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. 2014 Aug 26:2:126.
doi: 10.3389/fpubh.2014.00126. eCollection 2014.

The Development of a Multilingual Tool for Facilitating the Primary-Specialty Care Interface in Low Resource Settings: the MSF Tele-Expertise System

Laurent Bonnardot  1 , Joanne Liu  2 , Elizabeth Wootton  3 , Isabel Amoros  4 , David Olson  5 , Sidney Wong  6 , Richard Wootton  7
Affiliations

The Development of a Multilingual Tool for Facilitating the Primary-Specialty Care Interface in Low Resource Settings: the MSF Tele-Expertise System

Laurent Bonnardot et al. Front Public Health. .

Abstract

In 2009, Médecins Sans Frontières (MSF) started a pilot trial of store-and-forward telemedicine to support field workers. One network was operated in French and one in English; a third, Spanish network was brought into operation in 2012. The three telemedicine pilots were then combined to form a single multilingual tele-expertise system, tailored to support MSF field staff. We conducted a retrospective analysis of all telemedicine cases referred from April 2010 to March 2014. We also carried out a survey of all users in December 2013. A total of 1039 referrals were received from 41 countries, of which 89% were in English, 10% in French, and 1% in Spanish. The cases covered a very wide range of medical and surgical specialties. The median delay in providing the first specialist response to the referrer was 5.3 h (interquartile range 1.8, 16.4). The survey was sent to 294 referrers and 254 specialists. Of these, 224 were considered as active users (41%). Out of the 548 users, 163 (30%) answered the survey. The majority of referrers (79%) reported that the advice received via the system improved their management of the patient. The main concerns raised by referrers and specialists were the lack of support or promotion of system at headquarters' level and the lack of feedback about patient follow-up. Because of the size of the MSF organization, it is clear that there is potential for further organizational adoption.

Keywords: developing countries; multilingual network; tele-expertise; telehealth; telemedicine.

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Figures

Figure 1
Figure 1
Country of origin of the specialists (n = 269). The countries are shaded: light gray, <5 specialists; dark gray, 5–25 specialists; black, >25 specialists.
Figure 2
Figure 2
Submission rate of clinical cases (n = 1067).
Figure 3
Figure 3
Country of origin of the telemedicine cases (n = 1039). The countries are shaded: light gray, <5 cases; dark gray, 5–50 cases; black, >50 cases. The country of origin could not be determined in a small proportion of cases (1.2%).
Figure 4
Figure 4
Number of queries per case.
Figure 5
Figure 5
Percentage of all referrers who had submitted a case.
Figure 6
Figure 6
Percentage of all specialists who had been sent a query.
See this image and copyright information in PMC

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