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Teledermatology in Low-Resource Settings: The MSF Experience with a Multilingual Tele-Expertise Platform

Introduction: In 2010, Médecins Sans Frontières (MSF) launched a tele-expertise system to improve the access to specialized clinical support for its field health workers. Among medical specialties, dermatology is the second most commonly requested type of tele-expertise. The aim of the present study...

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Autores principales: Delaigue, Sophie, Morand, Jean-Jacques, Olson, David, Wootton, Richard, Bonnardot, Laurent
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4231841/
https://www.ncbi.nlm.nih.gov/pubmed/25453029
http://dx.doi.org/10.3389/fpubh.2014.00233
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author Delaigue, Sophie
Morand, Jean-Jacques
Olson, David
Wootton, Richard
Bonnardot, Laurent
author_facet Delaigue, Sophie
Morand, Jean-Jacques
Olson, David
Wootton, Richard
Bonnardot, Laurent
author_sort Delaigue, Sophie
collection PubMed
description Introduction: In 2010, Médecins Sans Frontières (MSF) launched a tele-expertise system to improve the access to specialized clinical support for its field health workers. Among medical specialties, dermatology is the second most commonly requested type of tele-expertise. The aim of the present study was to review all MSF teledermatology cases in the first 4 years of operation. Our hypothesis was that the review would enable the identification of key areas for improvement in the current MSF teledermatology system. Methods: We carried out a retrospective analysis of all dermatology cases referred by MSF field doctors through the MSF platform from April 2010 until February 2014. We conducted a quantitative and qualitative analysis based on a survey sent to all referrers and specialists involved in these cases. Results: A total of 65 clinical cases were recorded by the system and 26 experts were involved in case management. The median delay in providing the first specialist response was 10.2 h (IQR 3.7–21.1). The median delay in allocating a new case was 0.96 h (IQR 0.26–3.05). The three main countries of case origin were South Sudan (29%), Ethiopia (12%), and Democratic Republic of Congo (10%). The most common topics treated were infectious diseases (46%), inflammatory diseases (25%), and genetic diseases (14%). One-third of users completed the survey. The two main issues raised by specialists and/or referrers were the lack of feedback about patient follow-up and the insufficient quality of clinical details and information supplied by referrers. Discussion: The system clearly delivered a useful service to referrers because the workload rose steadily during the 4-year study period. Nonetheless, user surveys and retrospective analysis suggest that the MSF teledermatology system can be improved by providing guidance on best practice, using pre-filled referral forms, following-up the cases after teleconsultation, and establishing standards for clinical photography.
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spelling pubmed-42318412014-12-01 Teledermatology in Low-Resource Settings: The MSF Experience with a Multilingual Tele-Expertise Platform Delaigue, Sophie Morand, Jean-Jacques Olson, David Wootton, Richard Bonnardot, Laurent Front Public Health Public Health Introduction: In 2010, Médecins Sans Frontières (MSF) launched a tele-expertise system to improve the access to specialized clinical support for its field health workers. Among medical specialties, dermatology is the second most commonly requested type of tele-expertise. The aim of the present study was to review all MSF teledermatology cases in the first 4 years of operation. Our hypothesis was that the review would enable the identification of key areas for improvement in the current MSF teledermatology system. Methods: We carried out a retrospective analysis of all dermatology cases referred by MSF field doctors through the MSF platform from April 2010 until February 2014. We conducted a quantitative and qualitative analysis based on a survey sent to all referrers and specialists involved in these cases. Results: A total of 65 clinical cases were recorded by the system and 26 experts were involved in case management. The median delay in providing the first specialist response was 10.2 h (IQR 3.7–21.1). The median delay in allocating a new case was 0.96 h (IQR 0.26–3.05). The three main countries of case origin were South Sudan (29%), Ethiopia (12%), and Democratic Republic of Congo (10%). The most common topics treated were infectious diseases (46%), inflammatory diseases (25%), and genetic diseases (14%). One-third of users completed the survey. The two main issues raised by specialists and/or referrers were the lack of feedback about patient follow-up and the insufficient quality of clinical details and information supplied by referrers. Discussion: The system clearly delivered a useful service to referrers because the workload rose steadily during the 4-year study period. Nonetheless, user surveys and retrospective analysis suggest that the MSF teledermatology system can be improved by providing guidance on best practice, using pre-filled referral forms, following-up the cases after teleconsultation, and establishing standards for clinical photography. Frontiers Media S.A. 2014-11-14 /pmc/articles/PMC4231841/ /pubmed/25453029 http://dx.doi.org/10.3389/fpubh.2014.00233 Text en Copyright © 2014 Delaigue, Morand, Olson, Wootton and Bonnardot. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Public Health
Delaigue, Sophie
Morand, Jean-Jacques
Olson, David
Wootton, Richard
Bonnardot, Laurent
Teledermatology in Low-Resource Settings: The MSF Experience with a Multilingual Tele-Expertise Platform
title Teledermatology in Low-Resource Settings: The MSF Experience with a Multilingual Tele-Expertise Platform
title_full Teledermatology in Low-Resource Settings: The MSF Experience with a Multilingual Tele-Expertise Platform
title_fullStr Teledermatology in Low-Resource Settings: The MSF Experience with a Multilingual Tele-Expertise Platform
title_full_unstemmed Teledermatology in Low-Resource Settings: The MSF Experience with a Multilingual Tele-Expertise Platform
title_short Teledermatology in Low-Resource Settings: The MSF Experience with a Multilingual Tele-Expertise Platform
title_sort teledermatology in low-resource settings: the msf experience with a multilingual tele-expertise platform
topic Public Health
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4231841/
https://www.ncbi.nlm.nih.gov/pubmed/25453029
http://dx.doi.org/10.3389/fpubh.2014.00233
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