title: A national teleradiology programme in Mali: implementation and results.
abstract: We reviewed the national teleradiology programme in Mali to establish whether it improved diagnosis for patients and improved the referring doctor's ability to give an accurate diagnosis. The teleradiology programme connected the University Hospital in Bamako to all seven regional hospitals in Mali and one private health clinic. The pilot phase began in 2005 in three hospitals. Initially the implementation involved connections via broadband, but subsequently satellite antennae were provided at three remote hospitals in the north. Between 2005 and 2013, X-ray and mammogram images from 5628 patients were read by teleradiology. Radiologists provided the sole diagnosis for 29% of cases (i.e. the referrer did not make a diagnosis) and altered the regional doctor's diagnosis in 12% of cases. The proportion of cases for which the regional doctor gave no diagnosis decreased from 93% to 24% over the same period, indicating an increase in the doctors' confidence and incentive to test their own diagnosis. The percentage of cases for which regional doctors made an inaccurate diagnosis decreased to 3% in 2013. Use of the teleradiology service varied widely between hospitals. Successful implementation depended on local ownership of a network, which was developed in close collaboration with hospital leadership, national radiologists and other healthcare personnel.
authors: Le Centre d'Expertise et de Recherche en Télémédecine et E-Santé, Bamako, Mali.
authors: Mohamed
authors: M
authors: Sangaré
authors: Jigsaw Consult, London, UK l.tanner@jigsawconsult.com.
authors: Lydia
authors: L
authors: Tanner
authors: Jigsaw Consult, London, UK.
authors: Sarah
authors: S
authors: Voss
authors: International Institute for Communication and Development, The Hague, Netherlands.
authors: Francois
authors: F
authors: Laureys
authors: Department of Geography, Royal Holloway University, London, UK.
authors: David
authors: D
authors: Hollow
authors: Faculty of Medicine and Pharmacy, University of Bamako, Bamako, Mali Radiology Department, University Hospital Point G, Bamako, Mali.
authors: Mahamadou
authors: M
authors: Touré
mesh_terms: D001291:Attitude of Health Personnel; D002983:Clinical Competence; D005260:Female; D006769:Hospitals, General / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008302:Mali; D015397:Program Evaluation; D011795:Surveys and Questionnaires; D019112:Teleradiology / Q000592:standards* / Q000706:statistics & numerical data