Setting up a Tele-ophthalmology Unit

Pranesh.T.S.,
ATN Coordinator,
Aravind Eye Care System

Tele-ophthalmology involves extension of services electronically irrespective of distance. This could happen in two ways: real time and store and forward. Real time involves ‘live’ patient examination by the referring ophthalmologist that is transmitted to the specialist using specialized equipment like videoconferencing attached to ophthalmic diagnostic equipment and expert gives his opinion or diagnosis as appropriate. Store and forward involves transfer of patient data electronically over email or Internet to seek second opinion/diagnosis. Expert will answer the query as he receives the email; here patient is not examined by the expert live. A hybrid of these two procedures involving both the methods is also followed based on the requirement.

REAL-TIME APPLICATION
Video conferencing:
The video conferencing is facilitated by TANDBERG equipment which is capable of connecting multi-point locations through ISDN lines and through IP.The normal rate of data transfer are 128 kbps/line.

Hardware Involved:

  • TANDBERG-6000 unit with camera
  • Monitoring Television
  • Computer
Connectivity:
Multi-point connectivity with 6 locations over ISDN line and up to 2Mbps over IP connectivity.

STORE & FORWARD APPLICATION
Aravind has developed exclusive software, eyestalk that captures patient data along with images and transmits this to the expert using even on a ordinary dialup connection. This software also stores the data of the referred patients for future usage.

Hardware Involved:
  • Computer with 2GHz, 128 MB RAM, 40 GB Hard disk
  • Video Capture Device (to capture images from the ophthalmic equipment)
    • Full scale NTSC/PAL resolution (704 x 576/24 bit Color/30 fps)
    • A minimum of Digital Cool Pix camera which can be attached with the slit-lamp.
Connectivity:
  • Internet Connectivity
  • Minimum requirement of DSL or ISDN
Software:
  • Operating System (OS): Windows 2000/Windows 2000 Advance Server/Windows XP Professional
  • Internet Explorer 6.0 and above (This is the only feature required to browse through the software pages and work on it
  • MS Access (Office Application) loaded on the system.
Ophthalmic Equipment:
  • Video slit lamp or regular slit lamp with a digital still camera (equivalent to Nikon Coolpix 950) attached to it. The digital still camera should be conveniently mounted on the slit lamp; also appropriate ports should be available on the camera to transmit data from camera to the computer.
  • Video Indirect Ophthalmoscope (Optional)
  • Non-mydriatic Fundus Camera (Optional)
MANPOWER INVOLVED
  • The Technician is trained up with videoconferencing equipment, performs the establishment of connectivity process and he is responsible for maintaining the system and the smooth running if the process.
  • The Technician is trained up with VSAT equipments and following a standard format for establishing the connectivity through VSAT equipment and with knowledge in trouble-shooting procedures
  • The Software technician maintains and does upgrading of the eyestalk and DRAGON software.
  • The overall Academic Coordinator monitors the activities of the network, ensuring that the targets are met as specified in the project goals and reporting.
  • Program Director – overall administration of the activities of the Aravind Tele-ophthalmology Network.


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