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.