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Telemedicine – a lifeline for rural India?

Projects such as ReMeDi allow doctors to consult with patients using telemedicine
Projects such as ReMeDi allow doctors to consult with patients using telemedicine technology

Health Issues India has written at length about the many inadequacies of India’s healthcare system. They are perhaps most aptly summarised by Forbes, writing

“In India, public health care is free, yet years of under-investment in public health means that facilities are also grossly understaffed and under-equipped. The country also has a massive resource gap of over 4 million health workers and, to compound problems, nearly 60 of existing health workers practice in urban areas. 

With 70% of its people living in villages, often far from health care providers, it’s clear that there’s a lot of room for affordable health services to grow in India.”

At the beginning of September, we wrote of the potential of digital technology start-ups to be the revolution India’s healthcare sector needs.

One such example is the Remote Medical Diagnostic-Medical Data Acquisition Unit programme – ReMeDi-MADU or ReMeDi for short – a cloud-based diagnostics kit which aims to improve the delivery of basic healthcare to those living in rural areas.

ReMeDi was developed by Neurosynaptic Communications Pvt. Ltd. (NSCPL), a Bangalore-based telemedicine start-up founded in 2002 by Rajeev Kumar and Sameer Sawarkar. NSCPL is committed, in its own words, “to make quality healthcare affordable to the masses.” It aims to achieve this via the use of “technology solutions at a large scale…[to] enable end-to-end health care delivery.” It amassed series A funding earlier this year, from investors such as the Indian Angel Network (IAN), Healthquad and Axilor Ventures.

ReMeDi is indicative of this philosophy. Launched in 2008 according to Forbes, it allows patients in rural areas to consult with doctors digitally. The kit performs medical tests in six key areas, including blood pressure, electrocardiography, heart and pulse rate, oxygen saturation, and temperature, using electronic equipment. It records information about patients’ health in a central database. This information is then sent to doctors in urban hospitals, who are able to provide a diagnosis and prescribe treatment via video link.

Other entities have pursued similar ventures. The non-profit World Health Partners (WHP), for example, has invested in telemedicine to address the shortage of rural health practitioners. The WHP has established SKY Health Telemedicine Centres, which made use of the ReMeDi technology, to “enable remote diagnosis and audio-visual communication between rural patients and qualified city doctors” via the use of “the latest advances in communication technologies, reliable power backup and customised software.” The cost of a consultation would depend on a patient’s economic status, with those living above the poverty line being charged INR 50 (1 USD) and those below the povery line being charged INR 30 (0.6 USD).

In 2014, Health Issues India interviewed Gopi Gopalakrishnan, President of WHP, who expanded upon the role of the SKY Health Telemedicine Centres:

Telemedicine Provision Centers called SkyHealth Centers are operated by an entrepreneur with a health background, and serve as tele-diagnostic and SkyCare support and coordination hubs. Each SkyHealth Center has 7-10 SkyCare providers underneath it that refer patients requiring more sophisticated care. SkyHealth Centers are thus situated in larger, more centrally located villages. Modern tele-medicine services located at the SkyHealth Centers connect patients with doctors at Central Medical Facilities via the ReMeDi system. 

Based on tele-diagnostic consultations, SkyHealth Centers may either refer patients to Franchisee Clinics, or provide them with transportation to a hospital.The investment in technology is sustained through the providers vested interest in providing services and maintaining the systems as he is earning some profit.

With regards to NSCPL and ReMeDi, the kit itself is priced at $300; however, the cost of per consultation and examination,  is between 63 cents and 2.5 USD, according to an Access Health release on NSCPL and ReMeDi. This is in comparison to the 5 USD charged for an electrocardiogram alone by urban doctors.

There are, of course, caveats. Internet connectivity is sparse in India; in March, CNN reported that just 22% of Indian adults had access to the internet, citing a lack of adequate, infrastructure, affordability and awareness as key obstacles. However, there have been measures taken over the past few years to rectify this. In 2015, it was reported that the Modi government would invest  ₹70,000 crore into helping rural communities gain access to the internet. A partnership between Google and Microsoft was also reported, with the objective of delivering low-cost broadband to 600,000 rural Indian villages.

Livemint reports that, by 2020, 315 million Indians in rural areas will be connected to the internet, compared to 120 million at present. Rural India will then account for almost half of India’s internet users. If this is the case, the ReMeDi program could well take off – and with improvements to their digital lives, rural Indians could anticipate better health to boot.

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