Telemedicine on cutting edge
High-speed internet, mobile devices, applications, the Internet of Things, artificial intelligence and mixed-reality technology are playing a major role in revolutionising telemedicine as Thailand faces a shortage of physicians and nurses.
A prototype technology project uses emergency telemedicine via a high-speed digital network in remote areas, commissioned by Naresuan University in collaboration with the Broadcasting and Telecommunications Research and Development Fund for the Public Interest (BTFP).
"Thailand has a ratio of one physician per 3,000 people," said Dr Sirikasem Sirilak, dean of the medicine faculty of Naresuan University in Phitsanulok.
The ratio is 1:700 in Bangkok and 1:1,500 in major provinces because there is a shortage of medical practitioners in public healthcare, said Dr Sirikasem.
Adopting technology can improve the quality of life for citizens in rural areas, particularly for emergency medical treatment, he said.
The technology can synchronise data between district-level health promotion hospitals and large hospitals that have specialised physicians, improving medical services in small hospitals.
State-run district health promotion hospitals normally have only nurses. They can seek teleconsulting with specialised doctors via the "Nu Med" mobile application to provide treatment for patients.
Lab tests for blood and blood pressure can be sent to doctors for consultation through the app.
Doctors can access patients' medical records to prescribe medicines.
The system labels the emergency level to be displayed on the app as doctors are sought to discuss the cases via chat or video calls.
Paisarn Muneesawang, dean of the graduate school at Naresuan University, a project leader, said the app allows the public to keep health data in the system, which physicians can access and examine by scanning a QR code in emergency cases or for patients travelling to hospitals outside their home districts.
The app also updates patients on health promotion knowledge and helps hospital staff visiting patients look for health records through facial recognition, which would be useful for bedridden patients.
A first for the app allows patients to undergo the verification process and give consent to hospitals.
Users can alert emergency units through the app with locations and response units can explore patients' health information data to prepare to provide care.
"This would be very useful when patients fall unconscious as they normally have a survival rate of only 3%," said Mr Paisarn.
About 1 million village health volunteers visiting patients will also be able to use the app.
He said physicians and nurses can wear the mixed-reality HoloLens that links medical equipment with data that can be viewed in real-time.
HoloLens can share live images with specialised physicians at main hospitals for consultation.
"HoloLens can be applied for telesurgery in the future when higher speed internet networks, such as 5G, are available," said Mr Paisarn.
The project also involves the "haptic tablet", which can display ultrasonic vibration of patients.
General physicians in remote hospitals can use haptic tablets to check babies suspected of having cardiological problems and share images of ultrasound tests via the device with cardiologists to diagnose and make decisions as to whether a patient should be referred to other facilities.
Specialised doctors can use the haptic device to check babies more accurately.
In the future, all health data stored at the data centre will be processed through machine learning to help doctors diagnose the health conditions of patients, he said.
Blockchain technology can also be used to store health records of patients, he said.
Niphon Jongwichit, interim fund manager of BTFP, said the project was financially supported by BTFP, with 9.4 million baht set aside in the first phase in 2014. During the phase, 4-5 hospitals underwent tests for the scheme.
Another 14.5 million baht was set aside for the second phase, which began in 2019, he said, adding 289 hospitals can be connected through a telemedicine network, covering 157 hospitals in Phitsanulok and another 132 in Sukhothai.
The BTFP plans to expand the project in the next two years.