A review of the first year's experience with an automatic message-routing system for low-cost telemedicine.
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Date
2004-01-19
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Abstract
The Swinfen Charitable Trust has used email for some years as a low cost telemedicine medium to provide consultant support for doctors in developing countries A scalable automatic message routing system was constructed which automates many of the tasks involved in message handling During the first 12 months of its use 1510 messages were processed automatically There were 128 referrals from 18 hospitals in nine countries Of these 128 queries 89 70 were replied to within 72 h the median delay was 1 1 day The 39 unanswered queries were sent to backup specialists for reply and 36 of them 92 were replied to within 72 h In the remaining three cases a second line backup specialist was required The referrals were handled by 54 volunteer specialists from a panel of over 70 Two system operators located 10 time zones apart managed the system The median time from receipt of a new referral to its allocation to a specialist was 0 2 days interquartile range IQR 0 1 0 8 The median interval between receipt of a new referral and first reply was 2 6 days IQR 0 8 5 9 Automatic message handling solves many of the problems of manual email telemedicine systems and represents a potentially scalable way of doing low cost telemedicine in the developing world