Bridging the Knowledge and Skill Gap in Healthcare: SGPGIMS, Lucknow, India Initiatives

Prof. A K Mahapatra, MS,MCh.( Neurosurg.)Director

Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow

director@sgpgi.ac.in

PSC/APT Workshop, Okinawa,15-16, June 2007Okinawa, JAPAN

Organisation of Health Services in India(Central Government)

Ministry of Health:1. Organization of Medical Education and

Research(i) Medical Council of India (MCI)(ii) National Board of Examinations (NBE)(iii) Indian Council of Medical Research

(ICMR)

2. Running of Institutions(i) All India Institute of Medical Sciences

(AIIMS)(ii) Postgraduate Institute of Medical

Education and Research (PGIMER)(iii) Sanjay Gandhi Postgraduate Institute of

Medical Sciences (SGPGIMS)(iv) Institutions under UGC

• Total no of Medical

Colleges - 2624

Bridging the Knowledge & Skill Gap in HealthcareNeed

• Diversity in the standard of– Quality of Teachers– Availability of Educational Tools (slide projectors,

projecting microscope, still and moving digital images

– Books and Journals– Quality and type of patient materials (geographical

difference in the incidences of various diseases)– Rural, Urban and Semi urban patients – Diversity in the quality of students because of entry

and exit parameters

Bridging the Knowledge & Skill Gapthrough

Telemedicine

• Telemedicine is a powerful tool to bridge distance

between Student & Teacher

• Quality of Postgraduate education in Indian

Medical colleges needs improvement

• Tertiary academic medical centers can provide

additional inputs through Telemedicine

• Virtual classroom teaching

• Interactive bedside education in clinical medicine

Potential Benefits• Improving quality of medical / paramedical education and

meeting the educational needs of the students despite paucity of teachers

• Improving quality and reducing the cost of health care delivery by tele-consultation and tele-follow up

• Facilitating cognitive component of learning by providing interactive teaching material online developed by a group of competent teachers at undergraduate, postgraduate and super-specialty levels

• To promote psychomotor skill development through tele-mentoring

• To link Medical Libraries with adequate stock of books and journals for access to all thereby reducing state expenditure on medical college libraries (Digital Library Network)

Potential Benefits• To promote medical research by providing infrastructure for quick

exchange of ideas and co-ordination with group of researchers involved in collaborative multicentre studies and facilitating current information access through digital library network

• Online Continuing Medical Education (e CME) to enhance knowledgeand teaching skill and possible Accreditation of Medical Teachers and Health Care Professionals

• Implementing uniform examination pattern and evaluation. Coaching students with online and offline in MCQs

• Enhancing computer literacy among medical students and teachers

• Facilitating e Health Governance

• Sharing of resources and establishing effective communication between the medical colleges and its faculty

• Providing educational material & tools to medical teachers

Sanjay Gandhi Postgraduate Institute of Medical SciencesLucknow

Patient-care, teaching and research

“Institutes with tradition of excellence have demonstrated abundantly that research enhances the vitality of teaching, teaching lifts the standards of service, and

service opens new avenues of investigation.”

The Facilities

Beds 685Academic Departments 23Annual new patients 30,000Annual admissions 20,000

Target Groups for Distance Learning

• Practicing Medical Professionals

– Postgraduate students of medical sciences

– District hospital doctors

– Residents under training

– Nursing Professionals

– Paramedical healthcare professionals

• Knowledge sharing

• Tele-continuing Medical Education(Tele-CME)

Distant Medical Education

• Distance learning modules

– Lectures

– Case discussions

– Tele-radiology - image demonstration system wise

– Tele-pathology - pathology slide seminar

– Tele- CMEs- virtual environment CME participation

– Clinico-pathology Conference

– Common Grand Round (CGR)

SGPGIMS – National Network Partners

Raibarely

Telemedicine (1999)

CMC, Vellore

Medical College Rohtak, Haryana

International Partners

France Pakistan

Intra-hospital Telemedicine Network

Telemedicine Resource Center

Operation Theater

Mini Auditorium

Main Auditorium

Videoconference Kits

• Polycom MP view-station

• Aethra Vegastar Gold

• Falcon IP (VCON)

• Polycom Via-Video (PC Based)

• VCON Studio based VC System

• Zydacron (PC Based)

• Polycom VSX 8000

Communication Media

• ISDN - 768 Kbps

• Sify Fibre Optic Cable - 2 Mbps

• Gailtel Fibre Optic Cable - 2 Mbps

• ISRO Flexidama VSAT - 384 Kbps

• NIC KU Band - 384 Kbps

• BSNL Data One - 256 Kbps

MO

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Endocrine SurgerySurgical GastroenterologyENT

8-9AM1-2PM1-2PM

SGPGIMS – CMC, VelloreSGPGIMS-SCB MC, Cuttack SGPGIMS- Base Hospital Almora & Srinagar

15.11.06

RadiologyGeneral Medicine

9-10AM1-2PM

SGPGIMS-SCB MC, Cuttack SGPGIMS- Base Hospital Almora & Srinagar

08.11.06

Endocrine SurgeryThyroid Cancer Tele-clinicNeuro-ophthalmology

8-9 AM4-5PM1-2PM

SGPGIMS-AIMS, KochiSGPGIMS-SCB MC, CuttackSGPGIMS- Base Hospital Almora & Srinagar

Wed01.11.06

Endocrine SurgeryRheumatology

3-4PM2-3PM

SGPGIMS-SCB MC, Cuttack SGPGIMS – District Hospital, Raibarely

28.11.06

General SurgeryMedical Genetics

1-2PM2-3PM

SGPGIMS- Base hospital Almora & SrinagarSGPGIMS – District Hospital, Raibarely

21.11.06

Gastroenterology2-3PMSGPGIMS – District Hospital, Raibarely14.11.06

General SurgeryGastroenterology

1-2PM2-3PM

SGPGIMS- Base hospital Almora & SrinagarSGPGIMS – District Hospital, Raibarely

07.11.06

Neurology2-3PMSGPGIMS – District Hospital, RaibarelyTues07.11.06

PathologyNeuro-surgeryEndosurgery Tele-followup

1-2PM3-4 PM4-5 PM

SGPGIMS- Base hospital Almora & SrinagarSGPGIMS-SCB MC, Cuttack SGPGIMS-SCB MC, Cuttack

27.11.06

Pathology Neuro SurgeryEndosurgery Tele-followup

1-2PM3-4 PM4-5 PM

SGPGIMS- Base hospital Almora & SrinagarSGPGIMS-MKCG MC, BehrampurSGPGIMS-SCB MC, Cuttack

20.11.06

Review Meeting Uttaranchal Telemedicine Network ProjectMicrobiology End surgery Tele-follow up

1-2PM3-4PM4-5PM

SGPGIMS- Base hospital Almora & SrinagarSGPGIMS-SCB MC, Cuttack SGPGIMS-SCB MC, Cuttack

13.11.06

Pathology Pathology

1-2PM3-4PM

SGPGIMS- Base hospital Almora & SrinagarSGPGIMS-SCBMC, Cuttack

Mon 06.11.06

Participating DepartmentsTimeTelemedicine CentersDay/Date

Tele-microbiology Tele-pathology

Tele-endosurgery Tele-gastrosurgery

Screen Shot of Various Distance Learning Modules

Postgraduate Students & Residents

• Orissa telemedicine network (3 medical colleges)

• Sept2001-Mar2007 (n=513)

• VSAT

• Rohtak medical College• March 2007 (n=6)• Common Grand Round• ISDN

Screen shot of Distance Learning

District Hospital Doctors(To develop and improve professional career)

• Uttaranchal Telemedicine Network (2 District Hospitals)

• April 2004-March 2007 (n=106)

• ISDN• Telemedicine Network

between Raebareli District Hospital & SGPGIMS

• April’06-March’07 (n=25)• Fiber Optic Network

• NIC Project for North East• July 2003-October 2004

(n=13)• Ku band satellite link• 8 North East states• Broadcast 450 community

centers

Paramedical Healthcare Professionals

Nursing Skills Development

(n=25)

Hospital Administration

(n=5)

Knowledge Sharing with peer institutions Nationally

• AIMS Kochi, Kerla• March’04-March’07

(n=72)• VSAT

• Christian Medical College, Vellore

• Sept’06-Mar’07 (n=6)

• SGPGIMS-AIIMS-PGIMER(n=11)

• October’05-march’07

• Point to multipoint

• Department of Urology -

29 topic

• Monthly sessions

• PGIMER, Chandigarh(n=6)

• Clinco-pathology Conference

• February 2007

• ISDN

• Weekly program received from PGIMER

Ranguel University, Toulouse, Francen=5

• June’06-December’06

• Department of Endocrine Surgery & Surgical Gastroenterology

Tele-CMEs(n=17)

Tele-mentoring Trial (Proof of Concept)

• AIMS, Kochi (April 2004)

• Primary Hyperparathyroidism

• Broadband telecommunication

(ISRO)

Conclusion

• SGPGIMS has acquired the technical skill and developed infrastructure for distance learning in super-specialty medical subjects not only for doctors but also for paramedical professionals

• Many departments has already integrated the module in their routine schedule of teaching program

• More and more partners are getting added into the network

• Midterm feedback analysis from distance learning partner nodes justifies cost-effective investment on the technology

Thank youSanjay Gandhi Post Graduate Institute

of Medical SciencesThank you