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The role of information communication technology (ICT) towards universal health coverage: the first steps of a telemedicine project in Ethiopia.

Shiferaw F, Zolfo M - Glob Health Action (2012)

Bottom Line: Telemedicine implementation does not depend only on technological factors, rather on e-government readiness, enabling policies, multisectoral involvement and capacity building processes.There is no perfect 'one size fits all' technology and the use of combined interoperable applications, according to the local context, is highly recommended.Telemedicine is still in a premature phase of development in Ethiopia and other sub-Saharan African countries, and it remains difficult to talk objectively about measurable impact of its use, even though it has demonstrated practical applicability beyond reasonable doubts.

View Article: PubMed Central - PubMed

Affiliation: Ethiopian Telecommunication, Department of Medical Services, Addis Ababa, Ethiopia. et_fassil@hotmail.com

ABSTRACT

Background: Eighty-five per cent of the Ethiopian population lives in remote areas, without access to modern health services. The limited health care budget, chronic shortage of health care workers and lack of incentives to retain those in remote areas further jeopardize the national health care delivery system. Recently, the application of information communication technology (ICT) to health care delivery and the use of telemedicine have raised hopes.

Objective: This paper analyzes the challenges, failures and successes encountered in setting-up and implementing a telemedicine program in Ethiopia and provides possible recommendations for developing telemedicine strategies in countries with limited resources.

Design: Ten sites in Ethiopia were selected to participate in this pilot between 2004 and 2006 and twenty physicians, two per site, were trained in the use of a store and forward telemedicine system, using a dial-up internet connection. Teledermatology, teleradiology and telepathology were the chosen disciplines for the electronic referrals, across the selected ten sites.

Results: Telemedicine implementation does not depend only on technological factors, rather on e-government readiness, enabling policies, multisectoral involvement and capacity building processes. There is no perfect 'one size fits all' technology and the use of combined interoperable applications, according to the local context, is highly recommended.

Conclusions: Telemedicine is still in a premature phase of development in Ethiopia and other sub-Saharan African countries, and it remains difficult to talk objectively about measurable impact of its use, even though it has demonstrated practical applicability beyond reasonable doubts.

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‘TelemedETH’ telemedicine software developed for use in Ethiopia.
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Figure 0001: ‘TelemedETH’ telemedicine software developed for use in Ethiopia.

Mentions: During project implementation, a telemedicine software from WDS technologies, Switzerland, was trialled. It was found that the software platform minimum clinical data compression rate was too poor, and that to send a 1–2 megabyte (MB) picture could take more than 45 min, using a regular dialup line as was available in 70% of the pilot sites. Moreover the ‘on and off’ internet connection resulted in frequent error messages such as ‘download time expired’. Because of these technical difficulties, a technical task force was established and a new ‘homemade’ open source telemedicine software developed: ‘Telemed-ETH’ (Fig. 1). This software was able to send minimal clinical data in a compression range of 45–60 kb (Fig. 2). The quality of the compressed images assessed by different dermatology and radiology specialists was around 90%, with an overall good quality of the pictures, allowing an appropriate remote consultation and second-opinion gathering.


The role of information communication technology (ICT) towards universal health coverage: the first steps of a telemedicine project in Ethiopia.

Shiferaw F, Zolfo M - Glob Health Action (2012)

‘TelemedETH’ telemedicine software developed for use in Ethiopia.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3318899&req=5

Figure 0001: ‘TelemedETH’ telemedicine software developed for use in Ethiopia.
Mentions: During project implementation, a telemedicine software from WDS technologies, Switzerland, was trialled. It was found that the software platform minimum clinical data compression rate was too poor, and that to send a 1–2 megabyte (MB) picture could take more than 45 min, using a regular dialup line as was available in 70% of the pilot sites. Moreover the ‘on and off’ internet connection resulted in frequent error messages such as ‘download time expired’. Because of these technical difficulties, a technical task force was established and a new ‘homemade’ open source telemedicine software developed: ‘Telemed-ETH’ (Fig. 1). This software was able to send minimal clinical data in a compression range of 45–60 kb (Fig. 2). The quality of the compressed images assessed by different dermatology and radiology specialists was around 90%, with an overall good quality of the pictures, allowing an appropriate remote consultation and second-opinion gathering.

Bottom Line: Telemedicine implementation does not depend only on technological factors, rather on e-government readiness, enabling policies, multisectoral involvement and capacity building processes.There is no perfect 'one size fits all' technology and the use of combined interoperable applications, according to the local context, is highly recommended.Telemedicine is still in a premature phase of development in Ethiopia and other sub-Saharan African countries, and it remains difficult to talk objectively about measurable impact of its use, even though it has demonstrated practical applicability beyond reasonable doubts.

View Article: PubMed Central - PubMed

Affiliation: Ethiopian Telecommunication, Department of Medical Services, Addis Ababa, Ethiopia. et_fassil@hotmail.com

ABSTRACT

Background: Eighty-five per cent of the Ethiopian population lives in remote areas, without access to modern health services. The limited health care budget, chronic shortage of health care workers and lack of incentives to retain those in remote areas further jeopardize the national health care delivery system. Recently, the application of information communication technology (ICT) to health care delivery and the use of telemedicine have raised hopes.

Objective: This paper analyzes the challenges, failures and successes encountered in setting-up and implementing a telemedicine program in Ethiopia and provides possible recommendations for developing telemedicine strategies in countries with limited resources.

Design: Ten sites in Ethiopia were selected to participate in this pilot between 2004 and 2006 and twenty physicians, two per site, were trained in the use of a store and forward telemedicine system, using a dial-up internet connection. Teledermatology, teleradiology and telepathology were the chosen disciplines for the electronic referrals, across the selected ten sites.

Results: Telemedicine implementation does not depend only on technological factors, rather on e-government readiness, enabling policies, multisectoral involvement and capacity building processes. There is no perfect 'one size fits all' technology and the use of combined interoperable applications, according to the local context, is highly recommended.

Conclusions: Telemedicine is still in a premature phase of development in Ethiopia and other sub-Saharan African countries, and it remains difficult to talk objectively about measurable impact of its use, even though it has demonstrated practical applicability beyond reasonable doubts.

Show MeSH