TELEMEDICINE PILOT PROJECT – ANOTHER SIGNATURE PROJECT OF ROTARY CLUB OF POONA NORTH (RCPN) By PP Surendra Agarwal Background Prime Minister Narendra M o d i ' s c a l l t o u s e Telemedicine project to combat the Covid-19 outbreak was the spark which ignited the idea of Telemedicine Project. The idea of Telemedicine languished earlier as a major healthcare reform initiative due to regulatory vagueness and a lukewarm response by medical professionals and the public alike. The new guidelines issued by MCI (Medical Council of India) shields physicians from legal liabilities on account of teleconsultation. Even while the teleconsultation is underway, the doctor or patient can abort the consultant, if felt appropriate. Primary health centre (PHC) / Health & Wellness Centre (HWCS) under Ayushman Bharat form the bedrock of India's primary health care. PHC doctor can connect with specialist doctor in Secondary and Tertiary level institution via telemedicine. Draft Outline of Telemedicine Project of Rotary of RCPN President Ramgopal and the Board have been very supportive of this idea from the very beginning . During the last meeting of our club, Board members approved the project. President has constituted the following committee for the Telemedicine Project (e-Argoya): Chairman: PP Surendra Agarwal Members: 1. Rtn Prakash Karve 2. Rtn Mohan Poojary Our Rotarian Kulbir Dodd will be the patron member of the committee as he has supported the idea and agreed to contribute nancially. Our Technical partner will be a company named Kreativ Technologies, which has agreed to train AASHA workers (Accredited Social Health Activists) and also provide telemedicine App. This is a part of their CSR initiative. Telemedicine Pilot Project Objectives 1) To b u i l d a s u s t a i n a b l e h e a lt h c a r e infrastructure in rural part of India, viz. Ghatewadi village and surrounding areas of Gram Panchyat- Wadeshwar near KanhaPathe – Kamshet of Maharashtra State. This is the village adopted by our Rtn Kulbir Dodd to make it a Happy Eco village. 2) To provide doorstep health monitoring services using robust and handheld devices in remote areas away from medical clinics. 3) To provide easy acces s to remotely administered expert tele-consultation for the health problems and treatment thereof. Direct Beneficiaries: Entire population of Wadeshwar Gram Panchyat will benet from these facilities. Most of these families are from lower economic strata of the society. Advanced medical diagnosis and consultation facilities are not within reach of this population. Expert medical diagnosis and consultation are not available in the primary health centre (PHC) at Ghatewadi village and surrounding areas. Government offers basic / preliminary medical facilities. However, a patient must travel long distance to these centres, without good road infrastructure. Patients are reluctant, and often fearful to visit health facilities. Commonly required specialized services of paediatric, cardiology, dermatology, gastroenterology, orthopaedics, throat neck cancer, Covid-19 etc. are usually not available. The proposed Telemedicine Project aims to reach the population at its doorstep. Basic health data will be obtained by a trained health worker and stored on the hand-held smart device, and, based on queries and symptoms; preliminary tests will be carried out free of cost at the doorstep. The trained health workers will be resident of the same area and thus will be familiar with the population there and their conditions. They will also be aware of commonly encountered health issues. The health parameters and the test results so collected will be transferred to a Server at the Primary Health Centre (PHC). A qualied medical ofcer of the PHC will review the parameters of the examined persons for each day. If he/she notices any abnormalities or anomalies, he/she would then inform the respective health worker to schedule a visit of the said patient to the PHC. He/she would organize Tele-Consultation with an expert doctor in the related eld in Pune, through a cooperating organization in related eld. These expert doctors will render this consulting service free of charge or at a minimum charge. A 'Health Hub' will be set up at the PHC. A renowned NGO will coordinate activities among the Health Workers and the Hub. To start with the project, cost of consumables and the medical tests etc. will be borne by our club. The Health data will be recorded in mobile phone units with required Software App. The phone is equipped with SIM card for data transfer. The recorded observations and test results for each person will be transmitted, through a Cloud Server, to the Health Hub and to another cooperating organization. A Health worker will direct persons showing abnormal symptoms or test results to the Health Hub. The qualied medical ofcer of the PHC, on reviewing the data, may also ask a Health Worker to direct the respective patient to PHC for consultation. The Health Hub co-ordinator will schedule expert medical Tele-Consultation at the Health Hub with respective expert doctor in Pune for needy persons. This consultation will be carried out in presence of the qualied medical ofcer of the PHC. After Tele-Consultation, the expert doctor will inform the medical ofcer at PHC about the treatment to be carried out, including medication. Most of the basic drugs / medication are available at the PHC, which will be administered by the doctor at the PHC. If any diagnosis / treatment is to be carried out in Pune, then the patient will be directed accordingly. The Co-operating Organization of this project Kreati ve whi ch will be operating the Telemedicine Project, will be responsible for collecting information about symptoms and medical tests for monitoring and evaluation. The data so collected will not be shared / divulged / passed on by JP to any other unrelated organization for any purpose other than this project. The Health Workers will collect personal health data and test-results during their doorstep visits and record them directly into the App. The Hub Co-ordinators will collect data regarding Tele-Consultation and its outcome into the App at the Hub. The project will employ a software to record and store all the data into a cloud server and carry out required processing and analysis as per our requirement. The Health Workers will be selected from among Accredited Social Health Activists (ASHA) workers doing free-lance facilitation work with the PHC and will be compensated. A continuous Outreach Program will be conducted by the Health Workers in various localities to educate the population about health, hygiene and basic healthcare. Supplier of mobile test equipment will organize, additionally, training for operation of the instruments and test procedures for a week. MINI Health kits will be used by health workers to be carried in a back pack. The kits will have following instruments: 1. Thermometer 2. Automatic Blood Pressure Apparatus 3. Pulse Oximeter 4. Haemoglobin meter 5. Foetal Doppler 6. Glucometer These kits will be equipped with Finger Biometric device for record and identication of beneciaries, for easy retrieval. Health kit with the six devices and the nger biometric device will also be used at the hub at PHC. PHC will also be equipped with a 12-lead Digital ECG recorder for monitoring heart conditions. The health workers will obtain health data from the tests listed below. The same data will be collected at PHC also. List of Tests: 1. Body temperature 2. Blood Pressure 3. Oxygen Saturation in blood 4. Haemoglobin 5. Blood Sugar level random 6. Heart sound record 7. Foetal heart sound record in case of pregnant female 8. 12 lead ECG recording (at PHC) Our Project Team will get a good hands-on experience in running a telemedicine project and with this rich experience, our club could apply for a global grant for a mega Telemedicine project. TABLET PROJECT GLOBAL GRANT – GG4 By Rtn Girish Konkar Project Overview: Areas of Focus: Basic education and literacy in Rural Community Objectives: Main Objectives of the Project are as below: 1. To excite & motivate children/adults to become literate using most modern devices like Computer tablets. 2. To lay a Foundation for e-learning and for becoming a seed project to generate additional capacity to make basic education and literacy accessible to more & more beneciaries. The project is expandable exponentially. 3. Spreading awareness of becoming literate to write & read & count. 4. Empowering underprivileged children & adults to take up regular schools. 5. Acquainting beneciaries with further opportunities in education & employment elds. 6. Enhancing learning outcomes of students: Ÿ Improving students' abilities in self & group e-learning, enhancing students' learning outcomes Ÿ Improving students' abilities in speed of learning, speed of comprehensions, speed of understanding difcult subjects. Ÿ Make the students' learning entertaining, interactive, intensive & effective. Ÿ Improving student's grades & hence school's status. Ÿ Enhancing Adult Literacy rate. 7. Transform School Teachers to motivated e-School Teachers. Who will benefit: The Project envisages making approx. 20000+ children/adults over5 years who are largely located in remote rural areas across the State of Maharashtra. The focus is on addressing the education needs of small rural schools with only 2-3 teachers, 1-3 school rooms, and between 10 to 100 students across 1st to 7th/8th grades. Tablet Based Literacy Project is executed by providing Computer Ta