Telemedicine by email—experience in neonatal care at a primary care facility in rural India

Abstract

During an 18-month study period, teleconsultations were conducted by email between a neonatal intensive care unit at an urban teaching hospital in western India and a rural primary care centre 40 km away. There were email consultations about 182 newborn babies; these consultations comprised 309 messages sent from the primary care centre and 272 messages from the teaching hospital. The average reply time was 11.3 h. Thirty-eight babies were referred to the intensive care unit at the teaching hospital after these consultations. The remaining 144 babies were managed at the primary care centre. Telemedicine helped in the diagnosis, referral, treatment and follow-up of patients. The cost of the email service was estimated to be Rs12,000 and the savings in avoided transfer were estimated to be Rs546,000, a cost-benefit ratio of 1:45.

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.…”

Distributed, multiplatform high fidelity human-patient simulation environment: a global-range simulation-based medical learning and training network

“…Rapid growth of internet connectivity in the technologically advanced countries is associated with the most important attribute of electronic healthcare knowledge dissemination -rapid erosion of distance as the main obstacle in accessing postgraduate professional education among healthcare personnel in rural and remote regions of the world (Von Lubitz et al, 2002). The existing internet/web-based medical training and/or consultation programmes cover a wide range of topics (Casebeer et al, 2002;Fieschi et al, 2002;Greengold, 2002;Mann and Colven, 2002;Poyner et al, 2002;Tichon, 2002), satisfy almost every need for specialised knowledge, and, with the increasing sophistication of the existing models, may involve a large variety of approaches spanning from e-mail exchange (Deodhar, 2002;Pastuszak and Rodowicz, 2002) to videoconferencing and multimedia offerings (Allen et al, 2002a,b;Davis and McCroaen, 2002;Haythornthwhite, 2002;Pastuszak and Rodowicz, 2002). The main disadvantage of didactic distance learning is its essentially static nature that may not reflect the dynamism of medicine, particularly in the context of specialties like emergency/trauma and military medicine, or surgery (Von Lubitz et al, 2000a).…”

Open Source Software

“…Because of the widely varying state of communications infrastructure in developing countries, western models of development which emphasize in-hospital systems linked by fixed line, high-capacity networks may not be appropriate. In the context of less developed countries, there have been a number of telemedicine projects, often concerned with communication from centers of excellence in western nations ( e.g., Swinfen, Swinfen, Youngberry, & Woot-ton, 2005), or within developing countries (Deodhar, 2002), but a shared approach to development is vital (Wooton, 2001).…”