Medical treatment in remote places

For specialized medical treatment doctor don't actually have to be present in a far-away village or town. Internet-based technologies allow for remote treatment.


Thailand has experienced a brain drain of doctors from public hospitals to private hospitals.

Some experts also say promoting medical tourism (attracting more foreigners to Thailand to take advantage of relatively low cost medical treatment) will only further exacerbate the brain drain (Read article #1 (20-11-2010) and #2 (05-11-2010)).

The internet has the potential to help provide high-quality treatment to remote places in rural Thailand to counteract this brain drain.

Many promising new technologies are being developed that could help deliver healthcare to remote rural areas.

Mobile phones can play a role in what is known as mobile health or mhealth (See Wikipedia).

Google Health even has a dashboard to track your own health (See website).

Today's article is an extract from a larger article discussing healthcare technologies developed by internet hardware giant Cisco. Read the full article here.

Also read an evaluation of primary health care for the rural poor done in 2006 five years after universal health care coverage was introduced in Thailand (Read academic paper).

Click button to listen to Bridging the Gap and rightclick to download

Bridging the gap by Don Sambandaraksa

The problem in Thailand is that the gap between public sector healthcare - which Cisco is focusing on in Europe - and private sector is huge....

For the past three years, [Cisco] has been working on getting many private hospitals to adopt Unified Communications, allowing hospital staff, doctors and patients to get through to the right services without having to go via an operator.

Both Bangkok Hospital and Samitivej Hospital use Cisco Wi-Fi with unified communications to help locate translators.

Cisco has had some success with video-conferencing. A hospital in Nakhon Ratchasima uses video-conferencing for second opinions for cancer patients. Instead of repeatedly travelling to Bangkok, they can now go only a couple of times for diagnosis and then confer remotely.

Recently, Cisco trialled a project with Samitivej Hospital and Boots in which anyone could see a skin specialist via video-conferencing, but that failed as patients wanted the assurance of a doctor beside them.

Doctors were also very reluctant to give any diagnosis remotely.

Vatsun said the reluctance to use the technology was a cultural block.

HealthPresence has not been attempted yet in Thailand, mainly because of lack of connectivity, limited bandwidth and jitter (lack of consistent latency or delay). Because of these network issues, such a solution would be limited only to major cities anyway.

The benefit might be hard to justify in terms of operational return on investment, but it is all about equality and providing better healthcare to under-served rural populations. Ultimately, the benefits will be felt in greater economic benefit to the GDP.

(Source: Bangkok Post, Database, Bridging the gap, Don Sambandaraksa, link)

remote - distant, far, far away ไกล
specialists - medical specialists, doctors who have been specially trained to treat certain kinds of diseases including Surgery, Anesthesiology, Pediatrics (children), Obstetrics (mothers during pregnancy and birth), Gynecology (women), Cardiology (heart), Dermatology (skin) (See Wikipedia)
specialized medical treatment - the sort of treatment that "specialist" doctors provide patients

primary health care - first contact healthcare, the first health care that a patient receives for their problem, if the problem is bad then the patient is sent to a specialist for further treatment (referral), primary health care providers ensure "coordination of care and continuity over time"
secondary healthcare - "treatment by specialists to whom a patient has been referred by primary care providers"
tertiary health care - a specialized and highly technical level of healthcare in sophisticated large research and teaching hospitals with "specialized intensive care units, advanced diagnostic support services, and highly specialized personnel"

universal - involving everyone ทั่วไป
universal healthcare coverage - a government system for providing every person with medical care and treatment

brain drain - when skilled workers are drawn away from where they are needed because they can earn more money someplace else (for example, Indian doctors educated in the US choosing to stay in the US rather than go back to India and help poor people) (See Wikipedia)
medical tourism - the rapidly-growing practice of traveling across international borders to obtain health care (See Wikipedia)
exacerbate - make a problem worse, aggravate a problem ทำให้แย่ลง
potential - has a good possibility of success
counteract -
reduce negative effect by doing something with opposite effect, neutralize ลดผลกระทบ, ทำให้ผลน้อยลง

role -
the function, position or responsibilities that a person has in a situation or project, the tasks that you do in a project บทบาท
play a role (in a situation or project) - the tasks that you must do in a project
mobile health - the use of mobile phones and other small devices in providing healthcare and medical treatment (See Wikipedia)
mhealth - same as "mobile health"
Google Health - "a personal health information centralization service (sometimes known as personal health record services) by Google. The service allows Google users to volunteer their health records – either manually or by logging into their accounts at partnered health services providers – into the Google Health system, thereby merging potentially separate health records into one centralized Google Health profile" (See Wikipedia)
dashboard - software dashboard, system that provides information in a graphic easy-to-read way on a person's computer screen, most commonly for managers in a company (See Wikipedia)

sector - a part of the economy ภาคเศรษฐกิจของประเทศ (public sector = government, private sector = all businesses, household sector = families and consumers, banking sector,...) (See Wikipedia)
public sector - the government
public sector healthcare - healthcare provided in government hospitals
private sector - all the companies in the ecoonomy of a country (owned by private individuals, not the government)
private sector healthcare - healthcare prvided in hospitals owned and operated by companies
Cisco Systems - one of the largest companies in the world selling technology that is essential to the operation of the internet such as routers (See Wikipedia)
gap - a separation, a space or opening in the middle of something or between things, a large difference between people or groups ช่องว่าง
gap between X and Y - a big space or difference between things or people X and Y
bridge gap - end the difference or space between two things, fill in the gap, end the separation
healthcare - the treatment and prevention of diseases and other medical problems

adopt - to start using something new นำมาใช้
unified  - when many different things are brought together into one thing ซึ่งทำให้เป็นหน่วยเดียวกัน, ซึ่งรวมเป็นหนึ่งเดียว
communications -
process of making ideas, information or emotions know to other people การสื่อสาร
staff - workers, employees, people who work for a company or organisation พนักงาน
operator - telephone operator
locate - to find where something is หาทำเล,หาที่ตั้ง

video-conferencing - using internet with audio and video to have a meeting between two groups of people in different places (See Wikipedia)
second opinion - when a second doctor looks at a person's health problem (and says what he thinks the problem is and what the treatment should be)
couple - two people who are married or are involved in a romantic relationship คุ่รัก
diagnosis - when a doctor makes a judgement about what disease a patient has
confer - when people talk together about a problem (in order to solve the problem)
(adjective) - far away

trial - test (before doing a full large version of the project)
Samitivej Hospital - a private hospital in Bangkok, well-known for healthcare tourism (See website)
Boots -
a pharmacy retail chain from the UK with many stores in Thailand (See Wikipedia)
pharmacy -
a store that sells medicine
retail chain -
a company that sells thing to customers directly through many stores in different places
skin specialist -
a doctor who treats skin diseases, dermatologist
assurance - a promise; a guarantee การรับประกัน, การรับรอง
doctor - to change a document, tape, film, etc. in order to deceive people ปลอมแปลงเพื่อหลอกลวง

reluctant (adjective) - not willing to do something (so are slow, hesitate, or do without enthusiasm) ลังเลใจ, ไม่เต็มใจ
reluctance (noun) - a state of not willing to do something ลังเล
diagnosis - what the doctor says what disease the patient has
block - to stop something from moving through or along something else กีดขวาง, ปิดกั้น
culture - a set of ideas, beliefs, and ways of behaving of a particular organization or group of people วัฒนธรรม
cultural block - when you don't want to do something or find it difficult to do something, because of your culture

full-blown -
having the full thing, not just part of something (example: he came down with a full-blown case of AIDS)
lack - does not have ขาดแคลน
connectivity - the ability of computers (mobile phones, etc) to connect successfully with other computers or devices
bandwidth - the capacity for a given system to transfer data, the data transmission rate; the maximum amount of information (bits/second) that can be transmitted along a channel
limited bandwidth - not very much bandwidth (at least not enough to make everyone happy and satisfy all their needs)
jitter - 1. a small irregular movement, 2. small rapid variations in a waveform resulting from fluctuations in the voltage supply or mechanical vibrations or other sources (See Google Definitions)

consistent - doing a task the same way (not changing all the time) อย่างสม่ำเสมอ อย่างเสมอต้นเสมอปลาย
delay - when you have to wait longer than expected for something to happen, or the time that you have to wait การเลื่อน
latency - roughly same as "delay"
network - a large system of connected parts, organisations, people, etc. เครือข่าย
issues - subjects that need to be considered, an important subect that people are discussing and debating about ประเด็น
Still, Cisco Thailand is trying to convince the Ministry of Public Health that Thailand should make the jump straight to a HealthPresence system rather than wait another three years

convince - saying things to make a person believe something
make the jump straight to - start using some new product right now (immediately) without thinking about it too much or delaying it

benefit - to get help or an advantage from something ผลประโยชน์
justify - provide a reason for doing something, to show that there is good reason for something แสดงเหตุผลที่ดีพอ
hard to justify - difficult to show that there is a good reason to do something
X in
terms of Y - X as shown by or measured by Y
- from operations, from running the business or organization
Return On
Investment (ROI) - rate of return from doing some project or activity, the ratio of money gained or lost on an investment relative to the amount of money invested (See Wikipedia)
investment - taking your money and putting it into projects to make a profit or earn interest (buying stock shares, bonds, real estate)
equality - the state of being equal, especially when people have the same rights, status and opportunities ความเสมอภาค
rural - in the countryside (farms, forests), not the city ชนบท
benefits - goods things that can happen from anm activity ผลประโยชน์
GDP - Gross Domestic Product, a measure of the income of a whole country (and also perhaps of the country's "standard of living" and "quality of life") (See Wikipedia and also see Google Public Data)

About the author

Writer: Jon Fernquest
Position: Online Writer