In June 2006, the African Medical and Research Foundation (AMREF) completed an end of project evaluation of the very successful pilot of the Telemedicine Outreach Programme. Computer Aid was involved in supporting this project through the supply of computers and other technologies to AMREF. This involved 4 trial sites (2 in Kenya and 2 in Tanzania) and, during its implementation, the project demonstrated clearly that, when properly managed, ICT can vastly improve the quality of healthcare and improve access to it for rural populations in a cost-efficient manner. The original concept was to electronically connect rural healthcare facilities to academic medical centres in the cities in a regional health intranet, enabling access to bodies of medical knowledge that were previously inaccessible. In this way healthcare is taken to the patient rather than the other way round – a principle at the heart of AMREF’s approach to patient care. The achievements from the pilot project are: • All the pilot sites are now able to use the installed ICT system to send lists of patients with an initial diagnosis and inform the Outreach Programme management of the condition of the patients. This helps to prepare the specialists, equipment and supplies required for the outreach visits. For surgical specialists, theatres can now be prepared prior to the visits and the time taken to diagnose patients before surgery has also been reduced. • Specialists can now assist medical staff in remote hospitals to attend to patients by receiving patients’ notes, x-rays and photographs of conditions sent as file attachments on emails. Admitted patients can be monitored with the assistance of specialists located in referral hospitals. • The pilot sites can now email prospective drug suppliers for quotations, to place orders and to instruct them to deliver to the nearest town for collection. • Specimens sent to referral hospitals and the AMREF Central Laboratory can be reported through email within 3-7 days after delivery – a substantial improvement on previous waiting times. • Doctors and clinical officers at the pilot sites are now using the internet to search for medical journals and treatment guidelines for patient management. The implementation of the Telemedicine Outreach Programme involves a four-stage process: 1. Computer Aid selects, tests, refurbishes and ships all equipment from London to Nairobi. 2. After the equipment has arrived in Nairobi, a local IT technician accompanies the equipment on AMREF’s existing outreach flights. 3. The equipment is gradually installed in all 41 participating hospitals and all users are trained to a high level of competency. 4. Telemedicine is operational. The IT technician .is always on-call to provide technical support and training The overriding goal of the Telemedicine Outreach Programme is to improve the health of people in remote East Africa through the provision of ICT as a vital component of telemedicine. This will lead to: • Improved triage: urgent or life-threatening cases can be effectively prioritised, thus saving lives. • Improved access to healthcare for patients in remote settings. Patients can benefit from the expertise of specialists without having to travel hundreds of miles to urban hospitals. • Flying doctors have access to patient information before arrival: this means that their useful time ‘on the ground’ is maximised and more people can be treated. • Improved knowledge transfer: rural doctors are at risk of being professionally isolated and, by being able to liaise with experienced specialists, they can continue their practice-based learning and professional development. • Reduced waiting times and shorter delays: it is common sense that the sooner an illness is diagnosed, the more likely it is that the patient will make a full recovery. Telemedicine can and does speed up the process of lab tests, requesting supplies of medicines and the delivery of surgical items. It is no exaggeration to say that the introduction of telemedicine in any setting – particularly in an underdeveloped region such as East Africa – can save lives. Telemedicine allows the time and efforts of AMREF’s medical staff to be put to efficient and productive use. As such, it is a cost-effective and straightforward way of enhancing existing medical resources. For more information please contact Stephen Campbell.