Conference abstract

Paediatric telemedicine: the experience of MSF

Pan African Medical Journal - Conference Proceedings. 2018:9(37).21 Dec 2018.
doi: 10.11604/pamj-cp.2018.9.37.780

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Keywords: MSF telemedicine, resource limits settings, humanitarian paediatrics
Oral presentation

Paediatric telemedicine: the experience of MSF

Raghu Venugopal1,&, Sophie Delaigue1, Daniel Martinez Garcia2, Richard Wootton3, Jaap Karsten4

1Médecins Sans Frontières, Canada, 2Médecins Sans Frontières, Operational Center Geneva, Geneva, Switzerland, 3Médecins Sans Frontières, Collegium Telemedicus, Tromsø, Norway, 4Médecins Sans Frontières, Operational Center Amsterdam, Amsterdam, Netherlands

&Corresponding author
Raghu Venugopal, Médecins Sans Frontières, Canada


Introduction: MSF has operated in resource-limited settings since 1971. In 2010 it launched a telemedicine program to support complex cases. We have reviewed the first 7 years of activities.

Methods: we analysed cases (< 18 years age) submitted from April 2010 to June 2017. Cases were categorized as radiology-only or general. General cases could involve a radiologist and other specialists. We analysed evaluations made by the referrer 21 days after case submission.

Results: a total of 3136 paediatric cases were submitted (56% of all telemedicine cases). During the first three years 368 cases were referred (2/week) and in the last two years 2222 cases were referred (21/week). Of the paediatric cases, 1283 (41%) were radiology-only and 1853 (59%) were general. The median patient age was 3 years (IQR 1 - 8). There were 193 patients aged < 30 days, 972 aged 30 days to 2 years, 1194 aged 2 - 10 years and 566 aged 10 - 18 years. The median allocation time was 0.18 hours (IQR 0.07 - 0.53) and the median specialist answer time was 5.5 hours (IQR 2 - 17). Most general cases received multispecialty support (63%). The median dialogue time for paediatric cases (104 hours) was longer than adult cases (80 hours). There were 300 responses to the 1608 requests for feedback for general cases (19% response rate). More than 90% reported their case was sent to an appropriate specialist, that the response was sufficiently quick and that the teleconsultation provided an educational benefit. The outcome was deemed beneficial for the patient by 48% of respondents.

Conclusion: during the study period, paediatric telemedicine increased with support from headquarters and external specialists. Field teams are satisfied with the efficient and field-adapted support provided and report that it helps them manage their patients. The substantial volume of paediatric cases (more than half of all cases) requires specific case-coordination skills and support from multidisciplinary experts.