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Using e-mail in the management of tuberculosis patients, north-west Russia
S B Uldal1, E Nikishova, N Rakova
1Norwegian Centre for Telemedicine, University Hospital of North-Norway, Tromsø, Norway. siribu@start.no
Setting:
Ten health care institutions in north-west Russia.
Objective:
To improve the management of tuberculosis patients using e-mail.
Design:
Over an 18-month period, all outgoing and incoming e-mails at the Arkhangelsk Regional Tuberculosis Centre were saved and categorised. All e-mails relating to distance learning were logged, and a consensus panel discussed and answered questionnaires regarding 47 e-mail-based second opinions.
Results:
e-mail was found to speed up communication and increase the availability of specialist advice. Distance learning was positively received, but was used in moderation. For six of 47 consultations (13%), the consensus panel deemed that fast access to a second opinion saved lives. In 30 consultations (64%), the patient was saved a round trip to a specialist centre. In 24 consultations (51%), the panel considered that the patients had started correct treatment between 1 week and 1 month earlier than without e-mail access. In 11 of these consultations, 23% of the total, the patient was found to be infectious. The learning effects of second opinions were recognised.
Conclusion:
General e-mail use and the second opinion service in particular were found to be useful. Further studies are needed to investigate the advantages and disadvantages of using e-mail as a tool in the management of TB.
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