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Project HopeProject Hope::Telemedical Linkage between District and Teaching
Hospitals in Sind.
Dr. Mohammad Ali Malik
Jinnah Postgraduate Medical Centre
Karachi, Pakistan.
Total area: (803,940 sq km)
Population (2006 est.): 165,830,560 (growth rate : 201% about 60% population is rural
Population density per sq mi:551 (asymmetric spread)
Basic Health UnitTehsil Heath UnitTalqa Hospital District Health UnitTertiary Hospital
No of Doctors 128,.000No of Specialist 18,500Distribution uneven
Pakistan: Geography, Demographics andHealth Scenario
Table of Contents
� Telemedicine an Hope
� History of Telemedicine in Pakistan/Sindh
� Network
� Sites
� Connectivity/Communication
� Infrastructure
� Technical Facilities
� Method Adopted
� Project Management
� Sources/Progress of TM
� Future of Telemedicine
Telemedicine an Hope
� Telemedicine projects are meant to assist the government in Transforming delivery of healthcare services and making them available at the door-steps of common man, through the use of information and communicating technology as a solution. The project proposed with the objective to provide people lining in rural,. Remote areas of Pakistan. By consultation, advice and treatment form specialist doctors based in urban center hospitals, through Tele-Diagnosis/Consultation and Tele-Treatment.
History of Telemedicine in Pakistan/Sindh
� Initiative of Telemedicine in Pakistan
� The concept introduced by NGO’s as a partners in local hospitals.
� To expend healthcare in rural/remote area government focused on Telemedicine in year 2000.
� In commencement store and forward system applied
� On availability of multiple sources of bandwidth including national satllite the Ministry of IT interest started in 2005.
� At moment Pakistan is conducting Telemedicine via satllite as wall as landline (ISDN BRI)
� In Sindh pilot project launched in 31st April 2005 with collaboration of Sindh Government, Engro Chemical. Under the chairmanship of Prof. Rashid Jooma head of Neurosurgery JPMC Karachi at present DG Health Islamabad Pakistan.
Network
� PAKSAT – HealthNET
� Sites: PAKSAT HealthNET is designed as a pilot project has infrastructure linking three urban hospitals with twelve hospitals in rural/remote areas.
� Number of rural sites are covered in each province under this project are as follows:
� Sindh (JPMC)� Shikarpur, Gambat, Jacobabad, Mithi
� Punjab I (Holy Family Rawlapindi)� Attock, Khoshab, D.G Khan & Pindigheb
� Punjab 2 (Meo Hospital Lahore)� Jhang, Gujrat, Sahiwal & Rajanpur
Technical Facilities
1- D.G. Khan2- Pindi Gheb3- Attock4-Khushab
1- Sahiwal2- Rajanpur3- Jhang4- Gujrat
1- Mithi2- Jacoabad3- Shikarpur4- Gambat
Holy Family HospitalRawalpindi
Mayo Hospital Lahore
Jinnah Hospital Karachi
Holy Family HospitalRawalpindi
Mayo Hospital Lahore
Jinnah Hospital Karachi
30:70 Divide
30% Urban Area
Concentrated Healthcare Resources
Majority of the population without health services
70% Rural Area
Connectivity/Communication Sindh
� JPMC as a Hub is connected with referral spokes by:
PakSAT 1 ku band
Landline ISDN BRI
� 4 spokes are connected by PakSAT connectivity like
Jacobabad, Shikarpur, Gambat, & Mithi
� Rest 4 are on ISDN BRI line like Ghotki, Mirpurkhas, Sanghar
& Shadadpur
� 512 kbps full duplex data connectivity being provided
between Hub & Remotes.
� PakSAT bandwidth offering by Ministry of Information &
Technology services free of coast for all 4 spokes
Internet
Telemedicine Referral Unit
Gambat Institute of Medical
Sciences (GIMS)
Telemedicine Referral Unit
District Headquarter Hospital Shikarpur
(DHQHS)
Telemedicine Center
Jinnah Post Medical Center
Karachi
(JPMC)
First Telemedicine Pilot Project
For Sindh on Internet
HUB
Spoke 01
Spoke 02
Telemedicine Center
J P M C, Karachi
First Telemedicine Pilot Project
For Sindh on (ISDN BRI)
HUB
Our 08 Spokes
Shikarpur June 2005
Gimbat June 2005
Jacobabad June 2006
Ghotki June 2006
Mirpur Khas July 2006
Sanghar February 2007
Shahdadpur February 2007
Mithi January 2008
Hub with
Referral Units
Technical Facilities Hub/Sites
� Server Dell PowerEdge 2950
� Desktop computer Dell Core Duel Intel R
� TM software for database of Patients
� Digital ECG Machine
� Digital stethoscope
� Compaq video Otoscope
� Digital Camera
� X-ray scanner
� High Definition Video conference
equipment (Router, Pollycom cameras
VSX 7000, LCD Screen 32”
� ISDN lines linking sites
� TM software for database of Patients
� Digital ECG Machine
� Digital stethoscope
� Compaq video Otoscope
� Digital Camera
� X-ray scanner
� High Defination Video conference
equipment (Router, Pollycom cameras
VSX 7000, LCD Screen 32”
� ISDN lines linking sites
� Sites� Hub
Regular Consultant forVideo Conference
Medicine Prof. Muneer AhmedDr. Qurban SheikhDr. Kirpal Das Makheja
Dermatology Prof. Azam SamdaniDr. Nadeem AhmedDr. Samira RizwanDr. Sobia Liaquat
Neuro Medicine Dr. Shaukat AliDr. Khalid SherDr. Santosh Kumar
Epilepsy: Dr. Fozia Siddiqui
Pediatric Prof. Zeenat EssaniProf. Afroz RamzanProf. Abdul Ghaffar NagiDr. Khalid MehmoodDr. Deedar JunejoDr. Aatif Saeed Anjum
Gynae & Obst. Dr. Razia Kirojo
Dr. Haleema
Dr. Pakeeza
Chest Medicine Dr. Nasir Hussain
Psychiatry Dr. Iqbal Afridi
Neuro Surgery Prof. Rashid Jooma
Dr. Sattar Hashim
Nephrology Dr. Manohar Lal
Dr. Manan Juneju
Dr. Kaneez Zehra
Total Numbers of Patient, 2005 to2007
4612
3212
0
1000
2000
3000
4000
5000
1
Male Patient
Female Patient
Dermatology
Dermatology
25
2100
5200
0
500
1000
1500
2000
2500
3000
3500
4000
4500
2005 2006 2007
Dermatology
6000
TELEMEDICINE CENTRE,JPMC. NUMBER OF PATIENTSJAN TO DEC 2007
0
200
400
600
800
1000
1200
1400
1600
1800
RBUT GIMS MPK JCD GHK SNG SHD
Future plan TelemedicineSindh
Province
Sub HubNAWABSHAHKandyaroNow Shero FerozSakrandMoro
JAMSHORODadoSehwanUmerkotBadin
LARAKANAShahdadkotNow DeroRato DeroDokri
CME
Prof. Elahi Bux Soomro HOD, Medicine, Civil Hospital,Karachi.
Prof. Zeent Essani Ex. Director, NICH
Prof. Muneer Ahmed HOD, Medicine, JPMC
Dr. Waqaruddin Ahmed PMRC
Dr. Asghar Channa Deptt of Surgery
Dr. Ahmed Usman Deptt. Of
Dr. Rizwan Memon L.N.H
Dr. Azam Shafquat NICVD
Dr. Huma Qurashi PMRC
Major Achievements through Telemedicine
� Teleconsultation
Bridging the gap between highly trained healthcare
providers and patients & local healthcare providers
CME
By educating the physicians at the spokes in remote
areas raising their level of competence & expertise
allowing them to provide healthcare services at a
better level than before.