Seven years of telemedicine in Medecins Sans Frontieres demonstrate that offering direct specialist expertise in the frontline brings clinical and educational value
Seven years of telemedicine in Medecins Sans Frontieres demonstrate that offering direct specialist expertise in the frontline brings clinical and educational value
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DOI：
10.7189/jogh.08.020414
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发表时间：
2018-12-01
影响因子：
7.2
通讯作者：
Wootton, Richard
中科院分区：
文献类型：
--
作者：
Delaigue, Sophie;Bonnardot, Laurent;Wootton, Richard
无国界医生组织（MSF）是一个医疗人道主义组织，于2010年开始使用存储转发远程医疗。本研究的目的是描述在低资源setting.Methods的远程医疗服务开发的经验，我们研究了无国界医生组织的远程医疗服务期间，从2010年7月1日至2017年6月30日。我们比较了服务发展的三个连续阶段。我们还检查了2013年开始的质量保证计划的结果。结果在研究期间，共提交了5646例远程医疗病例。工作量稳步增加，转诊率中位数从每周2例增至18例。提交病例的医院数量和每家医院的病例数量也有所增加，病例复杂性也有所增加。尽管工作量增加，但分配时间从0.9小时减少到0.2小时，答复一个案件的中位时间从20小时减少到5小时。质量保证评分稳定。用户反馈普遍是积极的，超过90%的提供了关于其病例进展报告的咨询者表示，已将其发送给适当的专家，反应足够快，远程咨询提供了教育效益。转介人指出，该系统对患者的结果在39%的cases.Conclusions的积极影响的远程医疗服务的质量保持，尽管不断上升的案件量。该研究表明，在资源匮乏的环境中提供直接的专家专业知识，改善了对患者的管理，并为现场医生提供了额外的教育价值，从而为其他患者带来了更多的好处。
Background Medecins Sans Frontieres (MSF), a medical humanitarian organization, began using store-and-forward telemedicine in 2010. The aim of the present study was to describe the experience of developing a telemedicine service in low-resource settings.Methods We studied the MSF telemedicine service during the period from 1st July 2010 until 30th June 2017. There were three consecutive phases in the development of the service, which we compared. We also examined the results of a quality assurance program which began in 2013.Results During the study period, a total of 5646 telemedicine cases were submitted. The workload increased steadily, and the median referral rate rose from 2 to 18 cases per week. The number of hospitals submitting cases and the number of cases per hospital also increased, as did the case complexity. Despite the increased workload, the allocation time reduced from 0.9 to 0.2 hours, and the median time to answer a case decreased from 20 to 5 hours. The quality assurance scores were stable. User feedback was generally positive and more than 90% of referrers who provided a progress report about their case stated that it had been sent to an appropriate specialist, that the response was sufficiently quick and that the teleconsultation provided an educational benefit. Referrers noted a positive impact of the system on patient outcome in 39% of cases.Conclusions The quality of the telemedicine service was maintained despite rising caseloads. The study showed that offering direct specialist expertise in low-resource settings improved the management of patients and provided additional educational value to the field physicians, thus bringing further benefits to other patients.