Teleconsultations in Pohnpei State, Federated States of Micronesia

A case report of 6 years old female who sustained a difficult right subtronchanteric fracture of the femur is outlined. She was treated successfully, with local materials, over the internet with assistance of the orthopaedic surgeons at the Tripler Army Medical Center in Honolulu. Pohnpei State spends 10% of the health budget in referring patients off-island for tertiary treatments and this serves less than 1% of the total population. Before the use of the internet, approximately $US1,500 per month was spend on telephone bills, for outside consultations. After connection to the internet and the consult webpage, particularly at Tripler, this cost was reduced to below $US500 per month. To date, fifty consults, via the Internet, have been sent to the TAMC Consult Webpage. The introduction of this service has resulted in cost saving in terms of referral communication and perhaps avoided unnecessary off island evacuations. The difficulties so far have been limitation of on-line access and computer illiteracy amongst physicians.