Follow-up data for patients managed by store and forward telemedicine in developing countries

Abstract

There is very little published information about the outcomes of patients treated by telemedicine in developing countries. Over a two-year period, seven medical students from five universities spent their electives at a hospital in Papua New Guinea. They assisted with the review of a total of 44 e-referrals made by local doctors; the referrals resulted in 61 queries in a wide range of specialties. The major categories of these queries were internal medicine, paediatrics and surgery. Follow-up data were obtained in 22 of the 44 cases (50%) after a median period of 13 weeks (interquartile range 3-19). The cases were reviewed by an independent doctor. Telemedicine was considered to have assisted with the diagnosis in all cases (median score 5 on a five-point scale from 1 = not helpful at all to 5 = very good/excellent). The advice to the referring doctor for further action was considered helpful in all except one case (median score 5 on the same scale). The outcome for the patient was considered to be good in 15 of the cases (median score 4 on the same scale). Medical students were able to facilitate e-referrals by relieving the pressure on the local doctor to undertake the necessary clerical and technical work. The students reported a rewarding elective experience. The follow-up data showed that low-cost telemedicine can provide useful advice in a low resource setting.

A web-based telemedicine system for low-resource settings 13 years on: insights from referrers and specialists

“…Referrers thought that about a quarter of patients were better after the consultation and that the consultation helped over 90% of cases. This accords with the rather limited information available from patient follow-up in Papua New Guinea (9). Diagnosis was changed in 22% of referred cases and patient management in 33%, which would be considered as excellent outcomes for face-to-face consultations in the industrialised world.…”

Policy Innovation is Needed to Match Health Care Delivery Reform: The Story of the Champlain BASE eConsult Service

“…Worldwide, there are four other multi-specialty asynchronous services reported in the literature, which are located in the following institutions: San Francisco General Hospital (Kim-Hwang et al 2010), the Mayo clinic in Minnesota (North and Tulledge-Scheitel 2014), The Kaiser Permanente Hospital in Colorado (Palen et al 2012), and the Peijas hospital in Finland (Harno et al 2000). Similar to our findings, early results also suggest that these services improve access to specialist care, reduce wait times, and improve communication between PCPs and specialists (Straus et al 2011;Callahan et al 2005;Wootton, Menzies, Ferguson 2009). …”

Quality Assurance of Teleconsultations in a Store-and-Forward Telemedicine Network – Obtaining Patient Follow-up Data and User Feedback

“…It was based on accepted tools used in previous studies (3, 5). The final questionnaire was evaluated and approved by an independent evaluator.…”