Telehealth in Asia

Healthcare for the communities

Gabe Rijpma, Health and Social Services Industry Director Public Sector Group Microsoft Asia Pacific Singapore

The Internet and next generation communication technologies are revolutionising the delivery of care and are increasingly utilised to deliver better and more comprehensive care to communities that need it most. Telecare or the delivery of care virtually supported by Internet and communication tools is breaking new ground.

Asia is increasingly challenged by the social disparities between its urban and rural populations due to the massive growth it experienced in the recent years. Of the region’s 4 billion people, 80 per cent live in rural areas often without adequate access to education and healthcare.

Today, there is an immediate need for the region’s governments, communities and industry partners to address the challenges of the region’s existing healthcare structures and ensure that everyone has an access to adequate healthcare.

Currently most people in Asia rely on state subsidies, while more than 130 million people can pay for private healthcare. The majority of people in the region survives on US$ 1 per day and would by no means be able to access basic medical care (The World Bank, World Development Report 2008). Governments, companies and communities need to find solutions that will allow medical care to cross the geographical, social and cultural barriers within the health sector and ensure that everyone is able to access healthcare.

In the developed world, the growing availability of broadband Internet, Wi-Fi, cellular networks and the move to digital television are opening doors to an amazing array of telemedicine and telehealth services. But even in far less developed economies where broadband is scarce and electricity and phone service may be unreliable, commodity communications technologies are being used to extend healthcare services to those in need.

Microsoft believes that bringing together of the region’s technology capabilities with telehealth or the use of Information and Communication Technology (ICT) can help deliver health services, expertise and information over distances. Countries will be able to improve the quality of care, increase access and manage the cost of
implementation and management. Telehealth allows us to access the innovations and technological advancements within the region and apply them to support the communities including rural and the aged.

Reaching the remote communities
Healthcare facilities in most rural areas are usually non-existent or lack proper resources. Further, transportation problems to metropolitan hospitals pose a real barrier to access for the rural population. The low population density in rural areas makes it inherently difficult to deliver services that target persons with special health needs, including people with HIV/AIDS, people with chronic illnesses, mothers and children, the aged and people with disabilities.

Telehealth is not designed to replace clinicians or other healthcare staff, but to improve access to healthcare for people in remote locations or those for whom the access to healthcare is limited by culture, language or clinical resources.

One key success has been the Microsoft pilot project with Dristee in India’s Barielly and Madhubani districts. Seventy per cent of India’s population (some 700 million people) lives in rural areas and the per capita expenditure on healthcare is not more than US$ 7 per day. Limited financial resources coupled with the limited medical resources (there are about 60 doctors per 100,000 people in India) make the delivery of healthcare more challenging.

With the assistance of a medical facilitator and by means of a computer and dial-up Internet connection, villagers are able to discuss their health concerns with a medical professional at an urban centre. Vital signs, photos, medical records and other information can also be shared. Simple problems can often be addressed then and there. People needing more care can be referred for an appointment in a town, but with greater assurance that when they make the long trip to get there, they will see the appropriate specialist for their particular ailment. The computer is fitted with a solution developed by Neurosynaptic, a Bangalore-based firm Microsoft is partnering with.

The pilot project is a key example of how technology is able to bring the world of specialised healthcare to those in need of it. Dristee’s team of workers also educates the villagers who are unaware of their health conditions or the necessary steps required to treat them. The programme aims to provide a technology platform for rural communities and gives citizens greater access to qualified health information and medical services. The platform uses simple dial-up Internet access, computers and web cams to connect care givers and patients in remote villages with more highly qualified medical professionals in urban centers.

Digamber Jha, a retired school teacher in Mangrauni South Village suffers from a persistent stomach disorder and goes for regular check-ups and follow-up sessions with his doctor who is 150 miles away via telelink. “I am confident that the doctors there will be more qualified than those in Madhubani. Despite my poverty, I will try to follow the treatment they prescribe to the best of my ability”, he says.

Preparing to care for the aged
A key priority for Asian governments is the provision of adequate care for the ageing population. Over the past 50 years, the proportion of older people has been rising steadily, and in the next 20 years almost a quarter of the region’s population will require aged care, placing an enormous strain on existing healthcare systems.

The situation is further exacerbated by the shortage of qualified health workers.

According to the World Bank, there is a shortage of 4.3 million health workers around the world and 57 countries do not have enough health workers to provide even basic health services.

A key to manage the rising demand of aged care is to empower patients. As Professor Branko Celler, CEO of Australia’s TeleMedCare explains, “the empowerment of patients with the tools and the knowledge to self-manage a long-term condition, the facilitation of an all-population approach to improve healthcare outcomes at a distance by integrating social care, telecare and telehealth services throughout the primary care sector.”
Professsor Celler’s team has developed Medications Management and Reporting System, MEDSafe that is designed to facilitate medication administration at the point-of-care. Delivered via a medical grade tablet computer, the system works to reduce the possibility of medication errors and provides comprehensive management reporting. TeleMedCare conducted a trial with 22 patients aged between 58 and 82 with chronic illnesses. The patients found the solution easy to use and agreed that it helped them manage and control their health conditions better.

Empowering patients to better manage their own medication, takes the pressure off care takers and allow patients to get involved in their own treatment.

At Microsoft, we believe that as the reach of the Internet grows, and the number of ways to extend low cost, two-way audio and video into the home increases. Commodity telemedicine solutions and an entire range of ehealth services will emerge to help meet the demand for health information and medical care around the world.

Microsoft has a long standing commitment to support the underserved through technology. Our Unlimited Potential programme ensures that we invest in providing technology that enhances education and employment opportunities. We are applying this belief to our partnership in healthcare and through the adoption of telehealth solutions, we believe communities will be better supported. Costs will be managed, care given and innovation will continue.
At Microsoft, we believe that the greatest impact will be through strong public private partnerships. Through these partnerships, telehealth solutions will ensure that more efficient and effective care is delivered across the region. Already, an Internet-enabled, commodity telemedicine and telehealth service plays an increasingly important role in extending care to those who need it. By ensuring that these communities are supported by public private partnerships, they will be better supported. costs are better managed and innovation will be continued.

Telehealth is real and has begun to make an impact on the lives of people in our communities. Microsoft looks forward to the implementation of telehealth solutions and strong partnerships across the region that will ensure that the sick in our communities are in better contact with their health providers, care givers and others dealing with similar challenges.


Gabe Rijpma is the Director of Government Solutions for Microsoft Asia Pacific, working from Singapore. Gabe started his career at Microsoft in 2000 and joined as a Principal Technology Specialist focused on helping government customers realize the value from their Microsoft technology investments. Prior to joining Microsoft he was the Principal Consultant at Software Spectrum Inc in Sydney Australia looking after the business solution development practice delivering solutions on both the IBM and Microsoft platforms.

Author Bio

Gabe Rijpma