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.
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.
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
fn.,me
Iname
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contactJlo
IOQinJd
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ERD DIAGRAM
reliQion
o;Jender
.g. IOQinjd
P",SS
symptoms
IlI/ttIlhiL«Ut aoySUls <:Ir_I.�_el.n ''''II�II!HJ'
doctorjd
patienUd
,imhistofY
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RESULTS
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00 patieot=id
currenCproblem
rub
anemia_bd
diabetes
SlnJury
U_d
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hbp
thyroid_d
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d.p
d'''l)tI� .. � ... m."CIIIM�'" nl, ___ tlotM. pr.� no ... .., .... ,
W' ',j t.j\..�. ,..t,/fI'I .. �\.o 'ol Movm_C.I_ hotrnoolOl)l" """ __ ........ oM>d
Login: The login testing occurred with entering id and password via user.
LOoln ld PMswon:l ····T
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":"
'?='�.:: ":" ;.;.. . ..
.� "':"" "'T""
-:' c-� ....:.....
Register Patient: The BHU doctor fills the form of the
patient and clicks submit button and new account is being created
0_0,._
TaI(e .t«lOlntment �etlent
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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