Paediatric Telemedicine Support Experiences in MSF-OCA Peter Moons, Harriet Roggeveen / Médecins Sans Frontières Background:
Methods:
Globally paediatric telemedicine has made a positive contribution to the quality of healthcare provided for children. Descriptive studies of experiences with telepaediatrics from developing countries are few1. In MSF-OCA telemedicine advice by paediatric specialists is offered to doctors and nurses in all projects.
Retrospective analysis of All questions (by email, phone, MSF-Swinfen telemedicine website) from field teams to the paediatric advisors in 2011 and 2012. For each question information was collected on: Country of origin, Date of question and answer and Subject (15 predefined subject categories) For the comparison with paediatric morbidities in the project data from all hospitalised paediatric patients in 2011 were used.
Aims: - To identify the most important topics of consultations. - To compare frequency of subjects of consultations in telemedicine and frequency of paediatric morbidities in the projects.
Results – (Subject of ) consultations From where?
What topics?
1% 1% 1% 1% 2% 2%
203 questions received
2% 4%
43 (21.2%) - not related to an individual patient (but e.g. referring to the interpretation of a protocol) - Excluded from this analysis
4%
35%
5% 6% 6%
160 cases analysed - 129 emails (80.6%) - 31 through the MSF-Swinfen telemedicine website (19.4%)
13%
17%
South sudan DRC Ethiopia Bangladesh Pakistan Somalia Car Chad India Ivory coast Nigeria Haiti PNG Somaliland
Number
How many cases?
The three main topics subdivided Respiratory disease
Percentage
Results – comparison with child morbidities 50 45 40 35 30 25 20 15 10 5 0
Inpatient morbidity 2011 Cases in telepaediatrics 20112012
We found several differences in frequencies of morbidities in patients in MSF facilities and subjects of telepaediatric consultations. Main differences are lower proportions of questions on malaria and respiratory disease and more questions on fever of unknown origin, neurology, dermatology and ophthalmology.
10 8 6 4 2 0
Neonatal disease Number
20 15 10 5 0
Number
Number
Infectious disease
45 40 35 30 25 20 15 10 5 0
14 12 10 8 6 4 2 0
Discussion and conclusions This is one of few reports on telepaediatrics in developing countries A limitation of our study is that only questions directed at the paediatric advisors were reviewed. Questions about paediatric cases sent to other specialist advisors in MSF were not included. This is the first stage in the process of describing the MSF OCA telepaediatrics, future analyses on the usefulness for field teams, impact on case management is planned. We found several differences in frequencies of morbidities in patients subjects of telepaediatric consultations. This analysis helps to identify needs in paediatric support for filed teams and can guide the development of guidelines paediatric trainings.
Contact details: pmoons@amsterdam.msf.org References: 1. Wynchank S, Fortuin J. Telepaediatrics, primary health care and developing countries: a review 2008; 2 (4): 158-16044