Reliability and Validity of Mobile Teledermatology in Human Immunodeficiency Virus–Positive Patients in Botswana

Azfar, Rahat S.; Lee, Robert A.; Castelo‐Soccio, Leslie; Greenberg, Martin S.; Bilker, Warren B.; Gelfand, Joel M.; Kovarik, Carrie L.

doi:10.1001/jamadermatol.2013.7321

Cited by 31 publications

(39 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Each of the pilot projects focused on specific objectives and was evaluated based on the respective objectives as shown below: Cervical Cancer Screening: Evaluating the use of mobile phone telemedicine for cervical cancer screening ( 9 ). Teledermatology: Determining the reliability and validity of mobile teledermatology in HIV positive patients in a resource-limited setting ( 10 ). Teledermatology: Evaluating patients’ perception of mobile teledermatology ( 11 ).…”

Section: Pilot Projectsmentioning

confidence: 99%

See 1 more Smart Citation

Scaling up a Mobile Telemedicine Solution in Botswana: Keys to Sustainability

Ndlovu

Littman-Quinn

Park

et al. 2014

Front. Public Health

Self Cite

View full text Add to dashboard Cite

Effective health care delivery is significantly compromised in an environment where resources, both human and technical, are limited. Botswana’s health care system is one of the many in the African continent with few specialized medical doctors, thereby posing a barrier to patients’ access to health care services. In addition, the traditional landline and non-robust Information Technology (IT) network infrastructure characterized by slow bandwidth still dominates the health care system in Botswana. Upgrading of the landline IT infrastructure to meet today’s health care demands is a tedious, long, and expensive process. Despite these challenges, there still lies hope in health care delivery utilizing wireless telecommunication services. Botswana has recently experienced tremendous growth in the mobile telecommunication industry coupled with an increase in the number of individually owned mobile devices. This growth inspired the Botswana-UPenn Partnership (BUP) to collaborate with local partners to explore using mobile devices as tools to improve access to specialized health care delivery. Pilot studies were conducted across four medical specialties, including radiology, oral medicine, dermatology, and cervical cancer screening. Findings from the studies became vital evidence in support of the first scale-up project of a mobile telemedicine solution in Botswana, also known as “Kgonafalo.” Some technical and social challenges were encountered during the initial studies, such as malfunctioning of mobile devices, accidental damage of devices, and cultural misalignment between IT and healthcare providers. These challenges brought about lessons learnt, including a strong need for unwavering senior management support, establishment of solid local public-private partnerships, and efficient project sustainability plans. Sustainability milestones included the development and signing of a Memorandum of Understanding (MOU) between the Botswana government and a private telecommunications partner, the publication and awarding of the government tender to a local IT company, and the development and signing of a Memorandum of Agreement between the Ministry of Health Clinical Services department and the local tender winner. The initial system scale-up is scheduled to occur in 2014 and to ensure the project’s sustainability, the system is aligned with the national eHealth strategy and local ownership of the project remains at the forefront (1).

show abstract

Section: Pilot Projectsmentioning

confidence: 99%

“…Teledermatology: Determining the reliability and validity of mobile teledermatology in HIV positive patients in a resource-limited setting ( 10 ).…”

Section: Pilot Projectsmentioning

confidence: 99%

Scaling up a Mobile Telemedicine Solution in Botswana: Keys to Sustainability

Ndlovu

Littman-Quinn

Park

et al. 2014

Front. Public Health

Self Cite

View full text Add to dashboard Cite

show abstract

“…Mobile teledermatology uses cell phones to transmit images, allows for more versatility than its often more unwieldy store-and-forward counterpart, and has good concordance with the outcomes of a face-to-face visit (36–39). Teledermatology has been validated in both infectious conditions such as HIV-associated skin conditions and chronic conditions, such as atopic dermatitis (37,40). A cross-sectional survey of HIV positive patients in Botswana found that 91% of patients felt that a mobile teledermatology visit would provide the same level of care as a face-to-face visit (41).…”

Section: Improving Quality Of Care Through Innovationmentioning

confidence: 99%

Global Burden of Skin Disease: Inequities and Innovations

et al. 2017

View full text Add to dashboard Cite

Purpose of Review We review the current understanding of the burden of dermatological disease through the lens of the Global Burden of Disease project, evaluate the impact of skin disease on quality of life in a global context, explore socioeconomic implications, and finally summarize interventions towards improving quality of dermatologic care in resource-poor settings. Recent Findings The Global Burden of Disease project has shown that skin diseases continue to be the 4th leading cause of nonfatal disease burden world-wide. However, research efforts and funding do not match with the relative disability of skin diseases. International and national efforts, such as the WHO List of Essential Medicines, are critical towards reducing the socioeconomic burden of skin diseases and increasing access to care. Recent innovations such as teledermatology, point-of-care diagnostic tools, and task-shifting help to provide dermatological care to underserved regions in a cost-effective manner. Summary Skin diseases cause significant non-fatal disability worldwide, especially in resource-poor regions. Greater impetus to study the burden of skin disease in low resource settings and policy efforts towards delivering high quality care are essential in improving the burden of skin diseases.

show abstract

“…Clinical services (telemedicine) have also taken place within Botswana. Most studies (18) have been performed by a single research group, the BUP Partnership [13,18,20,21,[26][27][28][33][34][35][36][37][38][39][40][41][42][43]. The available evidence suggests this partnership is no longer functional.…”

Section: Literature Findingsmentioning

confidence: 99%

The Need for a Telemedicine Strategy for Botswana? A Scoping Review and Situational Assessment.

Ncube

Mars

Scott

2020

Preprint

View full text Add to dashboard Cite

Background Health, healthcare, and healthcare system problems within the developing world are well recognised. eHealth, the use of Information and Communications Technologies (ICT) for health, is frequently suggested as one means by which to ameliorate such problems. However, to identify and implement the most appropriate ehealth solutions requires development of a thoughtful and broadly evidence-informed strategy. Most published strategies focus on health informatics solutions, neglecting the potential for other aspects of ehealth (telehealth, telemedicine, elearning, and ecommerce). This study examined the setting in Botswana to determine the need for a telemedicinespecific strategy.Methods A situational assessment of ehealth activities in Botswana was performed through a scoping review of the scientific and grey literature using specified search terms, an interview with the project manager of the major mhealth stakeholder, and benchtop review of policies and other relevant Government documents including the country's current draft eHealth Strategy.Results Thirty-nine papers were reviewed. Various ehealth technologies have been applied within Botswana. These include Skype for educational activities, instant messaging (WhatsApp for telepathology; SMS for transmission of laboratory test results, patient appointment reminders, and invoicing and bill payment), and robotics for dermatopathology. In addition health informatics technologies have been used for surveillance, monitoring, and access to information by healthcare workers. The number of distinct health information systems has been reduced from 37 to 12, and 9 discrete EMRs remain active within the public health institutions. Many infrastructural issues were identified. A critical assessment of the current draft ehealth strategy document for Botswana showed limitations. Many telemedicine services have been introduced over the years (addressing cervical cancer screening, teledermatology, teleradiology, oral medicine and eye screening), but only one project was confirmed to be active and being scaled up with the intervention of the Government.Conclusions Botswana's draft 'ehealth' strategy will not, in and of itself, nurture innovative growth in the application of telemedicine initiatives, which currently are fragmented and stalled. This lack of focus is preventing telemedicine's recognised potential from being leveraged. A specific Telemedicine Strategy, aligned with and supportive of the pre-existing ehealth strategy, 3 would provide the necessary focus, stimulus, and guidance. BackgroundHealth and healthcare problems in developing countries abound, and include disease burden, poor doctor to patient ratios, lack of access to health specialists, and shortages of drugs and medicines.Although ICT4D (ICT for Development) is advancing and presenting opportunities to address such health problems, most developing countries find it challenging to use ICT for health activities, termed eHealth.Despite multiple definitions and misuse of terms, and although some people u...

show abstract

Reliability and Validity of Mobile Teledermatology in Human Immunodeficiency Virus–Positive Patients in Botswana

Cited by 31 publications

References 18 publications

Scaling up a Mobile Telemedicine Solution in Botswana: Keys to Sustainability

Scaling up a Mobile Telemedicine Solution in Botswana: Keys to Sustainability

Global Burden of Skin Disease: Inequities and Innovations

The Need for a Telemedicine Strategy for Botswana? A Scoping Review and Situational Assessment.

Contact Info

Product

Resources

About