An Internet Based Mobile Telemedicine System



Principal Investigators:


India                                                                           Germany

Prof. Dr. D. Janakiram                                                  Prof. Dr. Wilhem Stork


1. Introduction

2. How the telemedicine system (Arogyasree) works?

3. Publications

4. CEBIT 2009 Demo



1. Introduction


About 70% of the population in India lives in the rural areas while 75% of the doctors practice in the urban centres. Overall, there is only one doctor for every 15,500 people. Therefore, a large section of the population receives insufficient health care. Training of new physicians is lengthy and expensive. Hence, the doctors to patients ratio can be expected to remain low for a long time to come.


A goal of the Arogyasree project is to bring the expertise of doctors in the urban areas closer to the patients in the rural areas. The telecommunications and Internet infrastructure in India is continuously improving. Telemedicine, hence, is an appropriate technology to be used to achieve our goal. Telemedicine can fill up this gap by enabling specialists deliver medical advice to rural patients remotely. The recent advances in broadband technology for mobile phones add new dimensions to telemedicine by facilitating any time, anywhere access. Now, it is no longer mandatory for the doctor to be physically present at the hospital centre to be able to provide consultations.


The sheer number of underprivileged masses calls for the implementation of a large-scale telemedicine solution capable of managing the enormous amounts of patient data and providing medical services across the country. This gives rise to several issues such as scalability, robustness, cost-effectiveness, coverage width, context-awareness etc.



Figure 1. Life cycle of a patient request in Arogyasree



Arogyasree (figure 1) is a context-aware, P2P data grid framework for mobile telemedicine. This Internet-based scalable system integrates multiple hospitals, mobile medical specialists and rural mobile units/clinics to form a large virtual enterprise.




Figure 2. Telemedicine Kit


Arogyasree supports mobility both at the doctor's and the patient's end. Trained nurses in rural health centres can carry portable instruments for measuring vital health parameters such as blood pressure, electrocardiogram, blood sugar, weight, etc. These devices are wirelessly (Bluetooth/ZigBee) connected with a Smartphone, which transfers the data into our data Grid. Schedulers in the Grid can then find appropriate physicians to forward requests to. Willing physicians can make an evaluation of the measuring data and can provide consultations/therapeutic instructions by telephone/Internet.


The Arogyasree project receives support from the Indian Council of Medical Research (ICMR) and is collaborative work with Prof. Wilhelm Stork's team at the University of Karlsruhe, Germany. The team in Karlsruhe primarily works on the design of an ECG jacket which can be used for the continuous monitoring of a patient's ECG in a non-intrusive manner and without requiring hospitalization.



2. How the telemedicine system (Arogyasree) works?


Step 1: Patient registers with the system



Step 2: The patient gets an id on registration.

This id will be encoded into a smart card.


Step 3: Uploading the patient request onto the data grid.

The health worker captures the ECG from the patient using the ECG jacket which is then transferred to the PDA of the health worker. The patient id, category of ailment, and location are provided as inputs.



Step 4: Request gets redirected to a capable node in the data grid for being served.

The health worker specifies the mobile no., ECG image file and other attributes of the patient and uploads the request.


Step 5: The system schedules the request.

The doctors are already registered with the system (with their area of expertise). The request is scheduled to a nearby available doctor by means of SMS/email. The doctor can then look at the patient request on the PDA and provide the response. The doctor can also view the past history of the patient.



Step 6: The doctor provides the response which is relayed to the health worker.



3. Publications


1.      Sriram Kailasam, Santosh Kumar, D. Janakiram: Mobile Telemedicine using Data Grid, International Conference on Communication, Convergence and Broadband Networking (ICCBN 2008), Bangalore, July 2008.

2.      Sriram Kailasam, Santosh Kumar, D. Janakiram: Arogyasree: An enhanced grid-based approach to mobile telemedicine, accepted in International Journal of Telemedicine and Applications, Feb 2010.

3.      P. Kovendhan, D. Janakiram: Arogyashree: a Distributed File System for Large Scale Internet-Based Telemedicine, in Proceedings of the International Workshop on Mobilizing Health Information to Support Healthcare-related Knowledge Work – MobiHealthInf 2009, INSTICC Press, Portugal.


4. CEBIT 2009 Demo

          The Arogyasree project was demoed at CEBIT 2009. Here is a link to the videos. demo





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