The Hindu Business Line : A health link

The issue is triple-fold: first, specific preventive measures are not yet available in rural areas; second, public health measures are insufficient; and third, diseases specific to our geo-climatic features need more research in tackling.

Here we see how technology is now being harnessed to tackle disease outbreak in India.

With the advent of new networking solutions, falling prices of satellite equipment and bandwidth costs, a `Health Network' will soon be a reality in India.

The Government of India, in collaboration with the World Bank, began an initiative in 2004 called the Integrated Disease Surveillance Project (IDSP). This is intended to be the backbone of the public health programmes in the country.

The project is basically a network that will connect government hospitals, medical colleges, state headquarters, and district surveillance units to a central database. The World Bank is investing Rs 20 crore in the development of this Health Network.

To be completed by June 2007, the objective of IDSP is to generate early warning signals for epidemic. It will provide essential data in the right hands, will help monitor the progress of ongoing disease control programmes and is expected to become a crucial component of health programmes in the country.

The current emergency response process, as far as information systems are concerned, is based on a manual one. It involves collecting forms, analysing the information monthly and responding to the outbreak over telephone or radio.

With the setting up of the IDSP, the data collection, data analysis and data transmission system will be automated and strengthened to improve the emergency response system across 29 States, says Virendra Singh, the World Bank consultant on the IDSP project.

IT backbone

On the information systems front, the networking partner, Hughes Escorts Communication, in India has developed a set of applications for distance learning and video conferencing. The applications will enable the exchange of statistical data between the hospitals — such as number of afflicted patients and availability of medicines. "An hour-to-hour update on the health data per district will be logged," says K. Krishna, Senior Director, Marketing, Hughes Communications Ltd. At all remote locations, a daily log of number and nature of diseases will be reported by field engineers at the district surveillance units. Around 50-100 disease surveillance units are to be set up per district.

At the district level, non-governmental organisations (NGO) doing, and interested in disease surveillance, as well as representatives of the Indian Medical Association (IMA) and Indian Association of Paediatrics (IAP) are expected to

participate.

The reports will be recorded on a computerised database, which is connected to the district headquarters and state headquarters via a satellite link. A central IDSP location will have a back-up of the entire database.

This unit will be networked to various studios across the country where an expert panel of doctors could evaluate the situation and guide the local panel in case of a disease outbreak.

"Though this is not telemedicine, which would involve remote-diagnosing, it forms a base for introducing such services later on," says Krishna.

Video conferencing is a superior way to convey outbreak of diseases. It works better than plain telephonic conversation, as the video input could better convey the extent of damage.

Earth to space

The network is being built to connect 610 district hospitals, 35 state headquarters, one central unit (at Delhi) and 150-odd medical colleges. Previously, district units were to be provided with ISDN/dedicatedconnectivity (wireline). These were designed to access the central database and Web servers at the central unit for analysis and reports using fibre.

However, the World Bank decided to seek the help of the Indian Space Research Organisation and provide a satellite link for dedicated connectivity to all the locations. The advantage of the satellite link is its reliability.

Another plus is its capability to multicast — a process of disseminating information to multiple nodes in a single instant, while maintaining uniform quality. This is useful in distance learning.

The IDSP will be able to transmit eight simultaneous teaching sessions at any given time. The satellite can be augmented to transmit up to 45 MBps of out route capability. Currently, around 100 sites are complete. This will be scaled to 800 sites by June 2007.

The World Bank is investing Rs 3 lakh per site, for satellite equipment, video conferencing equipment, audio elements and PC, informs Virendra.By current standards, the network will be unable to handle the data throughput, but scalability could be achieved later.With the setting up of the Health Network in India, up to eight communicable diseases can be kept within control. It will mean a world of difference to rural India. It will let India's billions heave a sigh of relief, knowing that information about an epidemic in their region will reach them before its too late.

preethij@thehindu.co.in