Trained professionals are the need of time to identify and run the future telemedicine projects of the country. Joint collaboration between USA and Pakistan in field of science and technology opened a new era of telemedicine training by providing opportunity to train two doctors from Pakistan in telemedicine centers of the USA. A training program for Pakistani doctors in the field of telemedicine at the state of the art centers in USA was arranged.
The main idea of the training was to produce master trainers who will come back to train more doctors in the country and hence building a human resource in this particular field. This has lead to the concept of “telemedicine /E-health training project” to train more doctors and nurses in the field of telemedicine by using the expertise of the Pakistani master trainers and experts from USA.
This was a six-month project in which a model telemedicine training center was established and this was utilized to train 45 doctors and 10 nurses in field of telemedicine. The trained professionals are being utilized in developing telemedicine networks to overcome gross rural-urban disparity, which exists in the country.
This project was a joint collaboration between ministry of science & Technology (MoST) Pakistan and MoST, USA. This center was based in Holy Family hospital, Rawalpindi.
Holy Family Hospital/ Rawalpindi Medical College Rawalpindi Medical College is a comprehensive, state-assisted institution of approximately 1200 students that offers a diverse set of academic programs. All academic programs of the college are accredited by the College of Physicians and Surgeons of Pakistan and Pakistan Medical and Dental Council. The college strives to remain current and relevant through an adequate program of continuing medicine development and the exploration of innovative schedules, methods, and curricular design in keeping with then various needs of its diverse students.
The college has a distinguished record of research and scholarships. Members of teaching staff have won some of the most prestigious awards made by government agencies and private foundations. The college takes pride in the many scholarly books and articles written by members of teaching staff and in their contributions to upgrade the facilities provided to the humanity. Wherever possible, students are involved in research projects, the results of which are integrated into related course of instructions.
Holy Family Hospital was established in 1948 and has been affiliated with Rawalpindi Medical College since 1977. It is a 450 bedded hospital. The hospital has advanced equipment installed in most of the wards. The hospital is in stage of rapid expansion. A brand new 400-bedded 4-story block has been added to the hospital and is now fully operational. It is equipped with state of the art equipment including MRI and DSA.
- Tehsil Headquarter hospital, Pindi Gheb.
- Virginia commons Wealth University, Richmond, VA, USA.
- Telemedicine and Advanced Technologies Research Center (TATRC), Fortdetrick, USA.
- To set up Model telemedicine center at Holy Family Hospital.
- To setup remote telemedicine center: at THQ Hospital, Pindi Gheb and link it to Model telemedicine center.
- To develop of telemedicine training Manual.
- To Develop customized Telemedicine software
- To train 20 doctors & 10 nurses working in the rural areas and specialist hospitals of Rawalpindi region through proper built workshops for basic computer training with particular reference to telemedicine.
- To Exchange telemedicine experts between USA and Pakistan
Establishment of Telemedicine / E-Health Training center
The model telemedicine center was established in holy family hospital and was linked to remote center at THQ hospital, Pindi Gheb for telemedicine training and patient consultation. These centers were also in connectivity with Virginia commonwealth university, Richmond and Telemedicine and Advanced Technologies Research Center (TATRC), Fortdetrick, USA for online lectures and interactive sessions of trainees with US telemedicine experts.
Development of Training Manuals
Telemedicine training manual was developed which was utilized for training of doctors and nurses. This included information about basic computer skills, utilization of telemedicine equipment and software, and knowledge about doing Teleconsultations. These manuals were developed by joint expertise from Surgical department holy family hospital and VCU, USA.
Training of Regional Medical Staff in Telemedicine Applications
Forty five doctors and nurses from Rawalpindi/Islamabad region were trained at the model telemedicine center and remote hospital. This training was divided in three modules
- Introduction about basic computer skills
- Introduction about telemedicine software and telemedicine equipment
- On site telemedicine training, doing actual Teleconsultations between remote hospital and training center. and lectures about telemedicine applications and issues from experts from USA
Development of customized Telemedicine software
Customized telemedicine software was developed in lines with the IT knowledge of Pakistani medical personnel and the telecommunication network of the country. This software was utilized for telemedicine training and doing Teleconsultations with remote center for providing speciality care to underserved population of far flang areas.
Final Workshop of the trainees by US Telemedicine Experts
US telemedicine experts Prof. Roland Merrell and Dr. Azhar Rafiq visited Pakistan and conducted the final workshop of the training. The idea of this workshop was to provide an opportunity to the trainees to interact with the telemedicine experts and learn from their experiences in person. All the trainees of three courses attended the final workshop with interactive sessions from US experts. The final workshop included hands on training on derma scope, e-scope and otoscope by Dr. Azhar Rafiq. Prof Merrel had interactive sessions with the trainees and discussed their individual telemedicine proposals submitted as apart of their final training.
Role of Telemedicine / E-Health Training Center in Disaster Management
In Pakistan the Earthquake that struck on the morning of October 8th, 2005 left widespread destruction in its wake, killing at least 80,000 people, severely injuring another 70,000 and leaving 2.8 million people without shelter. Over 1,02,600 patients have been treated and/or airlifted to 70 hospitals in the earthquake neighboring areas. Over 27,700 operations have been performed on the referred patients. Telemedicine Center was identified as the only center in the country which could play its role in providing the relief to disaster areas through telemedicine . On special request from ministry of IT, Pakistan software board, this center established mobile telemedicine centers in earthquake effected areas of pakistan. Telemedicine center established mobile telemedicine units with collaboration of International telecommunication unity(ITU) and INTEL. The telemedicine software was customized for disaster relief. Remote Telemedicine center in the disaster areas were run by volunteers from Rawalpindi medical college and Islamic international university to facilitate relief efforts in the earthquake region. The mobile telemedicine centers were established at Muzafffarabad, Balakot, Pindi Gheb and Attock.
ITU (International Telecommunication Union) provided on loan 15 Inmar-Sat Satellite modems to be deployed in areas where there was no communication available. Intel Corporation provided 15 IBM Notebooks and webcams for mobile telemedicine units. The staff of the Telemedicine center customized the telemedicine software and trained volunteers before deployment in the earthquake areas for assisting in the relief efforts.
Members of the telemedicine / E-health center team visited Muzaffarabad, the main area of Kashmir hit by earthquake and conducted a day long telemedicine training activity at a hospital in Muzaffarabad and trained IT professionals about the basic working of telemedicine software and the troubleshooting of the satellite modems and other telemedicine equipment. The similar team also went to Hattian Bala, 35 miles away from Muzaffarabad and established a remote telemedicine center their and trained their IT professional on how to use the system.
Organization of International Conferences
Telemedicine / E-Health Training Center organized two major events in January 2006. The events were:
- Third International Surgical Conference 2006 and Continued medical Education program with Sanjay Gandhi Institute, Lucknow, India
Telemedicine / E-health Training Center in collaboration with the Society of Surgeons of Pakistan, organized the 3rd International Surgical Conference 2006. In the conference the team members presented their papers and the main activity which the center organized was the online State-of-art lecture by Dr. S.K. Mishra from Sanjay Gandhi Post Graduate Medical College, India to Pearl Continental Hotel, Rawalpindi (the venue of the conference) through videoconferencing.
- Fourth APT Telemedicine Workshop 2006
Telemedicine Center had unique honour in organizing the 4th APT workshop in collaboration with Telemedicine Association of Pakistan, Asia Pacific Telecommunity (APT), International Telecommunication Union (ITU) and Tokai University Japan. It was first international telemedicine event in the country where more than 30 international experts from Japan, India, Indonesia, Malaysia, Russia UK and USA participated.
Internation collaboration of Telemedicine Center
During the 4th APT conference delegates from Japan, India, Indonesia, Malaysia, Russia UK and USA visited the center. This opened new avenues of joint collaboration wkith well known telemedicine centers around the world. The center has already started regular Telemedicine grand clinical rounds/teaching sessions with following institutions
- Sanjay Gandhi post graduate medical institutes, Lucknow, India
- Maleor Medical University hospital, Wales, UK
Similar research and training program are being initiated in near future in following institutions :
- Tokai University, Tokyo, Japan
- University of Pittsburgh medical center, USA
Research and development Activities at telemedicine center
Following original research was conducted at the Telemedicine center. These studies have been presented during 4th APT workshop and published in proceedings of the workshop
- Improvement in IT and Telemedicine knowledge through telemedicine / E-health training project.
- Role of Telemedicine for pre & post op evaluation of elective surgical patients.
- Use of cellular phone camera in wound management: A feasibility Study.
- Follow up of Earthquake patients through Telemedicine.
- Asessment of earthquake paraplegics for their future rehabilitation through telemedicine
Telemedicine Training of Paraplegic victims of Earthquake in Pakistan
Telemedicine center involved students of Rawalpindi Medical College to conduct research on possible role of telemedicine in rehabilitation of paraplegic victims of earthquake. These patients require constant care. There are no rehab or physiotherapy centers available near their home towns. Keeping in mind this scenario, 15 paraplegics and their relatives were trained about the basics of telemedicine through customized workshops. The results are very encouraging. Future telemedicine workshops are planned using mobile telemedicine tools in their hospital and rehab facilities.
Telemedicine capacity building at national level
There is a dire need of trained healthcare professionals in telemedicine in country. Trained health professionals of this project will only serve the needs of Rawalpindi and Islamabad districts of Pakistan. To cater for the needs of rest of country we hope to play a major role in capacity building of healthcare professionals by organizing courses at national level utilizing the existing resources at the center.
Multitasking of Telemedicine/E-health training center
Apart from utilizing the facilities of center for telemedicine training activities, telemedicine center will be involved in tele-rehabilitation of paraplegics of earth quake and skill development of junior surgeons in minimal invasive surgery through telementoring and telepresence surgery.