Browsing by Author "Olson, David"
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- ItemThe Development of a Multilingual Tool for Facilitating the Primary-Specialty Care Interface in Low Resource Settings: the MSF Tele-Expertise System.(2014-09-10) Bonnardot, Laurent; Liu, Joanne; Wootton, Elizabeth; Amoros, Isabel; Olson, David; Wong, Sidney; Wootton, RichardIn 2009 M decins Sans Fronti res MSF started a pilot trial of store and forward telemedicine to support field workers One network was operated in French and one in English a third Spanish network was brought into operation in 2012 The three telemedicine pilots were then combined to form a single multilingual tele expertise system tailored to support MSF field staff We conducted a retrospective analysis of all telemedicine cases referred from April 2010 to March 2014 We also carried out a survey of all users in December 2013 A total of 1039 referrals were received from 41 countries of which 89 were in English 10 in French and 1 in Spanish The cases covered a very wide range of medical and surgical specialties The median delay in providing the first specialist response to the referrer was 5 3 h interquartile range 1 8 16 4 The survey was sent to 294 referrers and 254 specialists Of these 224 were considered as active users 41 Out of the 548 users 163 30 answered the survey The majority of referrers 79 reported that the advice received via the system improved their management of the patient The main concerns raised by referrers and specialists were the lack of support or promotion of system at headquarters level and the lack of feedback about patient follow up Because of the size of the MSF organization it is clear that there is potential for further organizational adoption
- ItemA Retrospective Analysis of Pediatric Cases Handled by the MSF Tele-Expertise System.(2014-12-24) Martinez Garcia, Daniel; Bonnardot, Laurent; Olson, David; Roggeveen, Harriet; Karsten, Jaap; Moons, Peter; Schaefer, Myrto; Liu, Joanne; Wootton, RichardWe conducted a retrospective analysis of all pediatric cases referred by M decins Sans Fronti res MSF field doctors via the MSF telemedicine system during a 4 year period from April 2010 A total of 467 pediatric cases were submitted representing approximately 40 of all telemedicine cases The median age of the patients was 4 years The median response time i e the interval between the case being submitted and the first response from a specialist was 13 h interquartile range 4 32 h We selected a random sample of 12 pediatric cases in each of four age categories for detailed analysis by an experienced MSF pediatrician In the 48 randomly selected cases the mean rating for the quality of information provided by the referrer was 2 8 on a scale from 1 very poor to 5 very good and the mean rating for the appropriateness of the response was 3 3 same scale More than two thirds of the responses were considered to be useful to the patient and approximately three quarters were considered to be useful to the medical team The usefulness of the responses tended to be higher for the medical team than for the patient and there was some evidence that usefulness to both groups was lower in newborns and adolescent patients The telemedicine system allows the quality of the medical support given to medical teams in the field to be controlled objectively as there is a record of all cases and answers Telemedicine has an important role in supporting the aims of medical humanitarian organizations such as MSF
- ItemTeledermatology in Low-Resource Settings: The MSF Experience with a Multilingual Tele-Expertise Platform.(2014-12-02) Delaigue, Sophie; Morand, Jean-Jacques; Olson, David; Wootton, Richard; Bonnardot, LaurentIn 2010 M decins Sans Fronti res MSF launched a tele expertise system to improve the access to specialized clinical support for its field health workers Among medical specialties dermatology is the second most commonly requested type of tele expertise The aim of the present study was to review all MSF teledermatology cases in the first 4 years of operation Our hypothesis was that the review would enable the identification of key areas for improvement in the current MSF teledermatology system