Ananta Risal - CKO, Knowledge Interface, Inc. -USA A team of medicals experts Team Lead Dentist Dr. Sushil Koirala - Nepal A team of IT experts Team Lead Suresh Regmi/Sushil Pradhan Nepal Amod Pokhrel (Berkeley, CA) Suraj Mathema (Healthcare IT Specialist, Queens, NYC) Dr. Srijana Sharma (MIT, MA) Dr. Avinay Baskota (Buffalo, NY) Dr. Padam Neupane (New Jersey) Dr. Yubaraj Bhattarai (Louisiana) Figure 1: Healthy Nepal Web Site Figure 2: Added Functions and Information Figure 3: Menu options Figure 4: PHD- Medical History Figure : Login to PHD Figure 5: PHD-Medical Follow-up Case II: Potential of Tele- ophthalmology u Prevalence of cataracts is 0.8% u Every year about 175,000 people becomes cataract blind u Prevalence is greater in females than in males u Cataract related services (surgical rate) is 1.2-1.7 times lower for females u Cataract is preventable disease u Examination of lens at the earlier stages will offer earlier intervention and prevention Bilateral Mature Cataract Study Procedure-Lens Opacity Study Lens Photographs Initial Lens Photographs Lens opacity severity score by LOCSIII Equipments Photographs taken by capture card Photographs taken by capture card Conclusion The geographical remoteness is contributing big inequity in health care Expansion of tele-medicine and tele- health increases access to specialty health care ICT secto