title: Comparative performance of seven long-running telemedicine networks delivering humanitarian services.
abstract: Seven long-running telemedicine networks were surveyed. The networks provided humanitarian services (clinical and educational) in developing countries, and had been in operation for periods of 5-15 years. The number of experts serving each network ranged from 15 to 513. The smallest network had a total of 10 requesters and the largest one had more than 500 requesters. The networks operated in nearly 60 countries. The seven networks managed a total of 1857 cases in 2011, i.e. an average of 265 cases per year per network. There was a significant growth in total activity, amounting to 100.3 cases per year during the 15 year study period. In 2011, network activity was 50-700 teleconsultations per network. There were clear differences in the patterns of activity, with some networks managing an increasing caseload, and others managing a slowly reducing caseload. The seven networks had published a total of 44 papers listed in Medline which summarized the evidence resulting from the delivery of services by telemedicine. There was a dearth of information about clinical and cost-effectiveness. Nevertheless, the services were widely appreciated by referring doctors, considered to be clinically useful, and there were indications that clinical outcomes for telemedicine patients were often improved. Despite a lack of formal evidence, the present study suggests that telemedicine can provide clinically useful services in developing countries.
authors.affiliation: Norwegian Centre for Integrated Care and Telemedicine, University Hospital of North Norway, PO Box 6060, 9038 Tromsø, Norway. r_wootton@pobox.com
authors.forename: Richard
authors.initials: R
authors.lastname: Wootton
authors.forename: Antoine
authors.initials: A
authors.lastname: Geissbuhler
authors.forename: Kamal
authors.initials: K
authors.lastname: Jethwani
authors.forename: Carrie
authors.initials: C
authors.lastname: Kovarik
authors.forename: Donald A
authors.initials: DA
authors.lastname: Person
authors.forename: Anton
authors.initials: A
authors.lastname: Vladzymyrskyy
authors.forename: Paolo
authors.initials: P
authors.lastname: Zanaboni
authors.forename: Maria
authors.initials: M
authors.lastname: Zolfo
mesh_terms: D000533:Altruism; D003906:Developing Countries / Q000706:statistics & numerical data*; D006302:Health Services Research; D006801:Humans; D017146:Models, Organizational; D011795:Surveys and Questionnaires; D017216:Telemedicine / Q000458:organization & administration* / Q000592:standards / Q000706:statistics & numerical data