Specialist advice on WhatsApp for remote patient care


Previously, a heart patient in remote rural areas of Himachal Pradesh used to get specialist treatment or advice after travelling for 11 to 24 hours, as heart specialists were available only at either Shimla or Kangra. But now, a physician sitting at a remote location can get special advice in 10-15 minutes, and this has been made possible with the innovative idea of Dr Vivek Chauhan of Internal Medicine at Dr Rajendra Prasad Government Medical College and Hospital in Kangra (RPGMCH).
He has developed an IT-based gateway using WhatsApp to transmit ECG images to specialists.
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It was observed by Dr Chauhan and his team that many patients of acute myocardial infarction (AMI) were reaching their hospital out of the 12-hour window period for thrombolytic that led to poor patient outcomes.

There were multiple reasons for the delay; prominent among them was lack of diagnostic facilities in rural healthcare centres. After this, they planned a tele-electrocardiography (tele-ECG)-based pilot project in Kangra district of Himachal Pradesh, which was funded by the Indian Council of Medical Research.

The intention was to reduce the pre-hospital delay in AMI by enabling the rural doctors of Kangra using tele-ECG facility, and a 24-hour physician support to manage patients of AMI.

RPGMCH principal Dr Anil Chauhan said the project was started in March last year in eight community health centres (CHCs) having an in-patient facility and 24hour emergency services. A 24-hour toll-free helpline was established at the medical college for the diagnosis of heart attack through teleECG.

He said specialists -on receiving the ECG, and based on telephonic conversation with doctors in rural locations -started advising them on how to go ahead with the treatment, that too within 10-15 minutes. "This gave doctors in remote locations confidence in treating heart patients, as they were sure of getting the help of cardiologists and experts from the medical college," he added.

He said the project was funded by the Union government. He said of the total 12 districts in the state, six could be linked to RPGMCH, while the remaining six districts could be linked to Indira Gandhi Medical College and Hospital (IGMCH), Shimla. "The project for the entire state would cost around Rs10-12 lakh, as only ECG machines need to be installed," he added.

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