Evaluating the potential impact of a mobile telemedicine system on coordination of specialty care for patients with complicated oral lesions in Botswana

Abstract

Mobile telemedicine involves the use of mobile device (e.g., cell phones, tablets) technology to exchange information to assist in the provision of patient care. Throughout the world, mobile telemedicine initiatives are increasing in number and in scale, but literature on their impact on patient outcomes in low-resource areas is limited. This study explores the potential impact of a mobile oral telemedicine system on the oral health specialty referral system in Botswana. Analysis of 26 eligible cases from June 2012 to July 2013 reveals high diagnosis concordance between dental officers and oral health specialists at 91.3% (21/23) but significant management plan discordance at 64.0% (16/25), over two-thirds of which involved the specialists disagreeing with the referring clinicians about the need for a visit to a specialist. These findings suggest mobile telemedicine can optimize the use of insights and skills of specialists remotely in regions where they are scarce.

Keywords: disease management; health impact assessment; mobile Health (mHealth); oral medicine; telemedicine.

Figure 1:

Screenshots of the Mobile Oral Telemedicine System Application First row, left: A question that had existed on the mobile phone application used by referring providers since its development. First row, right: A question added to the mobile phone application used by referring providers as part of the study. Second row: Sample of the view of a case submitted by a referring provider as seen from the web-based portal. Third row: Sample of the view of the response submitted by a specialist to the case submitted in the row above as seen from the web-based portal.