Wednesday, November 18, 2015

Telemedicine in Rural Haiti

Advances in information technology have revolutionized health care in developed countries, and we have use low-cost, user friendly technology in a rural hospital in Haiti with considerable success. Despite deficiencies in electricity, clean water and sanitation, much of Haiti has been wired to the internet by Digicel, an Irish Communications Company. We are now able to receive pathology and radiology reports in a timely fashion, contact patients (someone in a neighborhood or village will have an inexpensive cell phone), and communicate readily with colleagues both in Haiti and in the United States. Two technologies have been particularly useful: the development of patient tracking and data collection systems, and telemedicine.

A unique patient tracking system. Patients’ compliance in return visits to clinic is a major problem encountered in practicing medicine in rural, underserved areas.  Carson Crane, MFP’s information technology specialist, developed a unique computer program that assists us in tracking and finding patients as well as alerting us to delays in laboratory reporting or patient follow-up. Consequently, we now have a nearly 100% patient follow-up. This is remarkable since many of our patients come many miles over difficult terrain to attend or hospital clinics and rural dispensaries. Further, MFP health professionals in the U.S. can monitor patient data in real time during clinic visits of difficult patients of particular concern to us.

Telemedicine. Simple, low-cost communication technologies hold promise to bring expert medical consultation to remote medical facilities in the developing world who do not have access to specialists.  Carson has developed a unique, secure MFP website for Medicine for Peace that primary care physicians in Haiti can easily access to receive consultations by MFP dermatology experts in the United States.

Teledermatology consultations consist of a primary care physician in Haiti sending a clinical history of a patient and images of the patient’s skin lesion on the secure website. Within twenty-four hours an expert MFP dermatologist in the United States interprets the history and the images, and provides a diagnosis and recommendations for treatment. The system put in place is in accordance with guidelines put forward by the American Academy of Dermatology Task Force on Teledermatology. This service not only provides expert consultation to Haitian patients living in a remote area of the country, but provides a teaching opportunity between care givers in the United States and Haiti.

Our Women’s Health Initiative will benefit from this technology as we are now instituting similar  technology for physicians in the U.S. to offer consultation on problematic cervical examinations in our cervical cancer prevention program.