Long Distance WiFi for Telemedicine at Aravind Hospital,

Tamil Nadu, India

Sonesh SuranaTier Retreat, Oct 29, 2005

Tier, UC Berkeley

Outline

• Introduction to Aravind Eye Hospitals

• Need for Telemedicine

• Solution – Past and Current

• Link Usage

• Future Directions

Intro: Aravind’s Mission

• Eradication of Needless Blindness– 45m globally– 90% in developing world

• Sustainable

• Replicable

Intro: Patient Throughput

• 2003– 1.48m patients– 200k surgeries

– 1.5k free eye camps

• Each day– 4k patients– 540 surgeries– 3 camps/1000 ppl

• 1978-2003– 16m patients– 1.8m surgeries

– 19k free eye camps

Between 50% - 60% get free care. Yet sustainable and profitable

Need for Tele-Ophthalmology

• Shortage of Doctors 1

– No incentive to live in rural areas

• Low uptake of eye care services 2

– Transportation: Time, Cost, Company

• Intra-doctor/nurse consultation

1. Ref: http://aravind.org/Telemedicine_new/index.html

2. Ref: Low uptake of rural eye services in rural India: a challenge for programs of blindness prevention. Arch. Ophthalmology, 1999 Oct; 117(10):1393-9

Solutions: Existing Setup 1

• Mobile Van– VSat

• N-logue for video conf.– 35 Kbps– $50/month/center– Central Server – Served 3500

patients upto July 2005

1. More details at http://aravind.org/Telemedicine_new/index.html

Theni

Andipatti

Ambasamudram

N-logue

Solutions: Our setup• 10.5km 802.11b link – setup July 2005

• 24dbi Directional Antennas

• Soekris routerboards (~15watt)

• Voltage Stabilizers

• UPS batteries

• No LOS – need relay

Link Usage

• Operational for 3 months now (since Aug05)

• 4.5 Mbps UDP (~1-2% loss)

• 4-5 patients/day (better perceived video quality)

• Remote desktop management (VNC)– Training Nurses/Operators– Sotware Installation & Troubleshooting

• Streaming Movies (VideoLan)

Future Directions

Bodi

Theni Hospital

Ambasamudram

Andipatti

Kambam

Complex

Chimney

House

33.3 Kms

10.2 Kms