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Rudisill KE, Mathur N, Kalyanpur A. A teleradiology network for the improvement of healthcare and patient management in the developing countries of the African continent. Clin Imaging 2024; 111:110188. [PMID: 38759600 DOI: 10.1016/j.clinimag.2024.110188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 04/21/2024] [Accepted: 05/09/2024] [Indexed: 05/19/2024]
Abstract
INTRODUCTION Africa is the second-largest continent on Earth in terms of both size and population. However, inaccessibility and shortfall of trained radiologists impede the delivery of adequate healthcare to such a large population. Teleradiology holds considerable potential in improving patient outcomes and healthcare delivery in African nations by furnishing timely interpretation of radiological examinations, particularly in those areas where there is a particular scarcity of radiologists. The aim of the present study was to assess the impact of teleradiology in the improvement of healthcare and patient management in the developing countries of the African continent. METHODS In this retrospective study, from January 2017 and December 2022, the scans of a cohort of patients from eight African countries were uploaded to the teleradiology cloud server and interpreted by board certified radiologists empanelled by a teleradiology service provider. RESULTS The telehealth model proposed in the study was seen to provide timely and quality reporting of 58,223 scans of 39,513 patients with a mean turn-around-time (TAT) of 2.46 h 95 % CI (2.44-2.48). DISCUSSION A dedicated teleradiology model designed in this study allowed the interpretation and analysis of the scans of the cohort of patients from hospitals in African countries by teleradiologists via high quality DICOM-image transfer over a cloud-based platform. The outcomes of our investigation reflect that teleradiology provides an effective solution for early diagnosis/interpretation of examinations performed in Africa. Further, the currently proposed teleradiology model may be used for other developing countries across the world to improve quality of care.
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Affiliation(s)
- Katelyn E Rudisill
- Lewis Katz School of Medicine at Temple University, 3500 N Broad Street, Philadelphia, PA 19140, USA.
| | - Neetika Mathur
- Image Core Lab, Plot No. 7G, Opposite Graphite India, Whitefield, Bengaluru, Karnataka 560048, India.
| | - Arjun Kalyanpur
- Teleradiology Solutions, Plot No. 7G, Opposite Graphite India, Whitefield, Bengaluru, Karnataka 560048, India.
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Nigatu AM, Yilma TM, Gezie LD, Gebrewold Y, Gullslett MK, Mengiste SA, Tilahun B. Barriers and Facilitators Experienced During the Implementation of Web-Based Teleradiology System in Public Hospitals of the Northwest Ethiopia: An Interpretive Description Study. Int J Telemed Appl 2024; 2024:5578056. [PMID: 38883327 PMCID: PMC11178418 DOI: 10.1155/2024/5578056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 04/09/2024] [Accepted: 05/21/2024] [Indexed: 06/18/2024] Open
Abstract
Introduction: Teleradiology allows distant facilities to electronically transmit images for interpretation, thereby bridging the radiology service gap between urban and rural areas. The technology improves healthcare quality, treatment options, and diagnostic accuracy. However, in low resource settings like Ethiopia, teleradiology services are limited, posing challenges for implementation. Therefore, this study is aimed at exploring the factors that facilitated or hindered the implementation of web-based teleradiology in the public hospitals of the South Gondar Zone, Northwest Ethiopia. Methods: In this study, a purposive sampling method was employed to select seventeen participants, including hospital managers, physicians, emergency surgeons, and radiologists, for an in-depth interview (IDI). The interviews were conducted from March to May 2023. A reflexive thematic analysis was conducted using an abductive coding technique at the semantic/explicit level. Data were collected through semistructured interviews conducted face-to-face and virtually, with audio recordings transcribed, translated, and analyzed using Open Code version 4.02 software. Trustworthiness was ensured through prolonged engagement, reflective journaling, and review by coauthors. Results: The study examined eight main themes, with barriers to sustainable teleradiology implementation falling into five categories: technological, organizational, environmental, individual, and workflow and communication. Conversely, identified facilitators included improved radiology service efficiency, system accessibility, collaboration opportunities, and user trust in the radiology ecosystem. Within each theme, factors with potential impacts on teleradiology system sustainability were identified, such as the lack of system handover mechanisms, absence of a central image consultation center, and inadequate staffing of full-time radiologists and technical personnel. Conclusions: The study highlights the positive user perception of a web-based teleradiology system's user-friendliness and efficiency. Overcoming challenges and leveraging facilitators are crucial for optimizing teleradiology and improving service delivery and patient outcomes. A centralized consultation center with dedicated radiologists and technical personnel is recommended for maximizing efficiency.
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Affiliation(s)
- Araya Mesfin Nigatu
- Department of Health Informatics Institute of Public Health University of Gondar, Gondar, Ethiopia
| | - Tesfahun Melese Yilma
- Department of Health Informatics Institute of Public Health University of Gondar, Gondar, Ethiopia
| | - Lemma Derseh Gezie
- Department of Epidemiology and Biostatistics Institute of Public Health University of Gondar, Gondar, Ethiopia
| | - Yonathan Gebrewold
- Department of Radiology School of Medicine University of Gondar, Gondar, Ethiopia
| | | | | | - Binyam Tilahun
- Department of Health Informatics Institute of Public Health University of Gondar, Gondar, Ethiopia
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Karimian S, Rahimi B. A systematic review of effects of exchanging and sharing medical images systems in a sociotechnical context: Evaluation perspectives. INFORMATICS IN MEDICINE UNLOCKED 2023. [DOI: 10.1016/j.imu.2023.101212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/15/2023] Open
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Evaluation of Current and Former Teleradiology Systems in Africa: A Review. Ann Glob Health 2022; 88:43. [PMID: 35814283 PMCID: PMC9231578 DOI: 10.5334/aogh.3711] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 06/15/2022] [Indexed: 11/20/2022] Open
Abstract
Background: Teleradiology has grown tremendously across the globe, providing significant benefits to both patients and physicians. In the late 1990s, South Africa sought to lead teleradiology adoption efforts by creating a national telemedicine system through a structured and phased approach. Although initial reports of the system’s effectiveness were encouraging, the present status of this project, as well as comparable efforts in surrounding developing countries, has remained uncertain. Objective: To explore the status of teleradiology adoption in Africa, identify existing barriers to adoption, and explore potential solutions to the most commonly identified barriers. Methods: A narrative literature review was conducted to find articles that discussed current and past teleradiology systems in Africa. Each item was evaluated for relevance separately based on specified inclusion and exclusion criteria and was used to field further articles if relevant to the topic, even if not found in the initial search. The search began with articles published after January 1995 and included articles through December 2021. Findings: Although teleradiology systems in Africa has shown to have a benefit in improving patient outcomes, current implementation remains limited due to feasibility projects with no singular picture archiving and communication system (PACS) being utilized at the time of writing. Conclusions: Although teleradiology has significant potential and can benefit the developing countries in Africa, further expansion, in terms of both complexity and adoption rates, remains hindered by infrastructure development, clinician and technologist support, and general sociopolitical factors.
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Asukile M, Chishimba L, Chomba M, Mataa M, Mutete F, Mwendaweli N, Yumbe K, Zimba S, Habanyama G, Shampile S, Makupe A, Saylor D. Implementation of a Teleneurology Clinic in Zambia during the COVID-19 Pandemic. Ann Neurol 2022; 91:445-454. [PMID: 35150000 PMCID: PMC9082463 DOI: 10.1002/ana.26323] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Revised: 01/11/2022] [Accepted: 01/24/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The objective of this study was to assess the feasibility, acceptability, and benefits of a teleneurology clinic serving adults usually attending a neurology outpatient clinic in Lusaka, Zambia during the coronavirus disease 2019 (COVID-19) pandemic. METHODS Televisits were offered to patients scheduled for neurology appointments between March and July 2020 using the telephone, WhatsApp video, or Zoom calls based on patient accessibility. Visit outcomes were documented, and patient and neurologist satisfaction surveys were completed. RESULTS Of 323 patients, 195 (60%) were reachable by telephone, 179 of these were alive, and 74% (133/179) of those alive agreed to a televisit. Stroke (30%), seizures (20%), and headache (16%) were the most common diagnoses seen via televisit. Most televisits (80%) were by telephone call, 14% by WhatsApp video call, and 6% by Zoom. Nearly one-third (30%) of the patients were stable and discharged from the clinic, 32% only required medication refills, and 19% required an in-person visit. Sixty patients (out of 85 reachable and 71% response rate) and 7 of 9 neurologists (78% response rate) completed satisfaction surveys. Neurologists reported greater assessment confidence with Zoom, but confidence was high for all modalities. Patients preferring televisits (75%, 45/60) noted reduced expense and time requirements, whereas those preferring in-person visits (22%, 13/60) cited the desire for physical examinations. Overall, 98% of patients and 100% of neurologists were satisfied with televisits. INTERPRETATION Teleneurology visits were acceptable and feasible for adults attending an outpatient neurology clinic in Zambia and their neurologists. They offer a promising supplement to in-person visits in resource-limited settings, even when video-conference capabilities and electronic medical records are absent. ANN NEUROL 2022;91:445-454.
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Affiliation(s)
- Melody Asukile
- Department of Internal MedicineUniversity Teaching HospitalLusakaZambia
| | - Lorraine Chishimba
- Department of Internal MedicineUniversity of Zambia School of MedicineLusakaZambia
| | - Mashina Chomba
- Department of Internal MedicineUniversity of Zambia School of MedicineLusakaZambia
| | - Moses Mataa
- Department of Internal MedicineUniversity Teaching HospitalLusakaZambia
| | - Frighton Mutete
- Department of Internal MedicineUniversity Teaching HospitalLusakaZambia
| | - Naluca Mwendaweli
- Department of Internal MedicineUniversity Teaching HospitalLusakaZambia
- Department of Internal MedicineUniversity of Zambia School of MedicineLusakaZambia
| | - Kunda Yumbe
- Department of Internal MedicineUniversity Teaching HospitalLusakaZambia
| | - Stanley Zimba
- Department of Internal MedicineUniversity Teaching HospitalLusakaZambia
| | - Gloria Habanyama
- Department of Internal MedicineUniversity Teaching HospitalLusakaZambia
| | | | | | - Deanna Saylor
- Department of Internal MedicineUniversity Teaching HospitalLusakaZambia
- Department of NeurologyJohns Hopkins University School of MedicineBaltimoreMD
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Tahir MY, Mars M, Scott RE. A review of teleradiology in Africa – Towards mobile teleradiology in Nigeria. SA J Radiol 2022; 26:2257. [PMID: 35169498 PMCID: PMC8832073 DOI: 10.4102/sajr.v26i1.2257] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 10/18/2021] [Indexed: 11/26/2022] Open
Abstract
eHealth is promoted as a means to strengthen health systems and facilitate universal health coverage. Sub-components (e.g. telehealth, telemedicine, mhealth) are seen as mitigators of healthcare provider shortages and poor rural and remote access. Teleradiology (including mobile teleradiology), widespread in developed nations, is uncommon in developing nations. Decision- and policy-makers require evidence to inform their decisions regarding implementation of mobile teleradiology in Nigeria and other sub-Saharan countries. To gather evidence, Scopus and PubMed were searched using defined search strings (September 2020). Duplicates were removed, and titles and abstracts reviewed using specified selection criteria. Full-text papers of selected resources were retrieved and reviewed against the criteria. Insight from included studies was charted for eight a priori categories of information: needs assessment, implementation, connectivity, evaluation, costing, image display, image capture and concordance. Fifty-seven articles were identified, duplicates removed and titles and abstracts of remaining articles reviewed against study criteria. Twenty-six papers remained. After review of full-texts, ten met the study criteria. These were summarised, and key insights for the eight categories were charted. Few papers have been published on teleradiology in sub-Saharan Africa. Teleradiology, including mobile teleradiology, is feasible in sub-Saharan Africa for routine X-ray support of patients and healthcare providers in rural and remote locations. Former technical issues (image quality, transmission speed, image compression) have been largely obviated through the high-speed, high-resolution digital imaging and network transmission capabilities of contemporary smartphones and mobile networks, where accessible. Comprehensive studies within the region are needed to guide the widespread introduction of mobile teleradiology.
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Affiliation(s)
- Mohammed Y Tahir
- Department of TeleHealth, College of Health Sciences, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
- Medical Imaging Informatics ISID, King Abdulaziz Medical City, Jeddah, Saudi Arabia
| | - Maurice Mars
- Department of TeleHealth, College of Health Sciences, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Richard E Scott
- Department of TeleHealth, College of Health Sciences, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
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Adebayo PB, Oluwole OJ, Taiwo FT. COVID-19 and Teleneurology in Sub-Saharan Africa: Leveraging the Current Exigency. Front Public Health 2021; 8:574505. [PMID: 33569366 PMCID: PMC7868436 DOI: 10.3389/fpubh.2020.574505] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Accepted: 12/30/2020] [Indexed: 12/22/2022] Open
Abstract
Africa has over 1.3 billion inhabitants, with over 60% of this population residing in rural areas that have poor access to medical experts. Despite having a ridiculously huge, underserved population, very few African countries currently have any form of sustained and organized telemedicine practice, and even fewer have dedicated tele-neurology services. The ongoing COVID-19 pandemic has proved to be one of the most significant disruptors of vital sectors of human endeavor in modern times. In the healthcare sector, there is an increasing advocacy to deliver non-urgent care via telemedicine. This paper examined the current state of tele-neurology practice and infrastructural preparedness in sub-Saharan Africa. Currently, there is over 70% mobile phone penetration in most of the countries and virtually all of them have mobile internet services of different technologies and generations. Although the needed infrastructure is increasingly available, it should be improved upon. We have proposed the access, costs, ethics, and support (ACES) model as a bespoke, holistic strategy for the successful implementation and advancement of tele-neurology in sub-Saharan Africa.
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Affiliation(s)
- Philip Babatunde Adebayo
- Neurology Section, Department of Internal Medicine, Aga Khan University, Dar es Salaam, Tanzania
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Fry MW, Saidi S, Musa A, Kithyoma V, Kumar P. "Even though I am alone, I feel that we are many" - An appreciative inquiry study of asynchronous, provider-to-provider teleconsultations in Turkana, Kenya. PLoS One 2020; 15:e0238806. [PMID: 32931503 PMCID: PMC7491713 DOI: 10.1371/journal.pone.0238806] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Accepted: 08/23/2020] [Indexed: 01/29/2023] Open
Abstract
Non-physician clinicians (NPCs) in low and middle-income countries (LMICs) often have little physical proximity to the resources-equipment, supplies or skills-needed to deliver effective care, forcing them to refer patients to distant sites. Unlike equipment or supplies, which require dedicated supply chains, physician/specialist skills needed to support NPCs can be sourced and delivered through telecommunication technologies. In LMICs however, these skills are scarce and sparsely distributed, making it difficult to implement commonly used real-time (synchronous), hub-and-spoke telemedicine paradigms. An asynchronous teleconsultations service was implemented in Turkana County, Kenya, connecting NPCs with a volunteer network of remote physicians and specialists. In 2017-18, the service supported over 100 teleconsultations and referrals across 20 primary healthcare clinics and two hospitals. This qualitative study aimed to explore the impact of the telemedicine intervention on health system stakeholders, and perceived health-related benefits to patients. Data were collected using Appreciative Inquiry, a strengths-based, positive approach to assessing interventions and informing systems change. We highlight the impact of provider-to-provider asynchronous teleconsultations on multiple stakeholders and healthcare processes. Provider benefits include improved communication and team work, increased confidence and capacity to deliver services in remote sites, and professional satisfaction for both NPCs and remote physicians. Health system benefits include efficiency improvements through improved care coordination and avoiding unnecessary referrals, and increased equity and access to physician/specialist care by reducing geographical, financial and social barriers. Providers and health system managers recognised several non-health benefits to patients including increased trust and care seeking from NPCs, and social benefits of avoiding unnecessary referrals (reduced social disruption, displacement and costs). The findings reveal the wider impact that modern teleconsultation services enabled by mobile technologies and algorithms can have on LMIC communities and health systems. The study highlights the importance of viewing provider-to-provider teleconsultations as complex health service delivery interventions with multiple pathways and processes that can ultimately improve health outcomes.
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Affiliation(s)
| | | | - Abdirahman Musa
- Ministry of Health Services & Sanitation, Turkana County, Kenya
| | | | - Pratap Kumar
- Health-E-Net Limited, Nairobi, Kenya
- Institute of Healthcare Management, Strathmore University Business School, Nairobi, Kenya
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Weikert T, Sommer G, Tamm M, Haegler P, Cyriac J, Sauter AW, Hostettler K, Bremerich J. Centralized expert HRCT Reading in suspected idiopathic pulmonary fibrosis: Experience from an Eurasian teleradiology program. Eur J Radiol 2019; 121:108719. [PMID: 31706232 DOI: 10.1016/j.ejrad.2019.108719] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 10/08/2019] [Accepted: 10/19/2019] [Indexed: 11/17/2022]
Abstract
PURPOSE To share experience from a large, ongoing expert reading teleradiology program in Europe and Asia aiming at supporting referring centers to interpret high-resolution computed tomography (HRCT) with respect to presence of Usual Interstitial Pneumonia (UIP)-pattern in patients with suspected Idiopathic Pulmonary Fibrosis (IPF). METHOD We analyzed data from 01/2014 to 05/2019, including HRCTs from 239 medical centers in 12 European and Asian countries that were transmitted to our Picture Archiving and Communication System (PACS) via a secured internet connection. Structured reports were generated in consensus by a radiologist with over 20 years of experience in thoracic imaging and a pulmonologist with specific expertise in interstitial lung disease according to current guidelines on IPF. Reports were sent to referring physicians. We evaluated patient characteristics, technical issues, report turnaround times and frequency of diagnoses. We also conducted a survey to collect feedback from referring physicians. RESULTS HRCT image data from 703 patients were transmitted (53.5% male). Mean age was 63.7 years (SD:17). In 35.1% of all cases diagnosis was "UIP"/"Typical UIP". The mean report turnaround time was 1.7 days (SD:2.9). Data transmission errors occurred in 7.1%. Overall satisfaction rate among referring physicians was high (8.4 out of 10; SD:3.2). CONCLUSIONS This Eurasian teleradiology program demonstrates the feasibility of cross-border teleradiology for the provision of state-of-the-art reporting despite heterogeneity of referring medical centers and challenges like data transmission errors and language barriers. We also point out important factors for success like the usage of structured reporting templates.
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Affiliation(s)
- Thomas Weikert
- University Hospital Basel, University of Basel, Department of Radiology, Petersgraben 4, 4031 Basel, Switzerland.
| | - Gregor Sommer
- University Hospital Basel, University of Basel, Department of Radiology, Petersgraben 4, 4031 Basel, Switzerland.
| | - Michael Tamm
- University Hospital Basel, University of Basel, Clinics of Respiratory Medicine, Petersgraben 4, 4031 Basel, Switzerland.
| | - Patrizia Haegler
- Boehringer Ingelheim (Switzerland) GmbH, Hochbergerstrasse 60B, 4057 Basel, Switzerland.
| | - Joshy Cyriac
- University Hospital Basel, University of Basel, Department of Radiology, Petersgraben 4, 4031 Basel, Switzerland.
| | - Alexander W Sauter
- University Hospital Basel, University of Basel, Department of Radiology, Petersgraben 4, 4031 Basel, Switzerland.
| | - Katrin Hostettler
- University Hospital Basel, University of Basel, Clinics of Respiratory Medicine, Petersgraben 4, 4031 Basel, Switzerland.
| | - Jens Bremerich
- University Hospital Basel, University of Basel, Department of Radiology, Petersgraben 4, 4031 Basel, Switzerland.
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Sarfo FS, Adamu S, Awuah D, Ovbiagele B. Tele-neurology in sub-Saharan Africa: A systematic review of the literature. J Neurol Sci 2017; 380:196-199. [PMID: 28870567 DOI: 10.1016/j.jns.2017.07.037] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2017] [Accepted: 07/25/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND The rapid advancement in telecommunications on the African continent has opened up avenues for improving medical care to underserved populations. Although the greatest burden of neurological disorders is borne by Low-and-Middle Income Countries (LMICs) including sub-Saharan Africa (SSA), there is a profound paucity of neurologists to serve the population. Telemedicine presents a promising avenue for effective mobilization and utilization of the few neurologists in Africa. OBJECTIVE To systematically review the published literature on the use of telemedicine for improved care and outcomes for patients with neurological disorders in SSA. METHODS We searched PubMed and Cochrane library from January 1, 1980 to April 30, 2017 using the following keywords: "Telemedicine neurology Africa", "Teleneurology Africa", "Telestroke Africa", "Telerehabilitation Africa", "Telemedicine for epilepsy", "Telemedicine for Parkinson's disease Africa", "Telemedicine for dementia Africa", "Telehealth neurology Africa". Our inclusion criteria were randomized controlled trials, or case series that reported the utilization of telemedicine for care/education of individuals with neurological disorders in sub-Saharan Africa. RESULTS This search yielded 6 abstracts. By consensus between two investigators, 1 publication met the criteria for inclusion and further review. The one study identified utilized telemedicine for the purpose of improving education/knowledge of 16 doctors and 17 allied health professionals in Parkinson's disease (PD) in Cameroon. The study noted feasibility and satisfaction of participants with telemedicine as well as improved knowledge base of participants after the educational course but noted access to healthcare by patients did not change. No studies have evaluated the use of telemedicine for care of patients with neurological disorders. CONCLUSION The indication is that teleneurology may be feasible in SSA and studies are needed to assess feasibility, acceptability, efficacy, cost-effectiveness of this promising discipline of neurology in these resource-limited settings. We propose the setting up of trans‑continental, inter-regional, intra-regional, and national networks of neurologists to utilize teleneurology platforms to improve the reach of neurology care in SSA.
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Affiliation(s)
- Fred S Sarfo
- Kwame Nkrumah University of Science and Technology, Kumasi, Ghana; Komfo Anokye Teaching Hospital, Kumasi, Ghana.
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[Nursing care in telemedicine and telehealth across the world]. SOINS; LA REVUE DE RÉFÉRENCE INFIRMIÈRE 2017; 61:57-59. [PMID: 27894484 DOI: 10.1016/j.soin.2016.09.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Developments in cyberhealth are now accessible to all patients and healthcare professionals. These tools enable expert advice to be provided remotely and ensure a continuity of care for all those who need it. Telecare is developing across the world, as are networks of nurses who practise it and researchers who analyse the results.
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Latifi R, Gunn JKL, Bakiu E, Boci A, Dasho E, Olldashi F, Pipero P, Stroster JA, Qesteri O, Kucani J, Sulo A, Oshafi M, Osmani KL, Dogjani A, Doarn CR, Shatri Z, Kociraj A, Merrell RC. Access to Specialized Care Through Telemedicine in Limited-Resource Country: Initial 1,065 Teleconsultations in Albania. Telemed J E Health 2016; 22:1024-1031. [PMID: 27219617 DOI: 10.1089/tmj.2016.0050] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To analyze the initial experience of the nationwide clinical telemedicine program of Albania, as a model of implementation of telemedicine using "Initiate-Build-Operate-Transfer" strategy. METHODS This was a retrospective study of prospectively collected data from teleconsultations in Albania between January 1, 2014 and August 26, 2015, delivered synchronously, asynchronously, or a combination of both methods. Patient's demographics, mode of consultation, clinical specialty, hospitals providing referral and consultation, time from initial call to completion of consultation, and patient disposition following teleconsultation were analyzed. Challenges of the newly created program have been identified and analyzed as well. RESULTS There were 1,065 teleconsultations performed altogether during the study period. Ninety-one patients with autism managed via telemedicine were not included in this analysis and will be reported separately. Of 974 teleconsults, the majority were for radiology, neurotrauma, and stroke (55%, 16%, and 10% respectively). Asynchronous technology accounted for nearly two-thirds of all teleconsultations (63.7%), followed by combined (24.3%), and then synchronous (12.0%). Of 974 cases, only 20.0% of patients in 2014 and 22.72% of patients in 2015 were transferred to a tertiary hospital. A majority (98.5%) of all teleconsultations were conducted within the country itself. CONCLUSIONS The Integrated Telemedicine and e-Health program of Albania has become a useful tool to improve access to high-quality healthcare, particularly in high demanding specialty disciplines. A number of challenges were identified and these should serve as lessons for other countries in their quest to establish nationwide telemedicine programs.
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Affiliation(s)
- Rifat Latifi
- 1 Department of Surgery, Westchester Medical Center and New York Medical College , Valhalla, New York.,2 Department of Surgery, University of Arizona , Tucson, Arizona.,3 International Virtual e-Hospital Foundation and Integrated Telemedicine and e-Health Program of Albania , Tirana, Albania
| | - Jayleen K L Gunn
- 3 International Virtual e-Hospital Foundation and Integrated Telemedicine and e-Health Program of Albania , Tirana, Albania .,4 Department of Epidemiology and Biostatistics, University of Arizona , Tucson, Arizona
| | - Evis Bakiu
- 3 International Virtual e-Hospital Foundation and Integrated Telemedicine and e-Health Program of Albania , Tirana, Albania
| | - Arian Boci
- 3 International Virtual e-Hospital Foundation and Integrated Telemedicine and e-Health Program of Albania , Tirana, Albania
| | - Erion Dasho
- 3 International Virtual e-Hospital Foundation and Integrated Telemedicine and e-Health Program of Albania , Tirana, Albania
| | - Fatos Olldashi
- 3 International Virtual e-Hospital Foundation and Integrated Telemedicine and e-Health Program of Albania , Tirana, Albania .,5 Department of Neurosurgery, University Trauma Hospital , Tirana, Albania
| | - Pellumb Pipero
- 3 International Virtual e-Hospital Foundation and Integrated Telemedicine and e-Health Program of Albania , Tirana, Albania
| | - John A Stroster
- 3 International Virtual e-Hospital Foundation and Integrated Telemedicine and e-Health Program of Albania , Tirana, Albania
| | - Orland Qesteri
- 3 International Virtual e-Hospital Foundation and Integrated Telemedicine and e-Health Program of Albania , Tirana, Albania
| | - Julian Kucani
- 3 International Virtual e-Hospital Foundation and Integrated Telemedicine and e-Health Program of Albania , Tirana, Albania
| | - Ardi Sulo
- 3 International Virtual e-Hospital Foundation and Integrated Telemedicine and e-Health Program of Albania , Tirana, Albania
| | - Manjola Oshafi
- 3 International Virtual e-Hospital Foundation and Integrated Telemedicine and e-Health Program of Albania , Tirana, Albania
| | - Kalterina L Osmani
- 3 International Virtual e-Hospital Foundation and Integrated Telemedicine and e-Health Program of Albania , Tirana, Albania
| | - Agron Dogjani
- 3 International Virtual e-Hospital Foundation and Integrated Telemedicine and e-Health Program of Albania , Tirana, Albania .,6 Trauma Section, University Trauma Hospital , Tirana, Albania
| | - Charles R Doarn
- 7 Department of Family and Community Medicine, University of Cincinnati , Cincinnati, Ohio
| | | | | | - Ronald C Merrell
- 3 International Virtual e-Hospital Foundation and Integrated Telemedicine and e-Health Program of Albania , Tirana, Albania
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