Using e-mail in the management of tuberculosis patients, north-west Russia.
METHODS
Ten health care institutions in north-west Russia.


OBJECTIVE
To improve the management of tuberculosis patients using e-mail.


METHODS
Over an 18-month period, all outgoing and incoming e-mails at the Arkhangelsk Regional Tuberculosis Centre were saved and categorised. All e-mails relating to distance learning were logged, and a consensus panel discussed and answered questionnaires regarding 47 e-mail-based second opinions.


RESULTS
e-mail was found to speed up communication and increase the availability of specialist advice. Distance learning was positively received, but was used in moderation. For six of 47 consultations (13%), the consensus panel deemed that fast access to a second opinion saved lives. In 30 consultations (64%), the patient was saved a round trip to a specialist centre. In 24 consultations (51%), the panel considered that the patients had started correct treatment between 1 week and 1 month earlier than without e-mail access. In 11 of these consultations, 23% of the total, the patient was found to be infectious. The learning effects of second opinions were recognised.


CONCLUSIONS
General e-mail use and the second opinion service in particular were found to be useful. Further studies are needed to investigate the advantages and disadvantages of using e-mail as a tool in the management of TB.
Uldal
S B
SB
Norwegian Centre for Telemedicine, University Hospital of North-Norway, Tromsø, Norway. siribu@start.no
Nikishova
E
E
Rakova
N
N
Mariandyshev
A
A
Bye
S M
SM
Nisovtszevat
N
N
D020375:Education, Distance; D034742:Electronic Mail; D006767:Hospitals, District; D006801:Humans; D033181:Information Dissemination; D012041:Regional Medical Programs; D019114:Remote Consultation; D012426:Russia; D014376:Tuberculosis / Q000628:therapy*