Collaborative action to improve health care in Ethiopia
Most developing countries suffer from a severe shortage of health care
professionals, especially in remote and rural areas. They need improved
communications to link remote clinics and hospitals with urban hospitals
and medical specialists outside the country. They need improvements in
administration of their health care sector (e.g., in management of patient
records). Health care professionals need access to up-to-date medical literature,
both local and international. They need improvements in the provisioning
of rural clinics and hospitals with pharmaceuticals and other medical supplies.
They need to minimise the number of patients referred to distant hospitals
who may already be overwhelmed. They need to raise the level of awareness
about health care practices. They need rapid help in the event of a disaster
or emergency, such as the break-out of Ebola disease in Zaire. Telemedicine
techniques can help. Telemedicine is the use of telecommunications to provide
medical and health care at a distance. Telemedicine is usually taken to
mean curative practices while telehealth includes preventative measures,
but in this leaflet the term is intended to cover both aspects.
Telemedicine services
Examples of the different types of telemedicine and telehealth services
include the following:
Access to data bases
A pressing need for health care professionals in developing countries is
access to data bases which might be a source of information needed to identify
a problem or simply keep up to date with new developments in the field.
There are many types of databases. Some are specialised such as the MEDLINE
and MEDLARS which are based in the United States. There are many telemedicine
sites on the Internet’s World Wide Web. Health-on-the-Net is a non-profit
foundation based in Geneva which has the mission of extending Internet
access to hospitals, including those in developing countries, around the
world. While the Internet can be a rich source of information, it is not
yet commonly available in developing countries and there can be long delays
in finding and downloading information. Delays can be somewhat minimised
by switching off the colour graphics and other fancy capabilities and downloading
just text. Equipment could include · personal computer ·
modem · subscription with an Internet service provider ·
telephone line
Tele-consultation, tele-education and emergency
relief
Telemedicine also includes a simple consultation between two health care
professionals. This consultation can be as simple as a paramedic in a remote
area making telephone or e-mail contact with a doctor in an urban hospital
or telemedicine institute. Telemedicine also includes the on-going medical
education of health care professionals as well as the public. Equipment
could include: · laptop computer with modem · facsimile
· mobile phone (e.g., Inmarsat phone) · e-mail subscription
(e.g., Internet)
Vital signs monitoring
The vital signs of a patient can be monitored and transmitted for diagnosis
by distant doctors, at communications speeds as low as 2400 baud. Simple
devices attached to the patient can monitor and record ECG, pulse rate,
oximetry, blood pressure, and a number of respiratory parameters. Some
products come packed in a lightweight briefcase which can be connected
with any available means of communications. Equipment required includes:
· vital signs monitoring equipment · telephone line
Image transfer and videoconferencing
Another application of telemedicine could be either a videoconference between
doctors and/or the transfer of a medical image by a health care professional
in a rural area to a specialist in an urban hospital. Videoconferencing
equipment includes a video camera, microphones and monitors. Some Windows-based
software products enable a portion of the video screen to be used for a
live videoconference while another portion of the screen is used for display
of medical data. For higher resolution imaging, a snapshot can be taken
of any of the video inputs at any time during the telemedicine session.
Such snapshots give considerably higher resolution than live video. Snapshots
can be saved as Bitmaps, transmitted from a rural hospital or remote site
via a satellite link to consulting physicians who can have the images displayed
on a computer screen using any commercially available Bitmap viewer (e.g.,
Adobe Photoshop, Corel Draw, Paintbrush) or printed out in full colour
for further examination. In addition to software, the equipment needed
could include: · high resolution camera · microphone ·
speaker · scanner · personal computer and video monitor ·
modem · telephone line (e.g., via Inmarsat-B or ISDN) · video
cassette recorder
If you have any question, please contact us : Mr.
Jaroslav Liska, Bilton +420-602 310064, +420-2-4015008
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