Proceedings of 20121CME International Conference on Complex Medical Engineering

July I - 4, Kobe, Japan

Telemedicine System for THAR (Sindh,Pakistan) Engr. IInran Anwar Ujan Institute of Information &

Communication Technology, University

of Sindh, Jamshoro, Pakistan.

iujan@yahoo.com

Dr. Imdad Ali Ismaili Institute of Information &

Communication Technology, University

ofSindh, Jamshoro, Pakistan.

Chatar Veer Suthar Institute of Information &

Communication Technology, University

of Sindh, Jamshoro, Pakistan.

iai a@yahoo.com

Abstract -This is an application for providing health care

facilities to those who can't access them in their area. It is a

Telemedicine System for Rural Area like Tharparkar. It

maintains three levels of users.

1 Specialist Doctor Level (The doctor from main hospital)

2 BHU Doctor (The doctor from Basic Health Unit in Rural areas)

3 Patient

INTRODUCTION

The Telemedicine System includes:

LIt maintains patient details.

2.It provides prescription, precautions and diet advice.

3. It provides and maintains all kinds of tests for patient.

4. It provides video conferencing between doctor and patient

SCOPE OF TELEMEDICINE SYSTEM FOR THAR:

This System has been developed to provide a low cost

alternative against the existing desktop solution and meet all

the demands of the telemedicine environment. It is a web

based solution. It is developed in PHP technology. Its

primary aim is to develop a world class telemedicine

technology solution for providing health care to all at affordable cost. It would help the rural patients not only to save time and money but also access specialist opinion for

their ailments. Its function is to provide multi-specialty

health care to the common man at the most affordable cost. It will be used for improving access to medical care for

geographically or socio economically isolated patients. It will enable the expert consultation among the specialist of

the super specialty hospital. It has intuitively designed user

interface for interactive operation tele consultations and video conferencing. It is an effective utilization of medical

resources by creating an integrated network of primary,

secondary, and tertiary care.

978-1-4673-1618-7112/$31.00 ©2012 IEEE 327

Overview

Telemedicine is composed of the Greek word te?e (tele) meaning 'far' or 'at a distance' and the word 'medicine'. [1]

Generally, it is referred to as the use of telecommunications

to provide medical information and efficiency in delivering

health services to remote patients. cite {istepanian}. It may

be as simple as two health professionals discussing a case

over the telephone, or as sophisticated as using satellite technology to broadcast a consultation between providers at

facilities in two countries, using videoconferencing

equipment or robotic technology. [2]

Telemedicine refers to the use of electronic

communication technologies to provide clinical care.

Telemedicine enables a physician or specialist at one site to

deliver e-health, diagnose patients, give intra-operative

assistance, provide therapy or consult with another physicians or paramedical personnel at a remote site. The

aim of Telemedicine is to provide expert-based health care

to understaffed remote medical sites and to provide

advanced emergency care through modem

telecommunication and information technologies. There are

many different disciplines in telemedicine such as Teleradiology, Telepathology, Teleconsultation,

Teleconferencing and Telepsychiatry. [3]

Remote Database Access

RDA is a communications protocol for remote database

access that has been adopted as an International Standard by

the International Organization for Standardization (ISO) and

the International Electro technical Commission (lEC). It has

also been adopted as an American National Standard by

ANSI and as a Federal Information Processing Standard

(FIPS) for the U.S. federal government. [5]

Tele-monitoring:

Tele-monitoring is a medical practice that involves remotely monitoring patients who are not at the same location as the health care provider. In general, a patient will

have a number of monitoring devices at home, and the

results of these devices will be transmitted via telephone to

the health care provider. Tele-monitoring is a convenient

way for patients to avoid travel and to perform some of the

more basic work of health care for themselves. [6]

Tele-video conferencing:

It is when people who can't meet in the one location

will use cameras and TVs to see each other and have their

meeting, although they could be anywhere.

Case Handling:

Case handling systems offer a solution to the lack of

flexibility and adaptability in workflow management

systems. Because they are data driven they potentially provide good support for Product Based Workflow Design

(PBWD). [7]

Message Passing:

A model of parallel computing. Processors all use separate memory and pass messages to each other for

communication. This is the model used most on Beowulf

clusters. [8]

A telemedicine system in a small healthcare centers

consist of a personal computer with customized medical

software connected to a few medical diagnostic instruments,

such as an ECG or X-ray machine or an X-ray scanner for scanning X-ray photos. Through this computer, digitized

versions of patients' medical images and diagnostic details

(such as X-ray images and blood test reports) are dispatched

to specialist doctors through the satellite-based

communication link. The information, in turn, is received at

the specialist centre where experienced doctors examine the reports, diagnose, interact with the patients (along with local

doctors), and suggest appropriate treatment through video­

conferencing. The entire system is relatively user-friendly,

and only a short period of training is needed for doctors at

super-specialty centers and rural health centers to handle the system. And hospital technicians can take care of the

operation and maintenance of the equipment.

RESEARCH

SURVEY

We had divided our research about hospitals into two parts one dedicated to Basic health units (BHU) and second

part contains Main Hospitals.

SURVEY OF BASIC HEALTH UNITS

Basic health units are located in rural areas. We had observed they are mainly in one village and other

neighboring villages are connected with it. In Tharparkar

most of the villages are at distance from each other. Mainly

these BHU are lack of facilities even basic health care

facilities, there is no setup for emergency cases and mostly in emergency cases doctors are not available and fortunately

328

if they are available they are lack of expertise and

experience to handle emergency cases.

SURVEY OF CITY HOSPITALS

We had observed during our research that most of the

hospitals in cities are well equipped with recent medical

equipments. They utilize technology to treat patient in

modern way. Doctors in these hospitals are experienced and well educated. There laboratories are equipped with medical

devices and most of medical test are performed there.

But patients from rural areas face a lot of problems to

get treated from these hospitals.

The main problem is transport in most of village

ambulances are not available so they have to come in public

transport or in taxies. So it's tough for them to reach in city

hospitals. After reaching in main hospitals they have to take

appointment for checkup from doctor, in most of the cases they get appointment after 5,6 hours. After checkup if

doctor admitted that patient then those peoples who came

with patient have to stay outside the hospital due to strict

rules of hospital. And after treatment these hospitals demand

money which is mostly in thousands so for poor people it's not possible to get treated from these hospitals. And it's a

time and money consuming process.

RESEARCH ON UTILIZATION OF EXISTING

TECHNOLOGIES:

There are too many technologies that can be properly

utilized for betterment of human being, as per need of our

system; we have survey a lot for choosing proper and cheap

technology. Telemedicine System is a web-based

application that is for service of human kind.

We have chosen PHP as a server side scripting

language, because it is open source and specially used for

web application developments. There are lots of free build­

in modules are available in PHP that can be easily integrated with any web application. We found PHP as a best solution

for our project amongst all other technologies, like ASP.net.

For database of our project, we have given priority to

MySQL amongst other databases like Oracle, because it is

compatible with PHP and no need of any type of external

drivers for their connectivity. MySQL is open source so

there is no need for any license. It is easy to use and

implement.

For other interfaces we have used CSS, JavaScript, and Ajax for different purposes. As we observed that this application is going to be implemented for rural areas

betterment, so we preferred open source platforms.

INVESTIGATION AND ANALYSIS

Background:

The "Telemedicine System for Thar" is web-based

application/platform that allows patients and doctors to

connect with other expert doctors in different facilitated

hospitals. The expert doctor or team of doctors can easily treat, suggest tests and diagnose remotely. The patient

would just have to go to near health care center where a

doctor is connected with others doctors from different

hospitals. The patient will be registered from doctor and he

(doctor) will take his (patient) information regarding his

symptoms and store them to central database and connect to

a specialized doctor, remotely. Then the doctor will diagnose and suggest for furthers treatment like tests and

medicines.

DEFINITION OF PROBLEM:

Problems with conventional system

1. Lack of Medical Facilities in Rural Areas: The Rural

areas like Tharparkar are not facilitated in Medical Fields. No general life facility is available for doctors

so no one wants to work in that area.

2. Lack of Transportation: There are no roads so it is hard

to access major cities. There is shortage of vehicles also

so it creates problem for rural people and they can't

access major cities. 3. Lack of prompt updating: -Various changes to

information like patient details are difficult to make as

paper work is involved.

4. Preparation of accurate and prompt reports: -This

becomes a difficult task as information is difficult to collect from various registers.

5. Lack of prompt updating: -Various changes to

information like patient details are difficult to make as

paper work is involved.

6. Preparation of accurate and prompt reports: -This

becomes a difficult task as information is difficult to

collect from various registers.

Alternative Solutions:

To appoint experienced doctors to rural hospitals.

Improve manual

To improve manual system with more sophisticate

registers maintenance for various patient information, doctor

diaries.

Adequate staff may be maintained so that updating are

made at the very moment at the same time. Proper person

329

for proper work should be made responsible so that a better

efficiency could be achieved. This needs a lot of work force.

Online System

This system (Telemedicine System for Thar) provides

online storage/ updations, retrieval facility and video

conferencing facility. This system promises very less or no

paper work and also provides help to Doctor and operational

staff.

In this system everything is stored electronically so

very less amount of paper work is required and information

can be retrieved very easily without searching here and there

into registers. This system is been discussed here

Project Requirements

The requirements that describe the capabilities of the system with which, through which, and on which the

product will function.

We divide Requirements into two categories Hardware

and Software Requirements.

Hardware Requirements

Component

Processor

RAM

Hard disk

Devices

Minimum requirement

1.0 GHz

128MB

20 GB for system drive

Keyboard, Mouse, Monitor, Scanner, Headphone, Webcam

Software Requirement

Softwares Minimum requirement

Browser Internet Explorer Download from Microsoft

(http://www.microsoft.comlwindows/ie/ie

6/default.mspx)

Else Firefox, Google Chrome, Opera,

Safari

Adobe 10.1 version

Flash

Java JRE Download from link below

http://www.java.comlen/download/index.

lli2

PROJECT SPECIFICA nON AND DESIGN Use cases And Activity Diagram

Fig. I The use case for BHU doctor

Fig. 2 Use cases for specialist doctor

Fig. 3 Use cases for patient

3 3 0

Once fegl"eted with the system. SHU Doctor has to login each time helshe wants to use the system

System prompts BHU Doctor to enter login name and password.

BHU Ooaot a,eady �terOO and klgged ., to the system

BHU doctor enters hislher login name and password. lE-----..

BHU DoctOf logs Into the system

/' 7L-_______ -----'

FIG-4 LOGIN USE CASE FOR BHU

New Pallent. registered M can Iogf1 now to the system

FIG-5 NEW PATIENT REGISTRA nON USE CASE

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Register Patient: The BHU doctor fills the form of the

patient and clicks submit button and new account is being created

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CONCLUSION

Finally we achieved our goal of making an efficient and

effective system for helping mankind. This system has good

features, like storing patient data, test reports, appointment with doctors. This system has capability of fulfilling the need of human, health matters. Regardless that we have achieved a big part of our project, still some important goals

have to be covered in future.

REFERENCES

[ I ] Hung, Kevin and Yuan-Ting Zhang. "Wireless Internet in Telemedicine". Wireless Internet Handbook: Technologies, Standards and Applications. CRC Press, USA. 2003 . Retrieved October I S, 2010 from "Wireless Internet in Telemedicine"2. Brown, Nancy. "Telemedicine Coming of Age". <http://tie.telemed.org/articles/article.asp?path=articles\&article=tmc oming'-nb,-tie96.xml>. September 2006. Retrieved October I S, 2010 from "Telemedicine Coming of Age".

[2] esrajal An Online Telemedicine Consultancy http://esrajal.comiOtherPages/OverviewTeleMedicine.aspx Retrieved November 02, 2010 from "esrajal - An Online Telemedicine Consultancy" .

[3 ] e-Sanjeevani:In India,C-DAC Mohali develops telemedicine technology for web healthcare software application

[4] <http://telemed.esanjeevani.in/ Telemedicinel Telemedicine.aspx >November 02, 2010 from "e-Sanjeevani:In India,C-DAC Mohali develops telemedicine technology for web healthcare software application".

[5] Remote Database Access (RDA)<http://www.it!.nist. gov/divS97/ctg/dmlrda info.htrn>!. Retrieved on November 02,2010 from "Remote Database Access (RDA)"

[6] What is Telemonitoring? <http://www.wisegeek. comlwhat-is­telemonitoring.htm> Retrieved on December 11,2010 from "What is Telemonitoring?"

[7] [rene Vanderfeesten, Hajo A. Reijers and Wil M. P. van der AalstDepartment of Technology Management, Technische Universiteit Eindhoven

[S] Beowulf Cluster Construction at TRIUMF < http://www.csc.uvic.ca/-csmacoop/wtreports/triumfllees/htmVg276.ht ml>

[9] Retrieved on December 11,2010 from "Beowulf Cluster Construction at TRIUMF"

[10] Deke McClelland (1993 ). Photoshop 3 Bible. Deke McClelland. Retrieved December 17, 20 10 from Photoshop 3 Bible.

[ I I ] Ryan Frishberg (2001), JavaScript Object-Oriented Programming, Retrieved December I S, 20 I 0 from

[12] < http://articles.sitepoint.comlarticle/oriented-programming- I > [13 ] Sommerville (2004), Software Engineering, 7th Edition, Chapter 4.

Retrieved on December I I , 20 I 0 from "Software Engineering"

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