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A low-cost telemedicine solution that connects rural patients to urban doctors

ReMeDi (Remote Medical Diagnostics) is a solution kit that connects rural patients with urban doctors at a low cost. Trained operators at Internet kiosks transmit the patients’ readings to doctors who make diagnosis and issue prescriptions. ReMeDi measures four vital patients’ signs: temperature, blood pressure, heart beat and blood oxygenation.

Photo of Krassimira Iordanova
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Though all the measuring equipments look alike their traditional counterparts, the main components of the remote diagnostic equipment are electrodes and probes for ECG, temperature, blood pressure measurement, electronic stethoscope, a headphone for sound capture and the software. The sensors work with any standard Windows PC Laptop.


How does this work?
Imagine a village internet kiosk with a personal computer and a printer. The remote diagnostic equipment is connected to the PC and the required software is loaded. The kiosk PC is then connected to the doctor's PC through a video / audio conferencing facility.
Once a patient comes to the kiosk, he/she can talk to the doctor via the video / audio conferencing facility. The doctor then activates the remote diagnostic equipment at the kiosk from his PC and advises the kiosk operator to take the patient's temperature (keeping the probe under the armpit).
Similarly, the doctor would advise the kiosk operator to place the stethoscope at the relevant spots and the doctor could hear the heart beat by through a headphone.
Finally the doctor makes his diagnosis and types out a prescription, which can be seen on the PC at the kiosk and printed.

Who could run such a kiosk?

A group of enterpreneurs with some computer skills.

The team of doctors

As Colombia has 1,35 physicians per 1000 people and many of the impoverished people have no access to them, the idea is to connect with

- medical students from Colombia in the last year of theor studies

- doctors from a Spanish-speaking country, i.e. Cuba (5,91 physicians per 1000 people

Ecosystem
- back-end of doctors for consultation
- rural pharmacies
- connectivity providers

Costs to set up the ReMeDi solution:

- The set up of a telemedicine center in rural areas costs ~ 1500USD for the basic type of solution
- Training costs for the internet kiosk operator- minimal as the telemedicine solution is easy to operate

Scale:

I believe there is a strong potential. After 4 years ReMeDi serves some 50,000 villagers at four centers in southern India. (source: http://www.time.com/time/magazine/article/0,9171,1692387,00.html#ixzz1DkISik7t)


How do you envision this idea making money?

The coming patients pay ~50c per consultation-> this information is based on similar remote diagnostics projects in India.

How does this idea create social impact, particularly around improving health?

- A chance to have a conversation with a doctor via videoconferencing
- Ripple effect- if someone goes and is satisfied, he/she spreads the word (especially elderly males can spread the word and they are often regarded as an authority)
- The solution addresses three common problems in rural areas:
      - no electricity and frequent outages – the solution runs on 2 watts of power, which is a very low power consumption device
      - bandwith/connectivity available- the audio-video conferencing runs 32 kilobits per second
      - lack of skilled personnel

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Photo of SiuSue

Very interesting idea, but two questions:

a) in places such as India where ReMeDi has been tried, what has been the rate of misdiagnosis from telemedicine and

b) in addition to rural pharmacies (which would help to bring the treatment to remote communities), what would remote patients do if they received a diagnosis that required them to go to a hospital for surgery or for some other more serious follow up? Debatable, but some may even say that its worse to know what the problem is and not be able to treat it, than not to know at all. I think for this, the promotion of a health insurance program would be key

Photo of Krassimira

SiuSue, thanks a lot for your feedback:
a) I couldn't find data with regards to misdiagnosed cases as % of total cases
b) usually patients are referred to hospitals in case of complications. Remote Medicine is a great way to detect early simptoms and assign medication accordingly.
I agree with you that this could be coupled with an insurance program.

Photo of Krassimira

Siu Sue, I came across this article- http://www.spring.org.uk/2011/07/why-people-avoid-the-truth-about-themselves.php
I decided to post it here as it deals in a way with something that you mention in your comment "....but some may even say that its worse to know what the problem is and not be able to treat it, than not to know at all." Seems like that people tend to avoid the truth about themselves.

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