Success Story RKMH (Ramakrishna Mission Hospital)

RKMH - Arunachal Pradesh is a state in North-East India with a population of 10.91 Lakhs . It occupies an area of 83743 sq. kms . The state has 3 General Hospitals and 11 District Hospitals . It’s capital is Itanagar with a population of 35022.

Ramakrishna Mission Hospital is an institution established in 1979 and catering to especially the tribal population of the state. It is a referral hospital for the entire state.

The hospital’s technical and human resources both IT and radiology are limited when compared to the area it caters to . Of special note is the fact that it has the only CT scanner in the whole of Arunachal Pradesh.

Background & Constraints

As the CT scanner at Ramakrishna Mission hospital caters to the whole of Arunachal Pradesh, patients visit from all parts of Arunachal Pradesh and from neighboring Assam also. Most of the patients come from far flung areas and they cannot wait long for getting the CT scan report. Prior to the hospital approaching us , reporting at the hospital was being done by one full time and one part time radiologist.

Sometimes it so happened that both the radiologists would go on leave simultaneusly . During that time it became an arduous task for them to deliver the reports in time. The hospital had to send a CD containing DICOM images by courier service to a radiologist based in Guwahati and the report was being sent back to them via e-mail.

In-spite of their best efforts things used to get delayed either because of the late delivery made by the courier or failure in network. Even otherwise , catering to a large number of patients with just two radiologists that too one working part-time was a huge constraint.

Considering all these problems , Ramakrishna Mission Hospital approached us at Teleradiology Solutions , trying to find out a solution and workflow by which they could get CT reports early.

Considering the charitable nature of their institution , they did not want a high tech expensive solution , but a low cost bare minimum option that worked effectively.

Workflow

Based on our knowledge and experience of the various software available in the market , we initially explored proposing a low cost one amongst these at the hospital.

But as these were still ranging from Rs 1 Lakh upwards and more significantly were not suitable for the low [256 kbps DSL] and erratic bandwidth available at the hospital , we dropped this plan. The use of VSAT [ 384 kbps] internet connectivity available at the hospital , for transmission of studies , was also explored ; but was discarded as per the hospital’s feedback of it not being reliable.

Subsequently , it was decided to go ahead with a combination of Merge Healthcare’s shareware and FTP.

Our IT team requested and got access to the hospital’s PC [P-IV-2.4Ghz / 512 MB DDR / 40GB HDD (Compaq).] All settings were done remotely from Bangalore by our IT team using VNC software . PC maintenance including anti-virus fine tuning , cache tweaking etc were all done remotely from Bangalore.

Test studies uploaded at the hospital were accessed from our office.

Using the above workflow model and after interpretation by our radiologist , the reports were emailed back to them.

To date more than 3500 CT scans have been reported by us through teleradiology for the hospital . These include Head , Abdomen , Sinus , Pelvis, Chest , Lumbar Spine , Brain etc.
 

Interesting and challenging cases included

• 63year old female with abdominal pain. RCC with tumor thrombus in the IVC thrombus upto cavo-atrial junction.

• 2 year old female with history of gradual onset swelling on the posterior aspect of head since 2 months.