An evaluation of the first year's experience with a low-cost telemedicine link in Bangladesh

Abstract

In July 1999, the Swinfen Charitable Trust in the UK established a telemedicine link in Bangladesh, between the Centre for the Rehabilitation of the Paralysed (CRP) in Dhaka and medical consultants abroad. This low-cost telemedicine system used a digital camera to capture still images, which were then transmitted by email. During the first 12 months, 27 telemedicine referrals were made. The following specialties were consulted: neurology (44%), orthopaedics (40%), rheumatology (8%), nephrology (4%) and paediatrics (4%). Initial email replies were received at the CRP within a day of referral in 70% of cases and within thee days in 100%, which shows that store-and-forward telemedicine can be both fast and reliable. Telemedicine consultation was complete within three days in 14 cases (52%) and within three weeks in 24 cases (89%). Referral was judged to be beneficial in 24 cases (89%), the benefits including establishment of the diagnosis, the provision of reassurance to the patient and referring doctor, and a change of management. Four patients (15% of the total) and their families were spared the considerable expense and unnecessary stress of travelling abroad for a second opinion, and the savings from this alone outweighed the set-up and running costs in Bangladesh. The latter are limited to an email account with an Internet service provider and the local-rate telephone call charges from the CRP. This successful telemedicine system is a model for further telemedicine projects in the developing world.

Email communication at the medical primary–secondary care interface: a qualitative exploration

“…28 Rural GPs were especially able to benefit patients (relating to timely management and avoiding unnecessary travel over distance) by using email to share digital images with urban secondary care colleagues; this has also been of value in diverse parts of the world. [29][30][31][32][33][34] Differing approaches to the integration and sharing of patient-specific email communication were in evidence, as reported elsewhere. 6 Waldren and colleagues called for such communication to be 'seamlessly interfaced' with EHR software systems to maintain the integrity of the record, avoid potential for transcription errors, and to increase quality of care and patient safety.…”

The United States Army Ocular Teleconsultation program 2004 through 2009

“…Others have had similar experiences. 20 Given United States military deployment patterns since 2004, it is not surprising that United States Army personnel and Iraq constituted, respectively, the highest percentage of consultations by type of patient and location. In this setting, however, 13.0% of consultations concerned local civilians and 8.1% concerned children, indicating that care of the local population is not an infrequent activity in conflict.…”

Perspectivas de la telemedicina como una alternativa para la atención en salud en Honduras

“…Además de conectar proveedores de salud a la distancia con especialistas, se establecen nuevas redes internas y externas con un incremento en las comunicaciones entre instituciones locales e internacionales que ofrecen servicios regionales. Estas colaboraciones pueden ser usadas para atender en afecciones agudas y crónicas, aprendizaje a la distancia y entrenamiento, dando así estímulo a los proveedores de salud que se encuentran en áreas remotas (Vassallo et al, 2001). …”