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Roberto PolilloDerpartment of Informatics, Systems and Communication,University of Milano Bicocca
Intervento al corso elettivo “Promozione della salute infantile nei Paesi in via di sviluppo” per studenti della Scuola di Medicina dell’Università di Milano Bicocca – March 30, 2015
Internet & sustainable telemedicine for developing Countries: an introduction
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Il server dell’amministrazioneDell’ospedale Dipartimentale di Chinandega (Nicaragua)
What is telemedicine
"Telemedicine is the delivery of health care services, where distance is a critical factor, by all health care professionals using information and communication technologies,
for the exchange of valid information for diagnosis, treatment and prevention of disease and injuries, research and evaluation, and for the continuing education of health care providers, all in the interest of advancing the health of individuals and their communities.” WHO, Telemedicine, Opportunities and Developments in Member States, 2010
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Types of telemedicine applications6
DIS
TAN
CE
Synchronous or asynchronouscommunication
Types of telemedicine applications7
DIS
TAN
CE
Synchronous or asynchronouscommunication
Asynchronous:•E-mail / SMS / WhatsApp•Sharing docs, images, audio, videos via social media•Dropbox or cloud repositories•Specific applications
Synchronous:•Chat•Tele-conferencing (audio, video)•Virtual classes•Virtual healthpoints
Example: HealthPoint (India)8
www.healthpoint.com
Types of telemedicine applications9
DIS
TAN
CE
Synchronous or asyncronouscommunication
Teleradiology Telecardiology Telepathology Teledermatology Teleodontoiatry Teleaudiology Telepsycology …
The good news
Internet and mobile telephony
ALLOW NOW to develop affordable and sustainable telemedicine
applications for developing Countries
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”Affordable" telemedicine
“Reasonable” technological infrastructure Low initial costs Sustainability
Low operating costs “Reasonable” technical skills locally
necessary
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The “mobile miracle”13
CIS: Commonwealth of Independent States (ex Soviet Union)
Source: ITU Measuring teh Information Society Report, 2014
R.Polillo - Marzo 201314
And the Internet…15
The growth of the bandwidth16
Mobile broadband growth17
Source: Ericcson Mobility Report, June 2014
Types of telemedicine applications18
DIS
TAN
CE
Synchronous or asyncronouscommunication
Example: Store-and-forward 19
Asy
ncro
nous
com
mun
icat
ion
Examples:•Teleradiology•Teledermatology•Telepatology
Query with medical data:•text•images•[video]
Answer
Example: Store-and-forward 20
Asy
ncro
nous
com
mun
icat
ion
Query with medical data:•text•images•[video]
Answer
Data base
Example: Remote monitoring21
Com
unic
azio
ne s
incr
ona
/ as
incr
ona
Asy
ncro
nous
com
mun
icat
ion
Without Internet access:•SMS•MMS•TwitterWith Internet access:•TwitterWhatsapp•Social media•Mail
Example: Laptop + mobile for communication via SMS (software: FrontlineSMS)
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VIDEO: http://www.youtube.com/watch?feature=player_embedded&v=hEK0dTWgqzQ#!
www.kiwanja.net
• Patient monitoring / follow-up
• Vaccination campaigns• Medical info • Emergency management• …
www.medicmobile.org
Example: Interactive telemedicine23
Com
unic
azio
ne s
incr
ona
/ as
incr
ona
Sync
rono
us c
omm
unic
atio
nNo Internet access:•CellphoneWith Internet access:•Internet telephony (skype, whatsapp)•Video conferencing
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Know-how globalization
Example: www.cure4kids.org
A free, global online medical education and collaboration network
A web-based education project of St.Jude Children’s Research Hospital (Memphis, USA) to help health professionals in countries with limited resources to improve survival rates of children with catastrophic deseases
Seminars, papers, oncopoedia, interest groups, international live online web conferences
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www.cure4kids.org: growth
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Oggi: 42.000 iscritti in 160 Paesi
https://www.cure4kids.org/ums/home/public_area/c4k_user_stats/
Conclusions
The evolution of the Internet, the “mobile miracle” and the telephony / internet convergence open possibilities untinkable until a few years ago for developing Countries
Abilitating technologies: low cost asyncronous and synchronous communication, broadband, cloud computing software open-source low cost smartphone
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Substainability, delocalization
EXAMPLE: Pediatric Hospital La Mascota, Managua (Nicaragua)
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La Mascota and departmental hospitals
Policlinico Milano
La Mascota Managua
VPN
31• 1 central server (Managua)• 1 PC for every remote
hospital (db and procedures)• Internet connection• Data are consolidated on the
central server • Consultancy from Milano
