Telemedicine for Rural Areas
(PC and Smartphone based)
Abdullah-Al Amin
Ahamad Imtiaz Khan
AKM Bodiuzzaman
Zihad tarafdar
Ahmed Raihan Abir
M Obaidur Rahman
Kamrul Hussain
Papia Chowdhury
Nazimul Kadir
K Siddique-e Rabbani
Department of
Biomedical Physics & Technology
Dhaka University
<www.bmpt.du.ac.bd>
Bangladesh
 > 70% live in rural
areas
 3.6 doctors for
10,000 people
 70% people consult
village doctors or
quacks
No access to qualified (MBBS/Specialist) Doctors
What is telemedicine?
• Telemedicine  healing at a
distance (first used in 1970s )
• Telephone allowed earliest
tele-consultation by doctors
• ICTs can make a revolution in
Telemedicine
• Huge potential in Bangladesh
and throughout the globe
Rural Healthcare in Bangladesh
• Semi-rural Health Complexes: 
400 (hospitals with X-ray,
Pathology and other facilities)
• Very difficult to retain qualified
specialist doctors there.
• Rural Community Clinics: 
15,000 with short-trained
personnel, to provide very
primary healthcare and referral
of patients
Possibility of telemedicine in Bangladesh
 Need: Good communication
link providing consultation
with doctors in towns or cities
 Internet and mobile phone
networks cover almost the
whole of Bangladesh.
 Telemedicine can be used
effectively in Bangladesh
using both these media.
Telemedicine efforts in Bangladesh
• Several groups  mostly video
conferencing only  no diagnostic
equipment
• Telemedicine enabled diagnostic
equipment  imported costs
prohibitively high.
• Foreign equipment cannot provide
prolonged service  hot and humid
climate  abnormal electricity
supply
Our efforts at Dhaka University
 At Department of Biomedical Physics &
Technology [BMPT-DU]
• PC based system with integrated
diagnostic equipment  greater
capability of data capture
• Uses internet, Rural centres with PC,
Doctors at Expert centres
 A2I funding for Field Trial
 Recent fund from ISIF-Asia to develop a
mobile phone based system
• Health workers at rural homes 
doctors directly
Background work at BMPT-DU
 Primary target: Upazilla Health Complexes (have X-ray, Pathology
facilities but no specialists)
 We developed the following:
• ECG (12 lead, diagnostic quality)
• Stethoscope (Real time, needed for primary diagnosis)
• Respiration Monitor (Electrical Impedance based)
• X-ray viewer (for sending image to Radiologists)
• Microscope (for sending image of prepared specimen to Pathologists)
• Colposcope (for viewing the cervix, to diagnose cervical cancer)
Temperature, Blood Pressure, Blood Glucose, Weight, Height 
measured and data typed in manually
BMPT-DU DEVICES FOR TELEMEDICINE
Digital ECG, PC based
12 lead, Graphical User Interface for data
acquisition, display, storage and transfer.
Indigenous design
Certification for
ECG equipment
Given by DMCH,
Obtained through
DG Health,
Bangladesh Govt.
ECG, 12 lead, with live internet transmission
For telemedicine
Graphical User Interface for ECG
Instructions available on screen – both English and Bangla versions.
User clicks using a mouse to interact – lead selection, data acquisition,
transmission, etc.
ECG REPORT
Sent to Cardiologist through own server or email
ECG Report
Patient ID 1
:Age: 0
25 mm/sec
0s
Patient Name : null
Sex: Female
Wednesday 01 July 2015
10 mm/mV
5 mm/mV
2s
1s
3s
4s
0s
1s
2s
3s
4s
I
V1
II
V2
III
V3
aVR
V4
aVL
V5
aVF
V6
II
0s
1s
2s
3s
4s
Improvised
Digital Stethoscope
A microphone insert is
fixed at a cut end of the
rubber tube of a
commercial stethoscope
Variable delays through internet distorts
quality of sound and its time sequence
We are now using store and forward of
short recordings
14
Improvised Digital Microscope
Software zoom
A good webcam attached to a Chinese
microscope.
We are trying alternative methods using
USB camera modules and improvised
optics.
Digital
X-Ray View Box
software zoom
16
Digital Colposcope
for detection of Cervical Cancer
Improvised from a
binocular
Software filtering done to get effects
similar to that obtained using Red,
Green and Blue filters
17
Basic scheme of our telemedicine system
Rural/Semi rural Centers
Expert Centers
Helath Center
Expert Center
Helath Center
INTERNET
.
.
.
Expert Center
.
.
.
Helath Center
Outputs of our devices
Scheme at Rural/Semi-rural Telemedicine Center
Digital
Stethoscope
Sound input jack of PC
Digital X-ray
Viewer
USB port of PC
Digital
Microscope
USB port of PC
Telemedicine
Software
Display
Local PC
Digital
Colposcope
Digital ECG,
12 Lead
Typed data
entry
through PC
keyboard
USB port of PC
Report and
Prescription
Generation
Archiving and
Printing
USB port of PC
Video
Conferencing
INTERNET
Software for TELEMEDICINE,
Web based
• Address: www.bmpt.du.ac.bd/telemedbd
Software for TELEMEDICINE
<www.bmpt.du.ac.bd/telemedicine>
• Real time (almost)
• Registration and ID to
stethoscope
health operator and doctor
by admin
• Real time (almost)
respiration monitor
• Log in by remote operator
• Log in by doctor
• Real time (almost) ECG
• Patient registration, vital
information entry and
uploading
• Uploading of images of
Ultrasound, X-ray, previous
prescriptions A Prescription
- preliminary and final
• Doctor sees uploaded data
• Patient consults doctor
through video consultation.
• All records archived for
future reference
Prescription
Generation
• Mixed Bangla and
English
• User friendly
generation, use of data
bases of symptoms,
advices and drugs.
• Keyword linked for
fast prescription
generation
Future:
 Implementation in Bangladesh leading to a mature technology
through feedback and further R&D (both hardware and software)
 Development in other languages (for other countries)
As a philosophy, we are not patenting our innovations
We plan for an open source movement in healthcare technology
Ready to share, collaborate with others from any country
Please contact us if you are interested
<rabbani@du.ac.bd>
See our activities at: <www.bmpt.du.ac.bd>
Acknowledgements
1.
Farm Fresh brand of Akij group, Bangladesh
2.
ISP of Uppsala University, Bangladesh
3.
Access to Information (A2I) programme of Govt of
Bangladesh (partners: UNDP, USAID)
4.
Information Society Innovation Fund (ISIF)-Asia
5.
All post graduate students and staff at the
department who provided encouragement and
support to this project
Thank
You