Evaluating the potential impact of a mobile telemedicine system on coordination of specialty care for patients with complicated oral lesions in Botswana.
Mobile telemedicine involves the use of mobile device (e.g., cell phones, tablets) technology to exchange information to assist in the provision of patient care. Throughout the world, mobile telemedicine initiatives are increasing in number and in scale, but literature on their impact on patient outcomes in low-resource areas is limited. This study explores the potential impact of a mobile oral telemedicine system on the oral health specialty referral system in Botswana. Analysis of 26 eligible cases from June 2012 to July 2013 reveals high diagnosis concordance between dental officers and oral health specialists at 91.3% (21/23) but significant management plan discordance at 64.0% (16/25), over two-thirds of which involved the specialists disagreeing with the referring clinicians about the need for a visit to a specialist. These findings suggest mobile telemedicine can optimize the use of insights and skills of specialists remotely in regions where they are scarce.
Doris Duke Clinical Research Fellowship, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
Martha
M
Tesfalul
 Health Informatics and Telemedicine, Botswana-UPenn Partnership, Gaborone, Botswana Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
Ryan
R
Littman-Quinn
 Health Informatics and Telemedicine, Botswana-UPenn Partnership, Gaborone, Botswana.
Cynthia
C
Antwi
Department of Clinical Services, Botswana Ministry of Health, Gaborone, Botswana.
Siphiwo
S
Ndlovu
Department of Dermatology, Princess Marina Hospital, Gaborone, Botswana.
Didintle
D
Motsepe
Department of Oral Medicine, Princess Marina Hospital, Gaborone, Botswana.
Motsholathebe
M
Phuthego
Department of Oral Medicine, Princess Marina Hospital, Gaborone, Botswana.
Boitumelo
B
Tau
Department of Oral Medicine, Princess Marina Hospital, Gaborone, Botswana.
Neo
N
Mohutsiwa-Dibe
 Health Informatics and Telemedicine, Botswana-UPenn Partnership, Gaborone, Botswana Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA carrie.kovarik@uphs.upenn.edu.
Carrie
C
Kovarik
D000328:Adult; D001902:Botswana; D040421:Cell Phone; D003815:Dentists; D019468:Disease Management; D005260:Female; D006679:HIV Seropositivity; D006801:Humans; D008297:Male; D008875:Middle Aged; D009059:Mouth Diseases / Q000628:therapy*; D019242:Oral Medicine / Q000458:organization & administration*; D012017:Referral and Consultation; D013038:Specialization; D017216:Telemedicine
disease management; health impact assessment; mobile Health (mHealth); oral medicine; telemedicine