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Telemedicine as a tool for EuropeAfrica cooperation: a practical experience Manuel Dinis INOVETEL SA Luanda, Angola AFRICOMM 2009 1st International ICST Conference on e-Infrastructure and e-Services for Developing Countries 03-04 December 2009 - Maputo, Mozambique This document is intellectual property of INOETEL, SA and it´s use or spread is prohibited without express written permission.
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Overview Introduction
Telemedicine and its advantages
Telemedicine platform
Telemedicine experience
Telemedicine plans Conclusions
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Introduction • This talk addresses the experience of an Europe-Africa telemedicine network, focused on the pediatric area, and involving hospitals located in Luanda (Angola), Benguela (Angola), Praia (Cape Verde) and Coimbra (Portugal).
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Overview Introduction
Telemedicine and its advantages
Telemedicine platform
Telemedicine experience
Telemedicine plans Conclusions
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Telemedicine and its advantages (I) • Telemedicine is usually defined as the rapid access to remote medical expertise by means of telecommunications and information technologies regardless of where the patient, the physician and the relevant patient information are located. • By using modern telemedicine systems, various health related activities can be performed remotely, namely: – Teleconsultation – Telediagnostic – Telemonitoring
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Telemedicine and its advantages (II) • The following advantages are commonly accepted for what concerns the benefits of telemedicine: – – – – – –
Cost reduction and the process efficiency increase; Medical knowledge sharing and continuous training; Decrease on the number of patient transfers between hospitals; Decrease on the number of unnecessary hospitalizations; Availability of specialized services far from big urban centers; Increase on the patient satisfaction due to faster and more accurate diagnostic.
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Telemedicine and its advantages (III) • The utilization of telemedicine systems seems especially suitable in the following cases: – Initial and urgent assessment of patients in order to decide where they have to be transferred to specialized healthcare units; – Rapid access to a specialized second opinion; – Remote monitoring of post-hospitalization and post-surgical cases; – Regular medical teleconsultations; – Transmission of medical images for remote diagnostic; – Continuous remote monitoring of risky patient status; – Remote monitoring of patients with chronic diseases.
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Telemedicine and its advantages (IV) • Telemedicine is especially suitable for countries with a large area, low population density, reduced transport facilities and lack of human resources in the medical and nursing areas, mainly the lack of specialised doctors. • African countries have usually these characteristics, like for instance Angola, Cape Verde, etc. • The speaking language is also an important factor for the establishment of Telemedicine networks, in our particular case the Portuguese language.
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Portuguese speaking countries
Portugal 11 M Cabo Verde 550 K
Brasil 190 M
Guiné Bissau 1,4 M Guiné Eq. 480 K S.T. Principe. 170 K Angola 16 M
Timor 1M Moçambique 20 M
241 Million 39M in Africa
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Overview Introduction
Telemedicine and its advantages
Telemedicine platform
Telemedicine experience
Telemedicine plans Conclusions
16-12-2009
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Telemedicine platform Medigraf® (I)
Platform developed by PT Inovação SA
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Telemedicine platform Medigraf® (II) • The platform’s software has a number of features which are shortly enumerated bellow: – – – – – – – – – –
Multi-user access with login and password authentication; Encrypted communications over IP (Internet Protocol); Videoconference features; Collaborative work environment; Teleconsultation record management and storage; Interface to digital cameras, scanners and film digitizers; Real time transmission of clinical exams; Integrated DICOM image visualization and manipulation tool; Integration with Healthcare Information Systems and PACS; Web-based access, in intranet, for system and clinical data management.
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Overview Introduction
Telemedicine and its advantages
Telemedicine platform
Telemedicine experience
Telemedicine plans Conclusions
16-12-2009
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Long experience… • First telemedicine project was launched more than one decade ago (1998). • Since then the Pediatric Hospital of Coimbra (our partner since the beginning) has engaged in the provisioning of this service to several hospitals and medical centres in Portugal. • Until the end of 2008 approximately 8000 teleconsultations were performed by this hospital in Portugal. • More recently, in November 2007, the teleconsultations have been expanded to Angola via the PEDITEL project, and a few months ago to Cape Verde.
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Evolution of the number of teleconsultations
By Coimbra Pediatric Hospital
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PEDITEL Project (I) • The main goals of this pilot project were to: – Implement the basis for an integrated telemedicine solution in Angola (connecting Luanda and Benguela in its initial phase) for pediatric usage; – Focus the telemedicine activities, at the beginning on the cardiology area and expand later to other medical areas; – Identify and evaluate the use of the most cost effective telecommunications circuit solutions for the interconnection of the healthcare institutions; – Test and evaluate the network behavior and reliability concerning the proposed services; – Use the project resources also for training activities and evaluate its impact on the medical staff and the corresponding trainees; – Evaluate the impact and improvement on the corresponding medical services.
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PEDITEL Project (II) • PT Inovação • ANGOLA TELECOM • MULTITEL • UNITEL • Hospital Pediátrico de Coimbra • Hospital Pediátrico de Luanda • Hospital Provincial de Benguela • HemoPortugal/HemoAngola
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PEDIEL project overview (started Nov. 2007)
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PEDIEL project (phase 1)
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PEDIEL project (phase 2)
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Teleconsultations to Luanda Portugal
Angola
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Number of teleconsultations (International) 300
253 250
220 200
150
100
50
27
0 Nov-Dec 2007
2008
Jan-Out 2009
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Teletrainning to Luanda
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Teleconsultations to Praia Cape Verde Portugal
Building on the PEDITEL project. experience...
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Overview Introduction
Telemedicine and its advantages
Telemedicine platform
Telemedicine experience
Telemedicine plans Conclusions
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Expansion plans • Expansion of the telemedicine network in Angola to other provinces and cities. • Expansion to S. Tomé and Principe island. • Select a Mozambican Hospital partner to expand to Mozambique and find possible local sponsors. • Extend the telemedicine service to Telediagnostic as well to improve also the local capabilities in the Imagiology area. • Organise a Telemedicine Seminar for the PALOP (African Portuguese Speaking Countries) in Cape Verde. • In summary, to create a PALOP Telemedicine network.
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Overview Introduction
Telemedicine and its advantages
Telemedicine platform
Telemedicine experience
Telemedicine plans Conclusions
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In conclusion… A Telemedicine network is being deployed to interconnect the PALOP countries, as well as at national levels.
At medical staff level, a identified benefit was the continuous training, updating and knowledge sharing.
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Several benefits are already visible: decrease of the useless patients transfers, decrease on the number of unnecessary hospitalisations and early identification where the patients have to be transferred (emergency cases)
Telemedicina is not only for countries with lack of specialised doctors or huge size, but a necessary tool to optimise the costs and efficiency of the health system of modern countries as well. 28
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In conclusion… Telemedicine is seen as the only faster way to provide specialised medical services and training to remotes areas.
A major impairment is the lack of telecommunication infrastructures, mainly in remote areas, as well as the cost of the telecommunication circuits.
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Cooperation was even taken further in terms of helping building local surgery facilities and specific training to enable new local medical capabilities.
This Telemedicine network could be expanded to other African countries (not PALOP), mainly to those that have close links and usually accept patients for surgery purposes.
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Manuel Dinis INOVETEL S.A.
[email protected]
Thank you for your attention!
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This document is intellectual property of PT Inovação, SA and it´s use or spread is prohibited without express written permission.