I'm happy to hear Stuart Gannes' voice on alternative means of
connectivity. Stuart's Digital Vision program has been instrumental in,
among many other activities, promoting the use of store-and-forward
models as a way to deliver information services in advance of reliable
connectivity. And as many others have said, the answer to the question
"How much bandwidth is necessary?" is critically dependent on what your
program is trying to accomplish. For closed systems of data exchange --
as opposed to open systems such as browsing the World Wide Web and
accessing documents or media files -- low-cost, low-bandwidth solutions
may be ideal.

Jiva Institute's Teledoc project uses commercial, off-the-shelf
mobile-telephone technologies to reduce costs and enable sustainable,
enterprise-based healthcare to reach villages. Village-based field
representatives exchange data with the central clinic using a mobile
phone to access the Internet via a GPRS network. GPRS is widely
available in India, with higher-bandwidth CDMA networks now being
installed in the south. Custom applications written in Java 2.0
Micro-edition (J2ME) allow the phone to connect directly with a central
database of patient records at the Jiva clinic.

Field representatives are able to add new patients, review patient
treatment histories, and describe symptoms in detail. The telephone
interface has been designed to accommodate the phone's limited screen
'real estate' by providing field representatives with simple codes and
sequential decision-support. At the central clinic, Jiva's expert
Ayurvedic doctors analyze the data, and then prescribe medication and
treatment. Medicines are compounded at a regional office, picked up by
field workers, and delivered to patients in their homes-all for 70
rupees or US $1.50 per consultation.

Access to healthcare in villages is extremely limited, and is one factor
contributing to much higher morbidity rates in India's villages when
compared to cities. Teledoc is currently in pilot tests in the state of
Haryana, where Jiva is based, and is providing traditional,
cost-effective Ayurvedic treatments in villages. Jiva has offered
Ayurvedic care locally and internationally over the Internet (60+
patients per day) since 1995. However, we anticipate bundling other
healthcare services into Teledoc as the project evolves.

The combination of mobile telephones, GPRS, and J2ME results in an
extremely low-cost solution. Network installation and maintenance costs
are borne by the private sector. The ability to exchange data between
villages and the central database combines with a solid business plan
and pricing scheme, and with demonstrated demand in the villages to make
the project highly scalable.

Jiva's innovative, low-cost computing technology has just received the
World Summit Award for eHealth for the World Summit on the Information

Regards to all,

Edmond Gaible

www.natomagroup.com   |   www.jiva.org

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