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Remote HIV/AIDS consultations in resource-limited settings

Maria ZolfoInstitute of Tropical Medicine, Antwerp,

Belgium

BACKGROUNDBACKGROUND

Telemedicine is a way to deliver health care in remote areas

E-mails have been used for years as a low cost telemedicine support for colleagues working in low resource settings, by the Institute of Tropical

Medicine, Antwerp (ITMA)

BACKGROUNDBACKGROUND

In 2003 the ITMA set up a computer aided training project to guide doctors in the implementation of antiretrovirals (ARVs) and AIDS care in developing countries

AIMS (I)AIMS (I)

To facilitate the introduction of high-quality ARV care for HIV/AIDS patients, living in resource limited settings by providing adequate technical support for ARVs and management of opportunistic infections (OIs), to clinician from the South

AIMS (II)AIMS (II) To provide continuous medical

education in the field of HIV/AIDS for doctors following Short Course on Antiretroviral Therapy (SCART), through a discussion forum on a medical web site, supporting and guiding medical decision making and management of difficult clinical cases

Method of working

Expert advice from HIV/AIDS specialists is offered to colleagues in the field through a discussion forum on http://telemedicine.itg.be

Initial partners in the field:

Sihanouk Hospital Center of Hope, Phom Penh, Cambodia

Central Hospital, Kigali, Rwanda

Institute of Tropical Medicine Alexander Von Humboldt, Lima, Peru

MSF-Belgium projects in South East Asia

Receiving cases/questions:

E-mail

Receiving cases/questions:

E-mail

Web interface

Receiving cases/questions:

E-mail

Web interface

E-mail (alerts)

Receiving cases/questions:

E-mail

Web interface

E-mail (alerts)

1st year activity

2nd year evaluation

257/342 clinical cases

85/342 open questions

ARV

OIs Δ & Rx

Main topics

24/342

166/342

152/342

OIs Δ & Rx

ARV general use

ARV & TB

ARV side effects

ARV resistance

ARV with OIs

ARV in PMTCT

IRIS

Main topics

24/342

152/342

166/342

2nd year evaluation details

ARVs details

ARVs oriented questions

18

41

35

6

12

7

47ARVs general use

ARVs & TB

ARVs side effects

ARVs resistance

ARVs with OIs

ARVs in PMTCT

IRIS

What is iPath

iPath - an open source software to build telemedicine platforms. Developed at University of Basel

ipath.ch - an association to promote telemedicine and to support projects in developing countries

User Interface Group Display

- case list

Case Display

- Description & Images

User Interface

- Comments/Diagnosis

New comments: automatic email alert

General perception from the fieldGeneral perception from the field

E-mail/discussion forum support is considered important for:

patient management increased knowledge of medical staff avoiding referrals access to medical literature

SURVEY

• Off line function for posting !

• A hybrid web and email solution!

http://telemedicine.itg.be

Thank you!

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