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Third EHTEL ConferenceBrugge (Belgium), 28-29 November 2002

byProf. Leonid Androuchko

Rapporteur Telemedicine Study Group of the Telecommunication Development Bureau/International Telecommunication Union

Professor of Telecommunication at the International University, Geneva

How developing countries can benefit from e-health solutions

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Who needs telemedicine ?

• Patient who does not have easy access to health care:- lack of doctors/specialists- distance- preparation/transportation- medical conditions- social conditions- emergency

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Telemedicine applications for developing countries

• Primary health care

• Consultations with specialists

• Medical emergencies and disaster relief

• Access to specialized databases

• Provision of medical and health care information services

• Training

• Public health monitoring

• Etc.

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Telemedicine or e-health, where distance is a critical factor,

is the delivery of health care services byhealth care professionals using information and

communication technologies for the exchange of valid information for diagnosis,

treatment and prevention of disease and injuries, and for continuing education of

health care providersas well as research and evaluation.

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During the past few years, the BDT/ITU implemented a number of pilot projects in

developing countries in order to gain experience and to identify the suitable technologies and useful applications.

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BDT telemedicine missions1996: Cameroon

Mozambique

TanzaniaUganda

1997: BhutanViet Nam

1998: GeorgiaMongoliaSenegal

2000: EthiopiaGuineaUzbekistan

2001: Nicaragua2002: Zimbabwe

Cameroon

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BDT telemedicine projects

MozambiquePhase I: Teleradiology link between hospitals in Maputo and BeiraPhase II: Extension to Nampula and upgrading to ISDN connection (October 2002)

GeorgiaTranstelephonic electro-cardiogram monitoring

MaltaTelemedicine link between hospitals in Malta and Gozo

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MyanmarMedical information/communication system for the General Hospital in Yangon and a teleradiology link between this hospital and the University Medical School

UgandaTelemedicine network between Memga and Mulago hospitals in Kampala

SenegalTelemedicine network

UkraineIntroduction of a PBX-based mobile personal handy-phone system in the Ukrainian central emergency and trauma hospital in Kiev

NicaraguaTelemedicine network

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Future potential projects

Ethiopia: Telemedicine network Lebanon: Teleconsultation medical network for

Ain Weizein Hospital Uzbekistan: Teleconsultation system for the Centre of

Emergency Medicine Regional telemedicine project for teleconsultations

for the Arab States Regional/Global telemedicine project for continuous

medical education for developing countries Telemedicine Alliance project (WHO/ESA/ITU):

funded by the European Commission, operational from August 02.

Telemedicine projects in Guinea, Zimbabwe, Cameroon, Kenya, Oman, Bulgaria

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• 5 main islands

• 13,677 small islands

• Population 212 million

• Bandung Institute of Technology is a leader in promoting telemedicine

Indonesia

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WTDC-94 (Buenos Aires)Question 6/2

The Conference noted that the widespread use oftelemedicine services could allow universal access to

health and, consequently, facilitate the solution of the principal health problems, particularly in areas

where medical services are non-existent.

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RTDC-96 (Abidjan)Res.7 Telemedicine in Africa

Telemedicine demonstration took place during the conference, in which doctors

from Abidjan were consultingwith medical specialists in

Milan (Italy) and Toulouse (France) oncardiographic and dermatological cases.

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RTDC-96 (Beirut)

Recommendation onTelemedicine in the Arab States

The recommendation invites all Arab countriesto promote collaboration between

health care officials and telecom operatorsin order to identify solutions to meet

the health care needs.

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July 1997 (Portugal): First World Telemedicine Symposium for developing countries.

December 1997 (Geneva): World Health Organization convened an international consultation on telemedicine in relation to the development of their Health-for-All policy for the 21st century.

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WTDC-98 (Valetta)

ITU-D Study Group 2 presented the reportTelemedicine and developing countries.

The conference approved a recommendation promoting telemedicine pilot projects and a new Question (14/2) on telemedicine.

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June 1999 (Buenos Aires): Second World Telemedicine Symposium for developing countries

December 1999 (Moscow): Sub-regional seminar on telemedicine for CIS and Baltic States, jointly organized by the Telemedicine Foundation (Russia) and ITU

December 2001 (Cairo): Telemedicine workshop for the Arab States, jointly organized by UNIDO, WHO and ITU

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WTDC-02 (Istanbul)

ITU-D Study Group 2 presented the report Fostering the application of telecommunication in health care: Identifying and documenting success factors for implementing telemedicine

Res.41 on E-Health (including Telehealth/Telemedicine)

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Resolution 41 requests ITU• to continue its efforts to raise the awareness of

decision-makers, health professionals, partners, beneficiaries and other key players about the benefit of telecommunications for e-health applications;

• to continue to support e-health projects in collaboration with government, public, private, national and international partners, in particular with the World Health Organization (WHO);

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• to encourage collaboration on e-health projects on regional level;

• to set up, within existing budgetary resources, a fund for telecommunication facilities for e-health, and introduce e-health training the the centres of excellence;

• to promote, facilitate and provide technical support and training in information and communication technologies for e-health;

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• to work with the health sector to identify models for sustainability of e-health applications, particularly in remote and rural areas of developing countries, exploring possibilities for sharing infrastructure with other services and applications.

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The Resolution also requests the Member States of the ITU to consider the establishment of a national committee/task force comprising representatives from both the telecommunication and the health sector in order to assist with awareness-raising at national level, and with the formulation of feasible telemedicine projects.

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Successful introduction of telemedicine services requires more than just the delivery of

the right hardware to the users.

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It is far more important in each case to find the right method of incorporating telemedicine services into the medical practice and routine clinical consultations, and to teach the local medical staff how to operate and maintain the equipment.

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Forthcoming events in 2003

Luxembourg, 10-13 April: Telemedicine and TelecareInternational Trade Fare

Geneva, May:Workshop on“Standardization in E-Health”