title: Telemedicine--the way ahead for medicine in the developing world.
abstract: An e-mail link with the facility to send high-resolution digital images is a cheap and uncomplicated telemedicine method. The Swinfen Charitable Trust helped establish such a link in Patan Hospital Kathmandu, Nepal in March 2000. Over 12 months using this link 42 telemedicine referrals were sent to specialists throughout the world. Referrals were: 36% respiratory medicine; 21% neurology, 21% dermatology; 14% cardiology; 5% nephrology; and 3% radiology--28 had digital pictures attached, of which 96% were of high enough quality on which specialists were able to comment. Thirty-nine replies were received. The average time for a specialist reply was 2 days, and 45% were answered within 24 hours. All replies were judged by independent assessors to be helpful or very helpful for diagnosis, management and education. The assessors decided that in 50% of cases the advice if acted upon would have shortened hospital stay. This pilot study has shown that a low-cost telemedicine link is technically feasible and can be of significant benefit for diagnosis, management and education in a developing world setting.
authors.affiliation: Department of Medicine, Patan Hospital, PO Box 252, Kathmandu, Nepal. lorradam@wlink.com.np
authors.forename: L E
authors.initials: LE
authors.lastname: Graham
authors.forename: M
authors.initials: M
authors.lastname: Zimmerman
authors.forename: D J
authors.initials: DJ
authors.lastname: Vassallo
authors.forename: V
authors.initials: V
authors.lastname: Patterson
authors.forename: P
authors.initials: P
authors.lastname: Swinfen
authors.forename: R
authors.initials: R
authors.lastname: Swinfen
authors.forename: R
authors.initials: R
authors.lastname: Wootton
mesh_terms: D000293:Adolescent; D000328:Adult; D003906:Developing Countries; D034742:Electronic Mail; D005260:Female; D006801:Humans; D008297:Male; D009390:Nepal / Q000453:epidemiology; D010043:Outcome and Process Assessment, Health Care; D010865:Pilot Projects; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D017216:Telemedicine; D035502:Trust