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Teledermatology in Low-Resource Settings: The MSF Experience with a Multilingual Tele-Expertise Platform.

Delaigue S, Morand JJ, Olson D, Wootton R, Bonnardot L - Front Public Health (2014)

Bottom Line: The two main issues raised by specialists and/or referrers were the lack of feedback about patient follow-up and the insufficient quality of clinical details and information supplied by referrers.The system clearly delivered a useful service to referrers because the workload rose steadily during the 4-year study period.Nonetheless, user surveys and retrospective analysis suggest that the MSF teledermatology system can be improved by providing guidance on best practice, using pre-filled referral forms, following-up the cases after teleconsultation, and establishing standards for clinical photography.

View Article: PubMed Central - PubMed

Affiliation: Dermatology Department, Hopital Nord , Marseille , France.

ABSTRACT

Introduction: In 2010, Médecins Sans Frontières (MSF) launched a tele-expertise system to improve the access to specialized clinical support for its field health workers. Among medical specialties, dermatology is the second most commonly requested type of tele-expertise. The aim of the present study was to review all MSF teledermatology cases in the first 4 years of operation. Our hypothesis was that the review would enable the identification of key areas for improvement in the current MSF teledermatology system.

Methods: We carried out a retrospective analysis of all dermatology cases referred by MSF field doctors through the MSF platform from April 2010 until February 2014. We conducted a quantitative and qualitative analysis based on a survey sent to all referrers and specialists involved in these cases.

Results: A total of 65 clinical cases were recorded by the system and 26 experts were involved in case management. The median delay in providing the first specialist response was 10.2 h (IQR 3.7-21.1). The median delay in allocating a new case was 0.96 h (IQR 0.26-3.05). The three main countries of case origin were South Sudan (29%), Ethiopia (12%), and Democratic Republic of Congo (10%). The most common topics treated were infectious diseases (46%), inflammatory diseases (25%), and genetic diseases (14%). One-third of users completed the survey. The two main issues raised by specialists and/or referrers were the lack of feedback about patient follow-up and the insufficient quality of clinical details and information supplied by referrers.

Discussion: The system clearly delivered a useful service to referrers because the workload rose steadily during the 4-year study period. Nonetheless, user surveys and retrospective analysis suggest that the MSF teledermatology system can be improved by providing guidance on best practice, using pre-filled referral forms, following-up the cases after teleconsultation, and establishing standards for clinical photography.

No MeSH data available.


Related in: MedlinePlus

Confirmed histoid leprosy.
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Related In: Results  -  Collection

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Figure 2: Confirmed histoid leprosy.

Mentions: Most of the cases were focused on diagnosis issues. Among the 65 cases, 43 were tagged as dermatological cases (i.e., group 1) and 22 were cross-specialty cases (i.e., group 2). The three main specialties involved in these cases were infectious diseases (10), pediatrics (8), and internal medicine (4). Examples of these cross-specialty cases are given in Figures 2–4.


Teledermatology in Low-Resource Settings: The MSF Experience with a Multilingual Tele-Expertise Platform.

Delaigue S, Morand JJ, Olson D, Wootton R, Bonnardot L - Front Public Health (2014)

Confirmed histoid leprosy.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4231841&req=5

Figure 2: Confirmed histoid leprosy.
Mentions: Most of the cases were focused on diagnosis issues. Among the 65 cases, 43 were tagged as dermatological cases (i.e., group 1) and 22 were cross-specialty cases (i.e., group 2). The three main specialties involved in these cases were infectious diseases (10), pediatrics (8), and internal medicine (4). Examples of these cross-specialty cases are given in Figures 2–4.

Bottom Line: The two main issues raised by specialists and/or referrers were the lack of feedback about patient follow-up and the insufficient quality of clinical details and information supplied by referrers.The system clearly delivered a useful service to referrers because the workload rose steadily during the 4-year study period.Nonetheless, user surveys and retrospective analysis suggest that the MSF teledermatology system can be improved by providing guidance on best practice, using pre-filled referral forms, following-up the cases after teleconsultation, and establishing standards for clinical photography.

View Article: PubMed Central - PubMed

Affiliation: Dermatology Department, Hopital Nord , Marseille , France.

ABSTRACT

Introduction: In 2010, Médecins Sans Frontières (MSF) launched a tele-expertise system to improve the access to specialized clinical support for its field health workers. Among medical specialties, dermatology is the second most commonly requested type of tele-expertise. The aim of the present study was to review all MSF teledermatology cases in the first 4 years of operation. Our hypothesis was that the review would enable the identification of key areas for improvement in the current MSF teledermatology system.

Methods: We carried out a retrospective analysis of all dermatology cases referred by MSF field doctors through the MSF platform from April 2010 until February 2014. We conducted a quantitative and qualitative analysis based on a survey sent to all referrers and specialists involved in these cases.

Results: A total of 65 clinical cases were recorded by the system and 26 experts were involved in case management. The median delay in providing the first specialist response was 10.2 h (IQR 3.7-21.1). The median delay in allocating a new case was 0.96 h (IQR 0.26-3.05). The three main countries of case origin were South Sudan (29%), Ethiopia (12%), and Democratic Republic of Congo (10%). The most common topics treated were infectious diseases (46%), inflammatory diseases (25%), and genetic diseases (14%). One-third of users completed the survey. The two main issues raised by specialists and/or referrers were the lack of feedback about patient follow-up and the insufficient quality of clinical details and information supplied by referrers.

Discussion: The system clearly delivered a useful service to referrers because the workload rose steadily during the 4-year study period. Nonetheless, user surveys and retrospective analysis suggest that the MSF teledermatology system can be improved by providing guidance on best practice, using pre-filled referral forms, following-up the cases after teleconsultation, and establishing standards for clinical photography.

No MeSH data available.


Related in: MedlinePlus