title: Development of a pilot telemedicine network for paediatric oncology in Brazil.
abstract: We established a pilot telemedicine network for paediatric oncology in Brazil, linking the School of Medicine at the University of Sao Paulo in Sao Paulo City to the 'Hospital de Base' in Porto Velho, Rondonia, located in the Amazon region, 3,000 km away. The videoconferencing link used ISDN transmission at 384 kbit/s. The network was used for patient screening, follow-up, treatment monitoring and other activities. Between March 2000 and 2002, 69 videoconferences were held for 33 patients, 29 with cancer. During this period, 16 patients required transfer, 18 patients died and 11 achieved cancer remission. The main cause for patient mortality (infection) was not one that could be addressed directly by telemedicine. Using the School of Medicine as a benchmark, the average mortality rate for paediatric cancer patients in the pilot was higher. However, it was lower than previous levels observed at Rondonia (62% versus 80%).
authors.affiliation: Unidade de Onco-Hematologia, Instituto da Criança HC-FMUSP, Sao Paulo, Brazil. andrenm@gmail.com
authors.forename: André Nebel
authors.initials: AN
authors.lastname: de Mello
authors.forename: Adilson Yuuji
authors.initials: AY
authors.lastname: Hira
authors.forename: Regis Rossi Alves
authors.initials: RR
authors.lastname: Faria
authors.forename: Marcelo Knörich
authors.initials: MK
authors.lastname: Zuffo
authors.forename: Vicente Odone
authors.initials: VO
authors.lastname: Filho
mesh_terms: D001938:Brazil / Q000453:epidemiology; D002648:Child; D002662:Child Health Services / Q000458:organization & administration*; D002675:Child, Preschool; D006785:Hospitals, University; D006801:Humans; D007223:Infant; D009369:Neoplasms / Q000401:mortality; D016522:Oncology Service, Hospital / Q000458:organization & administration*; D010865:Pilot Projects; D017216:Telemedicine / Q000458:organization & administration* / Q000592:standards; D049269:Videoconferencing / Q000458:organization & administration* / Q000592:standards