Bulletin of the World Health Organization

Long-running telemedicine networks delivering humanitarian services: experience, performance and scientific output

Richard Wootton, Antoine Geissbuhler, Kamal Jethwani, Carrie Kovarik, Donald A Person, Anton Vladzymyrskyy, Paolo Zanaboni & Maria Zolfo

Volume 90, Number 5, May 2012, 341-347D

Table 2. General information about the telemedicine networks delivering humanitarian services

Information Africa Teledermatology Project ITM Telemedicine Pacific lsland Health Care Project Partners Online Specialty Consultations RAFT Swinfen Charitable Trust Teletrauma
First year of operation 2007 2003–2004 1997 2001 2001 1999 2000
Activities provided Clinical/educational Clinical/educational Clinical/educational Clinical Clinical/educational Clinical Clinical/educational
Clinical activities
Modality for tele-consultations Store-and-forward Store-and-forward Store-and-forward Store-and-forward Store-and-forward Store-and-forward Store-and-forward and videoconferencing
Clinical specialties offered Dermatology HIV/AIDS All specialties All specialties All specialties All specialties Trauma, orthopaedics, neurosurgery
Equipment purchase and maintenance Support from the American Academy of Dermatology and the Commission for Development Studies, Austrian Academy of Sciences Belgian Development Cooperation for web site maintenance and education of participants based in resource-limited settings US$ 250 000 start-up grant. Continued funding as part of core budget in jurisdictions and the TAMC Revenue from other sites, block grant from Partners HealthCare Financed by the network for 2 years, then by local funds Charitable funds State budget for the hospitals
Educational activities
Technology used in tele-education Computer-based learning Computer-based learning Audio computer-based learning Audio, video
Modality used in tele-education Asynchronous Asynchronous Both synchronous and asynchronous Synchronous
Clinical specialties offered Dermatology HIV/AIDS All specialties Trauma
Requesters
No. of requesters Hundreds registered; approximately 50 actively submitting Approximately 400 More than 300 10 More than 500 403 50
No. of requesting sites 15 About 80 11 4 More than 50 399 (not all are active) 7
No. of countries 13 42 9 1 15 58 5
Accreditation of requesters Someone in the network knows them personally Alumni of the SCART/eSCART course; physicians working in resource-limited settings for international organizations; manual approval of a membership Approval by the medical director based on recommendations of ministers/secretaries of health and local laws and regulations of jurisdictions None Verification of credentials by local coordinator Known personally to someone on the board or to a third party known by them Have to be physicians (service not for the patients directly)
Experts
No. of experts 25 Approximately 20 100 30 50 513 15
No. of expert sites 6 6 1 14 20 502 (not all are active) 5
No. of countries 3 5 1 1 15 22 3
Location of experts Same country that the requests are from; other industrialized countries Other developing countries; other industrialized countries Other industrialized countries Other industrialized countries Same country where the requests are from; other developing countries Other industrialized countries Same country where the requests are from; other industrialized countries
Accreditation of experts Experience in dermatology in the developing world. Internal review of experts. Training Linked with institutional collaborations; relevant work experience in resource-limited settings Selected and approved by the medical director, vetted by the Surgeon General of the US Army, credentialed by TAMC, certified by the American Boards of Medical Specialists, and licensed by at least one of the 50 states in the USA Practising physicians within the network subject to rules and accreditation requirements by the State of Massachusetts Verification of credentials by local coordinator Known personally to someone on the board or to a third party No special requirements; clinical experience in special questions and scientific degree
Funding of experts The consultants are volunteers The consultants are volunteers The consultants are volunteers The consultants are volunteers The consultants are volunteers; the network pays for their time The consultants are volunteers The network pays for their time
Coordinators
Management of requests and selection of experts Made by requesters Made by a coordinator Made by the medical director Made by both requesters and a coordinator Made by a coordinator Made by a coordinator Made by a coordinator
Funding of coordinators The coordinators are volunteers The network pays for their time Medical director is a volunteer The network pays for their time The coordinators are volunteers; the network pays for their time The coordinators are volunteers The network pays for their time

AIDS, acquired immunodeficiency syndrome; HIV, human immunodeficiency virus; ITM, Institute of Tropical Medicine; RAFT, Réseau en Afrique Francophone pour la Télémédecine; SCART, short course on antiretroviral treatment; TAMC, Tripler Army Medical Center; US$, United States dollars.