title: Cabo Verde telemedicine program: initial results of nationwide implementation.
abstract: BACKGROUND
  Telemedicine and e-health have been suggested as one solution for closing the health disparity gap between the developed world and the developing world. Yet evidence is lacking from current successful programs in the developing world and, in particular, from sub-Saharan Africa. The primary objective of our study was to present the preliminary results of our efforts in building the Integrated Telemedicine and e-Health Program for Cabo Verde (ITeHP-CV), with an emphasis on initial utilization and results.
  
  
  METHODS
  This is a prospective study of data collected while we worked to establish a fully functional, integrated national telemedicine network and virtual education network in Cabo Verde. We used the International Virtual e-Hospital Foundation strategic approach known as "initiate-build-operate-transfer" over a 26-month period (November 2011-December 2013). We describe herein the five main pillars of this process that have been implemented: (1) capacity building; (2) network development and deployment of equipment; (3) implementation of clinical telemedicine; (4) implementation of activities related to continuing medical education, delivered from within the country and from abroad; and (5) establishment and use of the electronic virtual library.
  
  
  RESULTS
  Based on comprehensive technical and medical assessment of the country's needs, 10 fully functional telemedicine centers in all nine inhabited islands of the Republic of Cabo Verde have been established. RESULTS are presented under the five main pillars of capacity building, network deployment, implementation of clinical telemedicine, implementation of continuing medical education activities, and establishment of the electronic virtual library.
  
  
  CONCLUSIONS
  The ITeHP-CV has been successfully launched, and the initial results are encouraging. The continuity of the program and sustainability are primary goals once the program is transferred fully to the Ministry of Health of Cabo Verde. A long-term follow-up study is required in order to ensure sustainability and continuity goals are met.
authors.affiliation: 1 Department of Surgery, University of Arizona , Tucson, Arizona.
authors.forename: Rifat
authors.initials: R
authors.lastname: Latifi
authors.forename: Erion
authors.initials: E
authors.lastname: Dasho
authors.forename: Ronald C
authors.initials: RC
authors.lastname: Merrell
authors.forename: Miguel
authors.initials: M
authors.lastname: Lopes
authors.forename: Vanda
authors.initials: V
authors.lastname: Azevedo
authors.forename: Flamur
authors.initials: F
authors.lastname: Bekteshi
authors.forename: Kalterina L
authors.initials: KL
authors.lastname: Osmani
authors.forename: Orland
authors.initials: O
authors.lastname: Qesteri
authors.forename: Julian
authors.initials: J
authors.lastname: Kucani
authors.forename: Ismet
authors.initials: I
authors.lastname: Lecaj
mesh_terms: D055726:Cabo Verde; D057191:Capacity Building; D020375:Education, Distance / Q000458:organization & administration*; D004501:Education, Medical / Q000458:organization & administration*; D006801:Humans; D016730:Program Development; D015397:Program Evaluation; D011446:Prospective Studies; D017216:Telemedicine / Q000458:organization & administration*
keywords: Cabo Verde; International Virtual e-Hospital Foundation; clinical telemedicine; telemedicine; telemedicine in island; “initiate–build–operate–transfer” approach