6. Limitations in Developing Countries
Shortage of general practitioners
- many rural clinics are run by nurses only
Shortage of medical specialists
- many countries have no dermatologists,
pathologists, ophthalmologists, radiologists, etc.
Limited access to current information
- medical libraries have no current material,
no continuing medical education (CME)
8. Limitations in Developing Countries
Limited Communication Infrastructure
Example: many islands in Solomons have no telephone –
communication only my VHF radio.
Existing telephones are often slow and too unreliable for
stable internet access.
Limited financial resources
9. Implications
Patients
- cannot afford to visit hospital
- visit hospital late
Doctors
- no access to specialist knowledge
- no advise for patient management
- no experience with rare diseases
- no communication with patient (unless at hospital)
10. Solomon Islands Pathology
Problem for Pathology Services:
– Specimen sent to Brisbane (AU) by air
– Time until diagnosis: 60 days!
Patients do not return:
– No communication infrastructure
– Limited transport
11. Suggested solution
Telemedicine:
Access to advice and diagnosis from
remote specialists with the help of
telecommunication technologies.
13. Phase 1: Histology Lab
Needs for Histology Lab:
Operational under local conditions:
- frequent power cuts
- high temperature and humidity
Sustainable
- locally available spare parts
19. Phase 2: Remote consultations
Step 1:
Selected images captured with digital
camera (Nikon CoolPix 990) and
submitted to server in Basel via email
Step 2:
Cases are reviewed by a
group of 7 pathologists
(Switzerland, Germany
and South Africa)
20. Phase 2: Remote consultations
Results:
360 cases submitted and diagnosed
turn-around time 10 days
(1-3 days for diagnosis)
Quality of diagnosis (preliminary results, n=80)*:
80% identical diagnosis
23% minor discrepancies
7% major discrepancies**
* Full report in preparation
** Includes two cases of sampling errors
(false negative needle biopsies)
