Nepal Telemedicine Project FindingsUniversity of Colorado SOM – Global Health TrackAvery Jeffers, Mandip KC, Laura Romcevich & Aaron Shupp

Faculty Advisor: Barry Bialek, MD

Findings

– Current State of Telemedicine in Nepal:• Two major systems

– Private: KMH, a hub to six satellite sites– Government: connected 25 district hospitals

Findings

– Telemedicine Sites: Government

Findings

– Telemedicine Sites: KMH

Findings

– Comparison of 2 current systems:• KMH uses live-real time consults where both

parties have to be online at the same time• The Government of Nepal uses the Store-and-

Forward system which is essentially emailing of forms.

Findings

– Government System:– No need of time coordination between parties– Requires less bandwidth– More economical and reliable– Not in real-time– No face-to-face between patients or providers

– Kathmandu Model Hospital System– Live in real-time– Allows face-to-face with the patients & providers – More useful for Continuing Medical Education– Allows resident physicians’ academic presentations

to be broadcast to the peripheral sites– Requires large bandwidth and is more expensive– Maintenance is difficult

Recommendations

– Recommendations for Best practices of Telemedicine in Nepal:• Hybrid system with both the store-and-forward

and the live-real time feed• Either system on their own cannot fulfill the

needs of the people in remote areas

Additional Findings

– Educational Pathway for Physicians in Nepal• Grade 1 – 10 (equivalent to high school

education in the United States)• Grade 11 – 12 (selective college prep program)• Medical School to receive MBBS Degree

( 4 years basic sciences and clinical studies)• MBBS Internship receive Licensure (1.5 years)• Post Graduate Program for MD Degree (2 – 5

years depending on specialty)

Additional Findings

– Telemedicine’s effect on the retention of medical officers in rural clinics• Benefits

– M.B.B.S. providers feel less isolated– Receive guidance remotely from specialists

• Problems– Telemedicine does not prevent brain drain– M.B.B.S. providers must return to Kathmandu to

finish training for MD

– CME is available but funding is currently a major barrier

Contacting Us:

• Mandip KC: mandip.kc@ucdenver.edu• Avery Jeffers:

avery.jeffers@ucdenver.edu• Laura Romcevich:

laura.romcevich@ucdenver.edu• Aaron Shupp:

aaron.shupp@ucdenver.edu

NAMASTE नमस्ते