In Utopia, every citizen may have immediate access to the appropriate specialist for medical consultation. However, this cannot even be a dream in the real world. It is a fact of life that “All men are equal, but some are more equal than others.” We in India are unable to provide even total primary medical care in the rural areas. Even in suburban and urban areas, secondary and tertiary medical care is not uniformly available. Incentives to entice specialists to practice even in suburban areas have failed.

In contrast to the bleak scenario in healthcare, computer literacy is developing quickly in India. Healthcare providers are now looking at Telemedicine as their newly found Avatar. Theoretically, it is far easier to set up an excellent telecommunication infrastructure in suburban and rural India than to place hundreds of medical specialists in these places. We have realized that the future of telecommunications lies in satellite-based technology and fiber optic cables. In India, telemedicine programs are actively supported by:

Department of Information Technology (DIT)

Indian Space Research Organization

NEC Telemedicine program for North-Eastern states

Apollo Hospitals

Asia Heart Foundation

State governments

Telemedicine technology also supported by some other private organizations(13)

DIT as a facilitator with the long-term objective of effective utilization/incorporation of Information Technology (IT) in all major sectors, has taken the following leads in Telemedicine:

Development of Technology

Initiation of pilot schemes-Selected Specialty, e.g., Oncology, Tropical Diseases and General telemedicine system covering all specialties

Standardization

Framework for building IT Infrastructure in health Information technology and telemedicine can be used to inform, influence, and motivate individuals and population organizations on health, health-related issues, and the adoption of healthy lifestyles. The various approaches and applications can advance and support primary, secondary, and tertiary health promotion and disease prevention agendas.

It can relay information to individuals as well as to the population as a whole. It can provide easy access to those living in remote areas.

It enables informed decision-making. It also simplifies the health decision-making process / or communication between healthcare providers and individuals regarding prevention, diagnosis, or management of a health condition. As a result, the users are exposed to a broader choice base.

It can go a long way to promote and maintain healthy behaviors in the community.

It can also help in peer information exchange and emotional support. Examples include online Internet applications that enable individuals with specific health conditions, needs, or issues to communicate with each other, share information and provide/receive emotional support.

It promotes self-care and domiciliary care practices. Many living in remote areas can be benefited from self-management of health problems which will supplement existing health care services.

It can be a very important tool for the evaluation and monitoring of healthcare services. It does not require too much of a stretch of the imagination to realize that telemedicine will soon be just another way to see a health professional. Remote monitoring has the potential to make every minute count by gathering clinical data from many patients simultaneously. However, information may be lost due to a software glitch or hardware meltdown. Therefore, relying too heavily on a computer system to prevent errors in healthcare data may be problematic. There has to be a smart balance between total dependence on computer solutions and the use of human intelligence. Striking that balance may make all the difference in saving someone's life. In 2008, the potential of telemedicine, telehealth, and e-health is still left to our imaginations. Time alone will tell that Telemedicine is a “forward step in a backward direction” or to paraphrase Neil Armstrong “one small step for IT but one giant leap for Healthcare”.