Digital Pulse - Ch 3 - Sec 4 - National Telemedicine Research Centre - South Africa

The Digital Pulse: The Current and Future Applications of Information and Communication Technologies for Developmental Health Priorities

Chapter 3 - Programme Experiences: Sixty Case Studies Of ICT Usage In Developmental Health

Section 4 - Telemedicine and High-Tech Medical Tools

National Telemedicine Research Centre - South Africa

South African Medical Research Council (MRC)

Development Issues: Telemedicine, Rural Access

Programme Summary

The healthcare delivery system in South Africa faces many challenges. Some people are offered services comparable with the best in the world, while millions are without access to even the most basic services. The South African government is committed to providing basic health care to all South African citizens, not as a privilege, but as a fundamental right. To achieve this goal, the government has identified Telemedicine as a strategic tool for facilitating the delivery of equitable healthcare and educational services irrespective of distance and availability of specialized expertise, particularly in rural areas.

In 1998 the South African National Department of Health (DoH) adopted its National Telemedicine Project Strategy. This called for the establishment of a National Telemedicine Research Centre (NTRC) and a network of Telemedicine links, to be implemented in three phases over a period of five years. In September 1999, a National Telemedicine Research Centre was established as a joint project of the DoH and MRC and promises to be a centre of excellence in Telemedicine Research on the African continent. This project will go a long way towards delivering a solution to the severe problem of inadequate services and geographical challenges which confound the South African health system, as a result of long-standing, previously misplaced priorities.

The objectives of the National Telemedicine Research Centre are:

• To evaluate the operations and systems of national Telemedicine projects in order to ensure improved delivery of health care services;
• To use a Telemedicine Clinical Research Testbed to test new Telemedicine Technologies for their clinical abilities and cost effectiveness;
• To provide tools for implementing Telemedicine, such as training, teaching materials and local capacity professional development; as well as research into relevant protocols, standards and medico-legal aspects of Telemedicine.

Summary of ICT Initiatives

In order to achieve the above objectives The Centre will:

• Scientifically evaluate the implementation of Telemedicine projects in South Africa, in order to improve clinical outcomes;
• Review national and international Telemedicine practices, protocols and standards in order to promote scientific evolution and integration of Telemedicine Technologies into the South African health care services;
• Co-ordinate research and training activities of various Telemedicine units in academic institutions in South Africa;
• Carry out clinical trials to test new Telemedicine technologies in order to evaluate their clinical ability and cost-effectiveness in the delivery of primary healthcare in SA;
• Collaborate with the Telemedicine Technical Working Groups and academic institutions in developing guidelines for comprehensive Telehealth policy;
• Carry out Telemedicine Research capacity development and training activities required to promote equitable access to quality health care at affordable cost by the South African rural communities.
• Publish in consultation with the DoH, the results of research in peer-reviewed literature, thereby fostering regional, continental and international collaboration on Telemedicine.

Observations

Projects – For a complete Evaluation of the 28 National sites of the DoH First Phase Telemedicine System, see the executive summary [click here]. Current projects have involved the establishment of a Telehealth Test Bed to investigate new Telemedicine, telecommunications and Internet technologies that support primary health care (PHC) services. These technologies include the support needed to combat STDs, HIV/AIDS, TB, Malaria and Trauma. The MRC, DoH, and SA Medical Universities will co-sponsor a Formal Telemedicine Training Programme for the National Telemedicine System, to be accredited by the Health Professions Council as a provider of CPD points. The MRC will promote and co-ordinate self-evaluation of Telemedicine by the provinces in collaboration with health institutions and Technikons. The MRC will develop a registry of current Telemedicine projects in SADC and other African countries.

Research – The results of the First Phase of the SA National Telemedicine System (NTS),spanning March 1999 to September 2000, were reviewed at the National Telemedicine Conference held in Johannesburg in November, 2000. The information for the report was collected through evaluation forms interviews and questionnaires and explored project management, clinical impact, technical infrastructure and the organizational factors at the pilot sites that aided or impeded the successful development and implementation of the Telemedicine system. Qualitative data collected from the users of the SA NTS demonstrated the following benefits of the system:

• Access to a specialist radiologist within an hour, compared with a 5 to 7 days delay when X-rays are transported by ground transport;
• Increased competence of primary care providers in interpreting radiographic studies;
• Improved ability of community service doctors to diagnose and manage various medical conditions, particularly those related to trauma and chest diseases;
• Reduced professional isolation usually felt by junior medical doctors performing community services in rural health facilities;
• Reduction of unnecessary transfers from rural to Urban Tertiary Centres;
• Education and training opportunities for all levels of health care providers (doctors, nurses and medical students).

Respondents also felt that other medical specialties would be able to make use of such a Telemedicine facility. The comparison in this evaluation study was between the Telemedicine system and healthcare in the absence of Telemedicine. In some parts of the country, the Telemedicine pilot was undertaken without a comparable system, because Telemedicine was used to provide a service that was not available before.

Partners: Medical Research Council.

Source: Medical Research Council of South Africa site

For more information, contact:

Dr S M Gulube

Telemedicine Research Centre

Medical Research Council

Private Bag X385

Pretoria 0001

South Africa

Tel: +27 12 339-8500

Fax: +27 12 339-8593

sam.gulube@mrc.ac.za