Every day, thousands of volunteer medical relief groups offer care to patients and assistance to understaffed medical teams in remote, underdeveloped locations around the world. Often, these groups of physicians and nurses come for a short time, offer care and return home. Â Once they leave, what then?
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â€śThe difficulty is continuity of care,â€ť says Blake Fechtel, Mayo Graduate/Mayo Medical School, a student in the M.D./Ph.D. program who is working in a poor and secluded area of Honduras conducting a 12-month study on the use of telemedicine. â€śBut, thereâ€™s no reason we canâ€™t maintain a relationship through some form of telecommunication.â€ť
Fechtel and his advisor, Bart Demaerschalk, M.D., Neurology, who is director of the Mayo Clinic Telestroke and Teleneurology program, presented initial findings from the study at the American Telemedicine Association meeting on May 7 in Austin, Texas. Telemedicine is the use of telecommunication or computer technology to provide health care from a distance. Doctors communicate with patients using digital video cameras, Internet telecommunications, robotic telepresence, smartphones and other technology.
Fechtelâ€™s project, "Satellite-Supplementation of Medical Outreach Clinics," uses a Very Small Aperture Terminal satellite Internet to connect with volunteer physicians in the U.S. to examine patients via teleconference in clinics run by Global Brigades in rural Honduras. The study, involving 445 patients, will produce insight into health care issues in these isolated areas and outline the obstacles to providing telemedicine services.
Speaking from Honduras, Fechtel says that the medical conditions are substandard because there isnâ€™t the financial infrastructure to provide needed health services. He works in a temporary clinic with two volunteer in-house physicians: those two physicians typically see more than 300 patients in five hours. The relief teams that come in help, but unfortunately, they canâ€™t stay long. Incorporating telemedicine may help that.
â€śWhen a physician has to see so many patients, thereâ€™s no chance to build rapport,â€ť Fechtel says. â€śTelemedicine makes more physicians available and they get to take more time. The telemedicine physician can concentrate solely on the patient on the screen so they donâ€™t feel the time pressure of a huge line in the clinic.â€ť
Fechtel says that despite some challenges, the feedback from patients who were seen in the initial phase of the study has been positive.
â€śEven though some of the patients have never even seen a computer, they love it,â€ť he says. â€śThey really like having the time with the physician.â€ť