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Electronic Follow-Up of Developing World Cleft Patients: A Digital Dream?
Tom W M Walker1, Ambika Chadha2, William Rodgers3
11 Department of Oral and Maxillofacial Surgery, School of Oral and Dental Science, Bristol Dental Hospital, University of Bristol , Bristol, United Kingdom .
Insights
Telemedicine follow-up for children with clefts is limited in the Philippines due to high costs and poor access to internet and devices. Electronic follow-up is not recommended for developing regions.
Area of Science:
- Global Health
- Telemedicine
- Pediatric Surgery
Background:
- Humanitarian missions provide essential cleft lip and palate surgeries in underserved regions.
- Post-operative care and follow-up are crucial for optimal outcomes in cleft patients.
Purpose of the Study:
- To assess the feasibility of telemedicine for follow-up care of children with clefts treated during a humanitarian mission.
- To identify barriers and facilitators to electronic follow-up in a developing country context.
Main Methods:
- A cross-sectional study surveyed parents of children undergoing cleft surgery in the Philippines.
- A questionnaire assessed access to internet, digital devices, and communication methods.
- Data collected on demographics, internet access, and device ownership.
Main Results:
- High mobile phone ownership (93%) but limited daily internet access (31%) and email usage (16%).
- Most parents traveled long distances (mean 187 km) to the clinic.
- Internet access was perceived as unaffordable, and mobile devices were the primary means of access (51%).
Conclusions:
- Perceived unaffordability of internet and devices, coupled with privacy concerns, hinders telemedicine adoption.
- Reliance on electronic follow-up for cleft patients in developing regions is currently not recommended.
- Alternative, affordable communication methods like SMS are most viable.
Objective:
To identify potential access to telemedicine follow-up of children with clefts operated on a humanitarian mission.
Methods:
A cross-sectional study of parents of children presenting to a humanitarian cleft lip and palate mission in a Provincial Hospital in the Philippines. A purpose designed questionnaire was used to assess access to electronic and digital resources that could be used to aid follow-up. Forty-five (N = 45) parents of children having primary cleft lip and or palate surgery participated. There were no interventions. Access to the Internet was through Parent Perceived Affordability of Internet Access and Parent Owned Devices.
Results:
Thirty-one (N = 31) respondents were female. There was 93% mobile phone ownership. The mean distance traveled to the clinic was 187 km. Majority (56%) were fluent in English. Thirty-one percent accessed the Internet daily. Sixteen percent reported use of e-mail. Fifty-one percent accessed the Internet on a mobile device, and short message service use was the most affordable means of communication.
Conclusions:
Due to perceived unaffordability and low levels of access to devices with cameras and the Internet, as well as issues with privacy, we cannot recommend relying on electronic follow-up of patients in the developing world.
