Healthcare in cardiology and other streams of medical sciences through Telemedicine is becoming a very acceptable method of extending primary and specialized care in remote and difficult to access parts of various geographies. Gauri Healthy Heart Project (GHHP) has worked out 2 projects one each in Jammu and Kashmir to be executed before the World Heart Day 2021 which falls on 29th September. This project is being executed in partnership with an NGO “UMMEED Foundation”.
As part of the “MISSION NO MORE HEARTATTACKS” for the first time in J&K through the dynamic vision and leadership of Prof. (Dr.) U. Kaul, a renowned cardiologist, twosmart heart facilities are almost ready to be set up. One is housed in Machil Sector, District Kupwara in the Kashmir valley and another in Kashmiri Pandit Migrant Township in Jagti Nagrotra, Jammu. Both the proposed units are being funded through the corporate social responsibility (CSR) of Indian Oil Corporation Limited.
Our Primary Healthcare is robust but still lacks in terms of doctor-patient ratio. The patient profile is immensely complicated with socio-economic disparities, very variable education levels, different language and dialects, and also conservative issues like male doctors examining female patients and vice versa. Doctors are also over-burdened and have little time to train their younger colleagues.
A high quality, efficient primary tele-consult gives immense satisfaction to the patients and to their families. With tele-consults, patients are treated effectively at the onset of the symptoms with good results, very often hospitalization is avoided. Monetary implications for hospitalization for the beneficiaries are huge apart from impact on family and stress it creates.
This project details a systematic framework for implementing Smart Tele Health delivery channel for GHHP innovations allowing healthcare providers to treat afflictions more effectively, care for patients more efficiently, and to prevent frequent occurrence and recurrence of illnesses.
Telecardiology is a modern medical practice that uses the power of telecommunications to achieve the remote diagnosis and treatment of heart disease. This includes coronary heart disease, both chronic and acute, as well as arrhythmias, congestive cardiac failure, and illnesses resulting in sudden cardiac arrest. It is a specialised part of the Telemedicine facility.
Doctors and other healthcare providers use electrocardiographic data, along with appropriate bio-markers [heart attack (troponins), heart failure (NT Pro BNP) and heightened clotting propensity (d Dimer) in the patients]. The reports are transmitted remotely, in real-time, for interpretation by a specialist.The unit is handled by a trained nurse/technician located in the periphery. This enables specialist care to be instituted for people in remote locations. Advancing technology is making it easier and less expensive to set up wireless or satellite networks for this purpose, thereby increasing their effectiveness and ease.
How telecardiology works
The practice of telecardiology depends on the availability of a specialized device, which not only takes and records a 12-lead electrocardiogram (ECG) in the primary care setting but also transmits the ECG image in the form of a sound signal over the telephone line.
At the other end, namely, the telecardiology facility, this data is converted back into an image on the screen. After specialists interpret this information, an oral report is quickly sent, while a written summary is e-mailed to the patient hub. All ECGs are stored in an electronic database at the telecardiology centre to enable future comparison of ECGs for the same patient over time.
Benefits of telecardiology
The primary use of telecardiology is the support it gives to primary care practitioners (PCPs) in the area of correct diagnosis, thus empowering them to manage cardiac patients with increased confidence. This is advantageous for both the patient and the healthcare system.
Telecardiology also improves the clinical training of the average practitioner by increasing the clinician’s level of knowledge at the primary level. Thus, this treatment approach equips PCPs to offer better care. This applies to the diagnosis and management of paediatric heart disease, chronic cardiac failure, and emergency events like heart attacks (myocardial infarctions). Furthermore, telecardiology can cut down the consulting time to a quarter while also affording the patient high-quality care when it is most needed.
Telecardiology also helps enormously to reduce the percentage of missed cardiac events. For instance, the single-lead ECG device is more efficient at detecting or monitoring arrhythmias as compared to a Holter machine, as it can be worn at all times and can be easily switched on when the patient feels that there is something wrong with the heartbeat. This helps to detect and monitor arrhythmias during the course of treatment.
Telecardiology is very useful for long-term monitoring of multiple coronary heart disease risk factors such as hypertension or hypercholesterolemia. The results have been found to be comparable with those of face-to-face monitoring.Telecardiology devices are small and portable, which means they can be easily moved to the patient’s bedside to make a quicker and more accurate diagnosis. Telecardiology has the proven ability to improve the quality of health care, increase cost-effectiveness, and save lives. The unit besides the diagnostic capabilities have important simple generic drugs to treat high BP, Diabetes, first aid for a evolving heart attack with drugs and also commonly needed anti biotics, pain killers, anti-histamines, anti -diarrhoeal etc . These are placed in separate compartments like a juke box.
Our Mission is to increase availability and quality of the consult, access to high-quality, convenient and affordable patient empowered healthcare services through Smart Health solution. With the innovative applications of technology to community healthcare, we have been working to make healthcare smarter, simpler and more accessible for everyone. We have designed an interconnected health system which will aid healthcare professionals and help patients manage illnesses and health risks better. Smart communities/ societies will use intelligent systems to promote wellness. With the adoption of smart healthcare systems, we can provide cost-effective quality healthcare services especially in remote areas for its people in close vicinity. For sicker patients needing to be shifted to a centre a fully equipped ambulance will be kept ready at the site to transport the patient to specialized centres in that area.
Ajaz Rashid is social entrepreneur and CEO, GHHP and Gauri Kaul Foundation