Follow-up data for patients managed by store and forward telemedicine in developing countries

There is very little published information about the outcomes of patients treated by telemedicine in developing countries. Over a two-year period, seven medical students from five universities spent their electives at a hospital in Papua New Guinea. They assisted with the review of a total of 44 e-referrals made by local doctors; the referrals resulted in 61 queries in a wide range of specialties. The major categories of these queries were internal medicine, paediatrics and surgery. Follow-up data were obtained in 22 of the 44 cases (50%) after a median period of 13 weeks (interquartile range 3-19). The cases were reviewed by an independent doctor. Telemedicine was considered to have assisted with the diagnosis in all cases (median score 5 on a five-point scale from 1 = not helpful at all to 5 = very good/excellent). The advice to the referring doctor for further action was considered helpful in all except one case (median score 5 on the same scale). The outcome for the patient was considered to be good in 15 of the cases (median score 4 on the same scale). Medical students were able to facilitate e-referrals by relieving the pressure on the local doctor to undertake the necessary clerical and technical work. The students reported a rewarding elective experience. The follow-up data showed that low-cost telemedicine can provide useful advice in a low resource setting.