A technology framework for remote patient care in dermatology for early diagnosis

Abstract

Healthcare in India has been organized into a three-tier structure. The Primary Health Center (PHC) is a part of the first tier, District Hospitals are in the second tier, and the Tertiary Care Center (TCC) forms the third tier. The PHCs have been set up to meet the healthcare requirements of the rural population, where limited diagnostic facilities are available. The District hospitals have better diagnostic facilities as compared to the PHCs, and the TCCs provide advanced diagnostic facilities.Studies suggest that the rural population is significantly affected by skin diseases and requires services of dermatologists. However, the PHCs do not have the required number of healthcare specialists, including dermatologists to provide treatment for all patients, and they do not have sufficient diagnostic facilities to detect skin related diseases. This lack of healthcare specialists and diagnostic facilities delays intervention and treatments that should be administered to the patients visiting the PHCs. We can enhance the quality of service at the PHCs by providing access to dermatologists and diagnostic facilities through Tele-dermatology, to address and avoid this delay in the onset of intervention. This can be administered to the patient at the rural center with the help of technology.The proposed Tele-dermatology framework connects the PHC to the TCC, equipped with an expert system to provide diagnostic suggestions. Patient details, along with skin lesion images, are acquired at the PHC and then transferred over the Internet to the TCC. The TCC archives the details of a patient and processes the patient image and text data. The expert system at the TCC derives the possible diagnosis of the case being referred. The suggested diagnosis is communicated back to the PHC. Alternatively, the PHC can retrieve the diagnostic suggestions from the TCC even at a later point in time. This diagnostic information would help the health worker at the PHC to begin preventive treatment, to avoid worsening of the patient condition until a physician could attend the case.The implementation of the framework is done using a mobile device and Simple Object Access Protocol (SOAP) based Web services. The developed framework could be a platform for providing suitable services and suggestions at rural health centers comprising mainly PHCs. Keywords: Rural healthcare, Primary health center, Tele-dermatology, Skin lesion, Web service, Image archival