TeleDoc - India

The process of creating TeleDoc began in 2001, when the India-based Jiva worked closely with community heads of villages in Haryana to identify healthcare priorities and test appropriate health solutions. The intended result was a system that used Java-enabled mobile telephones to provide village-based healthcare workers with real-time ability to record and transmit diagnostic information. Custom database applications, which synchronise with record-management systems at Jiva's clinic, were intended to enable doctors to analyse the data and then prescribe medication and treatment. Medicines were compounded at a regional office, picked up by field workers, and delivered to patients in their homes - a network of pharmacies and delivery people supported this process. The approximate cost of the entire TeleDoc process was 70 rupees (US$1.50) per consultation.

Organisers envisioned that this low-cost technology might have the following benefits:

• Families could increase savings and reduce stress with less travel to town-based clinics
• Village field representatives could speak local dialects and know village life. They could supply and encourage the use of hygiene products and promote a wellness-based perspective arising from traditional healthcare practices. They could also provide educational materials on HIV/AIDS, sanitation, and other topics.
• Women could be treated by women, encouraging discussion about birth control and other women's health issues.
• Networked health-care recordkeeping and intake mechanisms might improve lifetime care for individuals and facilitate large-scale epidemiological analysis.
• Jobs could be created in villages, offering local women and men income opportunities and ensuring that a share of healthcare revenues remains in the local economy. (Jiva designed Teledoc to be a sustainable social enterprise. Teledoc was intended to provide franchisees with licensed medicine compounders who were Jiva employees. This strategy was designed to facilitate effective supply-chain management, billing and revenue sharing, and oversight.)

Health, Technology, Economic Development.

According to Jiva, many villagers in India lack access to affordable healthcare. Travel, lost wages, and unmet needs of children and families add to the costs that villagers must pay for treatment. As a result, life expectancy in villages is 8 years less than for city dwellers, morbidity is high, and diseases of poverty such as malaria and tuberculosis often go untreated.

Jiva Health provides treatment and healthcare worldwide using the techniques of Ayurveda, a 5,000-year old system of traditional medical knowledge that is based on the idea that health arises from harmony of the body, the senses, the mind, and the spirit. Ayurveda combines medicinal herbs and plants. Since 1993, Jiva Institute has operated an Ayurvedic clinic in the city of Faridabad, Haryana State. Since 1995, Jiva's Ayunique programme has also offered Ayurvedic consultation, diagnosis, and products via the internet. However, this effort to reach rural areas has been impeded by very low literacy levels as well as the huge cost of setting up the infrastructure to support internet services. TeleDoc was designed as a mobile version of Ayunique that draws on the extensive mobile communication spectrum in India.

TeleDoc won the World Summit Award for eHealth, presented December 10 2003 at the World Summit on the Information Society (WSIS) in Geneva, Switzerland. Jiva planned to scale Teledoc throughout India (to as many as 5,000 villages), as well as to develop training and awareness components. For example, Jiva planned to include a component dedicated to women's health involving training, software, and village-appropriate information resources addressing women's reproductive health. Female field representatives who speak the local language would provide check-ups and consultation throughout pregnancies, and alert patients and town-based physicians to potential complications.