title: Design and implementation of an automatic message-routing system for low-cost telemedicine.
abstract: Email has been used for some years as a low-cost telemedicine medium to provide support for developing countries. However, all operations have been relatively small scale and fairly labour intensive to administer. A scalable, automatic message-routing system was constructed which automates many of the tasks. During a four-month study period in 2002, 485 messages were processed automatically. There were 31 referrals from eight hospitals in three countries. These referrals were handled by 25 volunteer specialists from a panel of 42. Two system operators, located 10 time zones apart, managed the system. The median time from receipt of a new referral to its allocation to a specialist was 1.0 days (interquartile range 0.7-2.4). The median interval between allocation and first reply was 0.7 days (interquartile range 0.3-2.3). Automatic message handling solves many of the problems of manual email telemedicine systems and represents a potentially scalable way of doing low-cost telemedicine in the developing world.
authors.affiliation: Centre for Online Health, University of Queensland, Australia. r_wootton@pobox.com
authors.forename: Richard
authors.initials: R
authors.lastname: Wootton
mesh_terms: D003906:Developing Countries; D034742:Electronic Mail / Q000295:instrumentation / Q000458:organization & administration*; D006801:Humans; D012017:Referral and Consultation / Q000458:organization & administration; D012984:Software; D017216:Telemedicine / Q000458:organization & administration*