title: Bridging the Distance in the Caribbean: Telemedicine as a means to build capacity for care in paediatric cancer and blood disorders.
abstract: Over the past 50 years, survival for children in high-income countries has increased from 30% to over 80%, compared to 10-30% in low and middle income countries (LMIC). Given this gap in survival, established paediatric cancer treatment centres, such as The Hospital for Sick Children (SickKids) are well positioned to share clinical expertise. Through the SickKids Centre for Global Child Health, the SickKids-Caribbean Initiative (SCI) was launched in March 2013 to improve the outcomes and quality of life for children with cancer and blood disorders in the Caribbean. The six participating Caribbean countries are among those defined by the United Nations as Small Island Developing States, due to their small size, remote location and limited accessibility. Telemedicine presents an opportunity to increase their accessibility to health care services and has been used by SCI to facilitate two series of interprofessional rounds. Case Consultation Review Rounds are a forum for learning about diagnostic work-up, management challenges and treatment recommendations for these diseases. To date, 54 cases have been reviewed by SickKids staff, of which 35 have been presented in monthly rounds. Patient Care Education Rounds provide nurses and other staff with the knowledge base needed to safely care for children and adolescents receiving treatment. Five of these rounds have taken place to date, with over 200 attendees. Utilized by SCI for both clinical and non-clinical meetings, telemedicine has enhanced opportunities for collaboration within the Caribbean region. By building capacity and nurturing expert knowledge through education, SCI hopes to contribute to closing the gap in childhood survival between high and low-resource settings.
authors.affiliation: Centre for Global Child Health, The Hospital for Sick Children, Toronto, Canada.
authors.forename: Ellie
authors.initials: E
authors.lastname: Adler
authors.affiliation: University of the West Indies, Cavehill, Barbados.
authors.forename: Cheryl
authors.initials: C
authors.lastname: Alexis
authors.affiliation: Department of Clinical Medical Sciences, Faculty of Medical Sciences, UWI, St Augustine Campus, Trinidad and Tobago.
authors.forename: Zulaika
authors.initials: Z
authors.lastname: Ali
authors.affiliation: Department of Paediatrics, University of Toronto and Division of Infectious Diseases, The Hospital for Sick Children, Toronto, Canada.
authors.forename: Upton
authors.initials: U
authors.lastname: Allen
authors.affiliation: Department of Paediatrics, University of Toronto and Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, Canada.
authors.forename: Ute
authors.initials: U
authors.lastname: Bartels
authors.affiliation: Centre for Global Child Health, The Hospital for Sick Children, Toronto, Canada.
authors.forename: Cassandra
authors.initials: C
authors.lastname: Bick
authors.affiliation: Community Child Health Service, Ministry of Health, St. Lucia.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Bird-Compton
authors.affiliation: Department of Clinical Medical Sciences, Faculty of Medical Sciences, UWI, St Augustine Campus, Trinidad and Tobago.
authors.forename: Curt
authors.initials: C
authors.lastname: Bodkyn
authors.affiliation: Milton Cato Memorial Hospital, Kingstown, St. Vincent and the Grenadines.
authors.forename: Rosemary
authors.initials: R
authors.lastname: Boyle
authors.affiliation: Centre for Global Child Health, The Hospital for Sick Children, Toronto, Canada.
authors.forename: Stephanie
authors.initials: S
authors.lastname: De Young
authors.affiliation: Collaborative for Professional Practice, The Hospital for Sick Children, and the Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada.
authors.forename: Bonnie
authors.initials: B
authors.lastname: Fleming-Carroll
authors.affiliation: Department of Paediatrics, University of Toronto and Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, Canada.
authors.forename: Sumit
authors.initials: S
authors.lastname: Gupta
authors.affiliation: Bustamante Hospital for Children, Kingston, Jamaica.
authors.forename: Patricia
authors.initials: P
authors.lastname: Ingram-Martin
authors.affiliation: Department of Paediatrics, University of Toronto and Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, Canada.
authors.forename: Meredith
authors.initials: M
authors.lastname: Irwin
authors.affiliation: Department of Paediatrics, University of Toronto and Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, Canada.
authors.forename: Melanie
authors.initials: M
authors.lastname: Kirby-Allen
authors.affiliation: Department of Paediatrics, University of Toronto and Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, Canada.
authors.forename: Sharon
authors.initials: S
authors.lastname: McLean-Salmon
authors.affiliation: Centre for Global Child Health, The Hospital for Sick Children, Toronto, Canada.
authors.forename: Paul
authors.initials: P
authors.lastname: Mihelcic
authors.affiliation: Bustamante Hospital for Children, Kingston, Jamaica.
authors.forename: Michelle Ann
authors.initials: MA
authors.lastname: Richards-Dawson
authors.affiliation: University Hospital of the West Indies, Kingston, Jamaica.
authors.forename: Michelle
authors.initials: M
authors.lastname: Reece-Mills
authors.affiliation: Department of Paediatrics, University of Toronto and Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, Canada.
authors.forename: Furqan
authors.initials: F
authors.lastname: Shaikh
authors.affiliation: University of the West Indies, School of Clinical Medicine & Research, Nassau, The Bahamas and Princess Margaret Hospital, The Bahamas.
authors.forename: Corrine
authors.initials: C
authors.lastname: Sinquee-Brown
authors.affiliation: Faculty of Medical Sciences, University of the West Indies, Mona Campus, Jamaica.
authors.forename: Minerva
authors.initials: M
authors.lastname: Thame
authors.affiliation: Centre for Global Child Health, The Hospital for Sick Children, Toronto, Canada.
authors.forename: Sheila
authors.initials: S
authors.lastname: Weitzman
authors.affiliation: University Hospital of the West Indies, Kingston, Jamaica.
authors.forename: Gilian
authors.initials: G
authors.lastname: Wharfe
authors.affiliation: Centre for Global Child Health, The Hospital for Sick Children, Toronto, Canada.
authors.forename: Victor
authors.initials: V
authors.lastname: Blanchette
mesh_terms: D017691:Caribbean Region; D003695:Delivery of Health Care / Q000458:organization & administration; D003906:Developing Countries; D005260:Female; D006293:Health Promotion / Q000458:organization & administration; D006297:Health Services Accessibility / Q000458:organization & administration; D006402:Hematologic Diseases / Q000175:diagnosis / Q000628:therapy*; D006405:Hematology / Q000458:organization & administration; D006801:Humans; D008297:Male; D008495:Medical Oncology / Q000458:organization & administration; D008507:Medically Underserved Area; D009369:Neoplasms / Q000175:diagnosis / Q000628:therapy*; D010372:Pediatrics / Q000458:organization & administration*; D017216:Telemedicine / Q000458:organization & administration*; D014900:West Indies