Telematics, the transfer of video data via computer, has potential to improve the management of patients in rural communities.
E-mail and access to health information systems have an important role from an educational point of view, however the transfer of patient data for specialist opinion could provide invaluable support for doctors and benefit individual patients in isolated primary and secondary health care institutions.
Pioneering examples of such links have been carried out in 1995 in Kenya, Uganda and Canada where links between the Canadian Medical School in Nairobi, Makerere Medical School in Kampala and the Health Sciences Centre of the University of Newfoundland allowed the transmission of EEG and ECG recordings to the latter for diagnostic purposes. Similar techniques have been used in tele-education involving Costa-Rica, Jamaica, Kenya and the USA and also in video conferencing and lectures involving Ghana, Kenya, Nigeria and Tanzania.
All of these systems have been managed and organised by staff recruited and trained locally and consequently have been cost-effective. The development of the infrastructure capable of utilising geo-stationary satellites is however expensive. Low orbit satellites which are only available at certain times of the day are much less so but still require a considerable financial outlay.
Computer / video conferencing systems linking medical centres by land-line could allow data transmission between any hospital with a computer and a telephone. This technique of communication is considered to be so important that 70 projects have been selected for funding by the telematics application programme of the European Union.
These have been classified into 7 groups:
- Multimedia patient records.
- Telematics-assisted co-operative work for health care professionals.
- Departmental systems and advanced imaging.
- Integration platforms, continuity of care and regional networks.
- Telediagnostics, teleconsultation, and emergency telemedicine.
- Information for citizens and health care professionals.
- Cohesive dissemination and exploitation of results and education.
The AIM of this project would be initiate a pilot project linking a peripheral hospital and the Johannesburg Hospital. This project would be of the type described in categories (2) or (5) above and would involve interpretation of data in order to assist in the more rapid management or disposal of hospitalised patients or in some cases to avoid the necessity for admission. A hoped-for by-product would be continuing medical education for the personnel involved in the project. Once all the technical difficulties have been sorted out and we have more experience with using the equiptment, the project will extended to include rural hospitals such as Tinswalo in Mpumalanga.