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Department of
Biomedical Physics & Technology
Dhaka University
<www.bmpt.du.ac.bd>
Telemedicine for Rural Areas(PC and Smartphone based)
Abdullah-Al Amin
Ahamad Imtiaz Khan
AKM Bodiuzzaman
Zihad tarafdar
Ahmed Raihan Abir
M Obaidur Rahman
Kamrul Hussain
Papia Chowdhury
Nazimul Kadir
K Siddique-e Rabbani
Bangladesh
> 70% live in rural areas
3.6 doctors for 10,000 people
70% people consult village doctors or quacks
No access to qualified (MBBS/Specialist) Doctors
What is telemedicine?
• Telemedicine healing at a distance (first used in 1970s )
• Telephone allowed earliest tele-consultation by doctors
• ICTs can make a revolution in Telemedicine
• Huge potential in Bangladesh and throughout the globe
Rural Healthcare in Bangladesh
• Semi-rural Health Complexes: 400 (hospitals with X-ray, Pathology and other facilities)
• Very difficult to retain qualified specialist doctors there.
• Rural Community Clinics: 15,000 with short-trained personnel, to provide very primary healthcare and referral of patients
Possibility of telemedicine in Bangladesh
Need: Good communication
link providing consultation
with doctors in towns or cities
Internet and mobile phone
networks cover almost the
whole of Bangladesh.
Telemedicine can be used
effectively in Bangladesh
using both these media.
Telemedicine efforts in Bangladesh
• Several groups mostly video
conferencing only no diagnostic
equipment
• Telemedicine enabled diagnostic
equipment imported costs
prohibitively high.
• Foreign equipment cannot provide
prolonged service hot and humid
climate abnormal electricity
supply
Our efforts at Dhaka University
At Department of Biomedical Physics & Technology [BMPT-DU]
• PC based system with integrated diagnostic equipment greater capability of data capture
• Uses internet, Rural centres with PC, Doctors at Expert centres
A2I funding for Field Trial Recent fund from ISIF-Asia to develop a
mobile phone based system
• Health workers at rural homes doctors directly
Background work at BMPT-DU
Primary target: Upazilla Health Complexes (have X-ray, Pathology
facilities but no specialists)
We developed the following:
• ECG (12 lead, diagnostic quality)
• Stethoscope (Real time, needed for primary diagnosis)
• Respiration Monitor (Electrical Impedance based)
• X-ray viewer (for sending image to Radiologists)
• Microscope (for sending image of prepared specimen to
Pathologists)
• Colposcope (for viewing the cervix, to diagnose cervical cancer)
Temperature, Blood Pressure, Blood Glucose, Weight, Height measured and data typed in manually
Digital ECG, PC based12 lead, Graphical User Interface for data acquisition, display, storage and transfer.
BMPT-DU DEVICES FOR TELEMEDICINE Indigenous design
Certification for ECG equipment
Given by DMCH,
Obtained through DG Health, Bangladesh Govt.
ECG, 12 lead, with live internet transmissionFor telemedicine
Graphical User Interface for ECG
Instructions available on screen – both English and Bangla versions.User clicks using a mouse to interact – lead selection, data acquisition, transmission, etc.
ECG Report
Patient Name : null Sex: FemaleAge: 0 Wednesday 01 July 2015
Patient ID :
1
I
II
III
aVR
aVL
aVF
V1
V2
V3
V4
V5
V6
25 mm/sec 10 mm/mV
II
0s 1s 4s2s 3s 2s 3s1s 4s0s
2s0s 4s1s 3s
5 mm/mV
ECG REPORTSent to Cardiologist through own server or email
14
Improvised Digital Stethoscope
A microphone insert is fixed at a cut end of the rubber tube of a commercial stethoscope
Variable delays through internet distorts quality of sound and its time sequence
We are now using store and forward of short recordings
Improvised Digital MicroscopeSoftware zoom
A good webcam attached to a Chinese microscope.We are trying alternative methods using USB camera modules and improvised optics.
16
Digital X-Ray View Boxsoftware zoom
17
Digital Colposcopefor detection of Cervical Cancer
Improvised from a binocular
Software filtering done to get effects similar to that obtained using Red,
Green and Blue filters
INTERNET
Helath Center
Helath Center
Rural/Semi rural Centers
Expert Center
Expert Center
Expert Centers
Helath Center
.
.
.
.
.
.
Basic scheme of our telemedicine system
Outputs of our devices
Scheme at Rural/Semi-rural Telemedicine Center
Digital Stethoscope
Digital X-ray Viewer
Digital Microscope
Digital Colposcope
Digital ECG, 12 Lead
Typed data entry
through PC keyboard
Sound input jack of PC
USB port of PC
USB port of PC
USB port of PC
USB port of PC
Local PC
Telemedicine Software
Display
Report and Prescription Generation
Archiving and
Printing
INTERNET
Video Conferencing
Software for TELEMEDICINE, Web based
• Address: www.bmpt.du.ac.bd/telemedbd
• Registration and ID to health operator and doctor by admin
• Log in by remote operator
• Log in by doctor
• Patient registration, vital information entry and uploading
• Doctor sees uploaded data
• Patient consults doctor through video consultation.
• Real time (almost) stethoscope
• Real time (almost) respiration monitor
• Real time (almost) ECG
• Uploading of images of Ultrasound, X-ray, previous prescriptions A Prescription - preliminary and final
• All records archived for future reference
<www.bmpt.du.ac.bd/telemedicine> Software for TELEMEDICINE
Prescription Generation
• Mixed Bangla and
English
• User friendly
generation, use of data
bases of symptoms,
advices and drugs.
• Keyword linked for
fast prescription
generation
Future:
Implementation in Bangladesh leading to a mature technology
through feedback and further R&D (both hardware and software)
Development in other languages (for other countries)
As a philosophy, we are not patenting our innovations
We plan for an open source movement in healthcare technology
Ready to share, collaborate with others from any country
Please contact us if you are interested
See our activities at: <www.bmpt.du.ac.bd>
Acknowledgements
1. Farm Fresh brand of Akij group, Bangladesh
2. ISP of Uppsala University, Bangladesh
3. Access to Information (A2I) programme of Govt of Bangladesh (partners: UNDP, USAID)
4. Information Society Innovation Fund (ISIF)-Asia
5. All post graduate students and staff at the department who provided encouragement and support to this project
Thank You
Thank You