Telemedicinetechnology in education and patient care

DR TEBOHO THABANE | 23 AUGUST 2017

Presentation Lay out

• Define Telemedicine

• Telemedicine in Lesotho.

• The experience through FMSTP.

• Telemedicine challenges.

What is telemedicine?

• The delivery of health care services, wheredistance is a critical factor, by all health careprofessionals using information andcommunication technologies for the exchangeof valid information for diagnosis, treatmentand prevention of disease and injuries,research and evaluation, and for thecontinuing education of health care providers,all in the interests of advancing the health ofindividuals and their communities”.

Map of Southern Africa

Potential for Telemedicine

Information and communication technologies (ICTs) havegreat potential to address some of the challenges facedby both developed and developing countries in providingaccessible, cost-effective, high-quality health careservices. Telemedicine uses ICTs to overcomegeographical barriers, and increase access to health careservices. This is particularly beneficial for rural andunderserved communities in developing countries –groups that traditionally suffer from lack of access tohealth care.A WHO sponsored study for the MOH Lesotho byTelemed Africa PTY (Ltd) strongly recommendedharnessing of full potential of eHealth.

Elements relevant to Telemedicine

• Providing clinical support

• Overcoming geographical barriers

• Use of various ICT technologies

• Improvement of health outcomes

Classification telemedicine Approaches

• Real time or synchronous

– Requires that involved individuals be simultaneously present for immediate exchange of information e.g videoconferencing

• Store and forward or asynchronous

– involves exchange of pre-recorded information between individuals

Adoption Telemedicine in Low income countries

• In low-income countries and in regions with limited infrastructure, telemedicine applications are primarily used to link health-care providers with specialists, referral hospitals, and tertiary care centres. Even though low-cost telemedicine applications have proven to be feasible, clinically useful, sustainable and scalable, these applications are not being adopted on a significant scale due to a variety of barriers.

Telemedicine in Lesotho

• Mobile phone penetration in Lesotho is at 75 %. However, telehealth potential in the public sector has barely been tapped.

• The National TB Program has tried to harness technology to get patient results from the TB laboratory to far away health centers via sms with some success though without long term sustainability.

• In Private Practice, telepathology and teleradiology are working with great success.

The Pan African e-Network Project

• The Indo-Pan African cooperation launched a project in 2005 that connects 5 universities,53 learning centers and 10 super specialty hospitals in India via satellite, fibre-optic and wireless networks.

• One such site was set up in Berea Hospital in Lesotho in 2010.

• Allows for both synchronous and asynchronous approach.

• Facility for patient consultation not in use.

Telemedicine in Lesotho

• Challenges

– Lack of commitment from above.

– Gross under utilization.

– Poor sound quality.

– Equipment pilferage.

Telemedicine experience in FMSTP

• Apart from direct contact learning and bedside teaching, online teaching is an integral strategy for achieving learning goals.

• Innovatively FMSTP registrars use whattsap technology for support from mentors and peers, and report better point of care decisions and satisfying results.

Telemedicine experience in FMSTP

• Dermatology teaching:– Africa teledermatology project.

– Real teaching from Boston dermatology department via GoToMeeting application.

• Real time Lectures via GoToMeeting during contact session from Boston University Department of Family Medicine.

• Local FMSTP faculty lectures during non contact time.

Real time Lecture From BU

Telemedicine experience in FMSTP

• Challenges

– Unreliable internet connection which affects real-time interactions.

– Loss to follow-up on patients while awaiting response in cases of store and forward or asynchronous interactions.

Barriers for Telemedicine in Lesotho

• Public Policy non existent – Regulation and licensing for the practice

• Lack of Infrastructure development.– Lack of reliable internet connection

• Ethical concerns (Confidentiality)• Lack of Quality Assurance and regulation either in

education or patient consultation.• Limited research capacity

– Determine impact on health and education outcomes– For advocacy and development.

Summary of eHealth Strategy

THANK YOU