How Telemedicine Can Help People in Rural Areas Live Longer

From the News Section: Science & Technology of the Daily Observer, Liberia, the author Darren Wilkins compares a remote clinic in Liberia with a clinic in Haiti, serving a similar rural population, but having access to telemedicine through information and communication technology (ICT). He discusses the potential of adding ICT in the health sector of Liberia by implementing a telemedicine programme, especially in rural areas. He also briefly discusses the need for more modern education for Liberian health workers.

Telemedicine is described as "the use of telecommunication technologies to provide healthcare services over long distances and can be used to improve healthcare as well as enhance economic development in a developing country like Liberia. It allows physicians to provide consultations, collect and share uniform laboratory data and medical records to provide health care...Telemedicine will allow doctors at the John F. Kennedy hospital in Monrovia to diagnose and treat patients in remote areas... without having these patients visit the main hospital in Monrovia..." and can be done through a real-time connection. The article suggests that development of a telemedicine system might provide disaster relief preparedness, a solution to the scarcity of specialists and of effective media of communications, and up-to-date information and education for health workers. "Telemedicine allows doctors to perform several tasks remotely and seamlessly - tasks which in the past required patients to travel long distances to hospitals in the main cities. The money patients pay in transportation costs could go toward their treatment costs."

The possible benefits include lowering rural, particularly infant, mortality rates. The means of implementation could include: Global System for Mobile Communication (GSM) technology, which "has brought affordable and universal mobile phone access, facilitating the potential implementation of a telemedicine program" and WIMAX (Worldwide Interoperability for Microwave Access), which "can enable video conferencing, while high speed broadband connections... allow the use of interactive media that will enable doctors and health workers provide quality health care for all Liberians." The author recommends involving all stakeholders, not exclusively the government, in the implementation.

The education of nurses, deemed by the author to be essential in developing the healthcare system, could be addressed through:

• Giving nurses universal access to the internet, "where they can gain a wealth of information and resources to better themselves as well as connect, collaborate, and communicate with other health workers in the global community."
  
• Allowing nurses to travel abroad (to developed countries) to attend training programmes and bring back best practices.
  
• Giving nurses Personal Data Assistants (PDAs) containing up-to-date basic reference materials as part of their continuing education.
  
• Providing "all necessary technologies to healthcare professionals so that they are informed about trends in healthcare and the practical impact, positive or negative, that new standards, technologies, and products will have."
  
• Providing healthcare workers with access to email, professional networking sites, video conferencing, and instant messaging. "All of these tools are very user-friendly and can be found in the Open Source community for free or obtained as COTS (Commercial Off-The-Shelf) solutions. They allow the sending of e-mail attachments such as image files, thereby permitting a form of low cost telemedicine. Video conferencing can also be done in a low cost way by using the appropriate application with cheap hardware such as webcams. SKYPE is an excellent tool that is ideal for health workers. Its video conferencing features are great for communications between doctors in the main cities and nurses in rural areas."
• Extending broadband capacity to villages.
  
• Purchasing vehicles that are equipped with telemedicine technologies to be used for travel to rural areas, to help train rural health workers, and to provide health services.
  
• Setting up an HIV/AIDS helpline to allow individuals to report illnesses anonymously. "Some individuals, for fear of disgrace, may not want to publicly report their illnesses. If a medium for anonymous reporting is established, more cases will be reported, and hopefully, there will be a decrease in the number of Liberians dying from the disease."

The author notes that: "It should be understood that while I advocate the use of ICTs - especially Western ICTs - to improve our healthcare system, I do not remotely recommend that we be tempted to emulate Western healthcare systems or paradigms, which incontrovertibly do not parallel ours. I do, however, espouse the use of modern technologies that suit our situation for improvement purposes." He concludes that telemedicine can help with the reconstruction of the medical infrastructure and with satisfying the increased demand for improved healthcare delivery.