Health diagnosis improvement in remote community health centers through telemedicine

Abstract

Introduction: Information and communication technologies (ICTs) applied to the healthcare offer multiple advantages for diagnostic services and remote consultations. However, evidence on the diagnosis improvement in rural communities is limited. The usability of telemedicine to improve the coverage of diagnostic services in Paraguay was investigated. Methods: The goal of this descriptive study was to evaluate whether a telemedicine system implemented in remote public regional and district hospitals in Paraguay over a period of 3 years from 2014 to 2016 could facilitate the universal coverage of diagnostic services in rural communities. Results: In the study period, 182,406 remote diagnoses from 54 hospitals through a telemedicine system were performed. Of the total, 37.31% (68,085) corresponded to tomography, 62.00% (113,059) to electrocardiogram (ECG), 0.68% (1243) to electroencephalogram (EEG), and 0.01% (19) to ultrasound (US). Tomography was performed in 12 hospitals: 54.4% corresponded to head injuries, 13.8% to chest, and the rest to other anatomical regions. ECG was carried out in 52 hospitals; and in 62.1% of the cases, the results were normal; 12.5% unspecified arrhythmias; and 10.4% sinus bradycardia among the most frequent pathologies. EEG diagnosis showed history of seizure (54.3%), evolutionary control (14.0%), and headache (11.5%) among the most frequent diagnoses. All 19 US studies corresponded to prenatal control. Conclusion: These results showed that telemedicine may enhance the diagnostic services in rural communities, thus reducing the number of referrals and optimizing human and financial resources. Keywords Information and communication technology in health, technological innovation, telediagnosis, telematics in health, telemedicine Date

National electrocardiographic mapping by telemedicine for diagnosis and prevention of cardiological pathologies in Paraguay

“…Moreover, the telemedicine network may be useful in implementing a contingency plan in order to provide special medical assistance in case of cardiological emergencies or to monitor the adherence to the prevention plan for cardiovascular disease patients. 7 The network model of the telediagnostic concept (webbased) allows a centralized application from any computer and in any place with access to Internet. To facilitate the technological innovation through the tele-EKG, it was necessary to develop a new diagnostic assistance protocol where a revision and improvement of the classic routine procedure was an important issue.…”

“…The improvement in the national coverage and equal access to diagnostic technology reached through the implemented tele-EKG is in accordance with that referenced by other authors in other countries. 7 , 8 Furthermore, the telediagnostic tool provided monetary and political benefits for the population because it reduced the costs of medical assistance and transportation of patients and trained specialized staff. Moreover, the telemedicine network may be useful in implementing a contingency plan in order to provide special medical assistance in case of cardiological emergencies or to monitor the adherence to the prevention plan for cardiovascular disease patients.…”

“…In addition, to achieve these goals, telemedicine apps showed considerable usability and proved to be a powerful promising tool. [7][8][9] In general terms, the populations living in remote areas of a country usually have no access to specialized medical care and treatment, as well as good support and counseling, often relying on local first aid medical services. These services have scarce resources and low ability to solve and make decisions.…”

“…These services have scarce resources and low ability to solve and make decisions. 7 The people in these remote locations have access only to an asymmetrical health system. In the end, the government cannot offer equity and universal coverage to the population.…”

“…Accordingly, the health policies should be focused on a broader health service plan for remote populations, which have no access to specialized medical care. [5][6][7] For this purpose, the telemedicine department of the Ministry of Public Health and Social Welfare of Paraguay, in collaboration with the Department of Biomedical Engineering and the Health Sciences Research Institute (IICS) of the National University of Asuncion of Paraguay and the Basque Country University (UPV/EHU) of Spain, undertook this study in order to evaluate the feasibility of telemedicine as an electrocardiographic (EKG) mapping tool for diagnosis and prevention plans of cardiological pathologies in Paraguay.…”