title: Using e-mail in the management of tuberculosis patients, north-west Russia.
abstract: 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.
authors.affiliation: Norwegian Centre for Telemedicine, University Hospital of North-Norway, Tromsø, Norway. siribu@start.no
authors.forename: S B
authors.initials: SB
authors.lastname: Uldal
authors.forename: E
authors.initials: E
authors.lastname: Nikishova
authors.forename: N
authors.initials: N
authors.lastname: Rakova
authors.forename: A
authors.initials: A
authors.lastname: Mariandyshev
authors.forename: S M
authors.initials: SM
authors.lastname: Bye
authors.forename: N
authors.initials: N
authors.lastname: Nisovtszevat
mesh_terms: 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*