Operationalizing a Hub-and-Spoke Telemedicine Model for Mpox Surveillance in a High-Alert, Zero-Prevalence Setting:...

Area of Science:

• Public Health
• Infectious Diseases
• Telemedicine

Background:

• Global monkeypox (Mpox) outbreak necessitated enhanced surveillance and response strategies.
• Fars Province, Iran, implemented a structured telemedicine approach for Mpox-like symptom management.

Purpose of the Study:

• To evaluate a tiered, hub-and-spoke telemedicine model for Mpox case management.
• Assessed the model's impact on triage, differential diagnosis, and cost-efficiency in a zero-Mpox prevalence setting.

Main Methods:

• An observational study involving 150 patients with fever and rash from August 27 to September 22, 2024.
• Utilized asynchronous WhatsApp consultations for escalating cases to a central specialist hub.
• Performed diagnostic testing based on telemedicine triage; conducted a cost-consequence analysis.

Main Results:

• No confirmed Mpox cases; varicella and herpes zoster were the most common diagnoses.
• Telemedicine prevented 81.3% of unnecessary in-person specialist referrals.
• Achieved a 76% reduction in direct costs, saving approximately 1.09 billion Iranian Rials.

Conclusions:

• A tiered telemedicine model is effective for outbreak preparedness and managing emerging infectious diseases with cutaneous manifestations.
• The model facilitates rapid expert triage, accurate diagnosis, and substantial resource savings.
• This approach offers a scalable blueprint for future public health alerts.