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Tele Health Services in the Himalayas: Operational Challenges

Ganapathy K, Premanand S,Chandralekha J, Lovakanth N, Arunab sarma



Under Himachal Pradesh Tele Health Services Programme, quality health care services are being provided at two isolated locations, Kaza and Keylong. This inventive public–private association (PPP) provides access to general, specialty, emergency, and tele-laboratory services.A MoU was signed between Apollo Hospitals and National Health Mission, Himachal Pradesh, to deliver health care services at these two locations.


A turnkey solution was employed, on a Program Management Mode (PMM), with quantifiable points like milestones and monthly reports. VerySmall Aperture Terminals were installed amidst landslides andSub-zero temperatures. LocalStaff were recruited from the community and along with local government staffs were trained in Chennai. Doctors at Apollo Hospitals, Chennai were sensitized about the interaction, through the Tele Medicine medium. Personal interaction by telemedicine coordinators on both sides ensured the traditional human touch. Point of Care Diagnostics were stationed at both the centers and a complete emergency set up was installed. Internal audit was performed and Voice of Customer utilized for obtaining patient feedback on the services.


From the day of initiating the operations (21st April 2015) till July 2016 a total of 3,154 tele-consults were done. Of which 2,870 were general and speciality consults and 284 were emergencies. 1109 patients were benefited by tele-laboratory services and 23 women were screened udner tele cervical screening. Under tele-emergency, 9 cases of Myocardial Infarction (MI) were stabilized, including two cases of Cardioversion.

Findings & Conclusions:

Among major challenges were internet connectivity, power supply, and health seeking behavior of the patients, timely availability of doctors, and availability of medicines. In spite of all these challenges, this programme provides a proof of concept that quality health can be provided in isolated mountainous areas.

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