A Telemedicine Innovation for the Poor That Should Open Eyes
Retinopathy of prematurity (ROP) is the leading cause of preventable infant blindness. In India, over 8% of nearly 30 million births each year are at risk of this potentially blinding condition. This requires a fast, efficient way to screen infants, especially in rural areas. The telemedicine challenge is the retinal screening of nearly 250,000 premature babies a month in some of the remotest parts of the country. Experts qualified to diagnose and treat ROP are located mainly in the cities.
A potential solution has emerged. It begins with the availability of a portable (albeit in a van) retinal camera with a unique image capture design ideally suited for newborns. This camera allows trained technicians, not medical experts, to capture images and upload them (sometimes while traveling between remote locations) via a data card using telePACS software developed by i2i TeleSolutions in Bangalore. The images and data are uploaded to a remote server, in this case located in a bomb shelter in Houston, Texas. This shelter provides a cost effective, scalable, secure way to store the data with no worries about back-up, interruptions in power and air conditioning, etc., which are major considerations in India.
Once uploaded, these images are accessed either on the iPhone, the iPAD, or the PC. Feedback and corrective measures can then be provided back to the technician via the secure server. The window of opportunity for treatment is only a few days (72 hours). This scale of screening in such large numbers can only be possible through telemedicine. This model has now been adopted as part of the National Rural Health Mission (NRHM) in the state of Karnataka in India and is being deployed across eighteen health centers across six rural districts.