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Tele-medical Collaborations Platforms Deployed in Rural and Undeserved Areas in Latin America

Tele-medical Collaborations Platforms Deployed in Rural and Undeserved Areas in Latin America.

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Tele-medical Collaborations Platforms Deployed in Rural and Undeserved Areas in Latin America

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  1. Tele-medical Collaborations Platforms Deployed in Rural and Undeserved Areas in Latin America Alécio P. D. BinottoIlias SachpazidisStephan KieferRoland Ohl Luiz MessinaAlexandre SalesAlfonso LozanoLeonardo YundaLeonardo VitoriaGeorgios KonnisSotoris Pavlopoulos Eduardo CarrascoAugusto ValderramaGeorgios Sakas 10th Congress of the International Society for Telemedicine 2° Congresso do Conselho Brasileiro de Telemedicina e Telessaúde Sao Paulo, october 23-26, 2005

  2. Motivation • R&D Institution cooperation • Telemedicine research • @lis oportunity • T@lemed • Colombia • Brazil

  3. Outline • Colombia Case • Topcare • Brazil Case • Ultrasound Teleconsultation • Preliminary Results • Sustenability and Dissemination • Conclusion

  4. Colombia Case • Malaria and Tuberculosis diagnosis • Every year 8.8 billion people develop active TB • According to the WHO Report of Infectous Diseases 2002, between 2000 and 2020, additional 1 billion people will be infected, 200 million will be sick and 35 million will die of TB in the world if no diagnosis/treatment expansion will be carried out • Colombia had TB incidence in 1996 of 26.5 per 100,000 people and 3.4 of mortality • Malaria is responsible for about 300 million of clinical cases and over 1 million of deaths per year

  5. Colombia Case • Use of the Fraunhofer store-and-forward TOPCARE platform • www.topcare.info • Platform adaptations for the goal of Malaria and Tuberculosis • Kiosk composed by PC with videophone, medical devices and a microscope with and integrated digital camera • Images transference • Correct Diagnosis and treatment

  6. Colombia Case • Kiosks implanted in 3 cities making teleconsultations with • International Vaccine Center in Cali • National University in Bogota • More 2 kiosks are planned

  7. Outline • Colombia Case • Topcare • Brazil Case • Ultrasound Teleconsultation • Preliminary Results • Sustenability and Dissemination • Conclusion

  8. Brazil Case • Based on Ultrasound images, but any other image can used • Espírito Santo State • Trauma and Radiology • Rio Grande do Sul State • Abdominal and Obstetrics • Cardiology

  9. Brazil Case

  10. Brazil Case

  11. Brazil Case – Espírito Santo • FAHUCAM Hospital Center • It is on the begining and will conect the Reference Center with 4 Remote Cities

  12. Brazil Case – Rio Grande do Sul • Santa Casa de Porto Alegre Hospital • Medical reference center • Average of 5000 ultrasound exams • 2000 from out-patients • Reduce to 1000 out-patients • Non-critical cases

  13. Tele-consultation system On/off-line transmission and Real-time Tele-consultation Remote location Video / Images acquisition Save DICOM and compression Connection (TCP/IP, modem, satellite) Data transference Tele-consultation Excellencecenter Accept connection Data reception Tele-consultation Brazil Case real-time

  14. TeleConsult

  15. TeleConsult

  16. TeleConsult

  17. TeleConsult

  18. Outline • Colombia Case • Topcare • Brazil Case • Ultrasound Teleconsultation • Preliminary Results • Sustenability and Dissemination • Conclusion

  19. Preliminary Results • Lagoa dos Três Cantos • 1,200 inhabitants • 1 health center • 1 dedicated generalist MD • Preventive health care • 321 patients submitted to US exams (in one year) • 67 exams (21%) needed a second opinion and were transmitted to Santa Casa • 12 exams had to be repeated (wrong image acquisition)

  20. Preliminary Results • Sao Borja • 68,000 inhabitants • 1 Hospital – Ivan Goulart • 45 MDs and 1 radiology expert • Obstetric – Ginecolocic application • 60 exams needed a second opinion and were transmitted to Santa Casa in 7 months operation • 8 patients presented critical cases identified by the Reference Hospital

  21. Preliminary Results • Mostardas • 12,000 inhabitants • 1 Hospital – Sao Luiz • 4 MDs and 1 radiology expert (1 day per week) • Abdomen application • 4 exams transmitted to Santa Casa in 1 month operation (no one needed a second opinion yet)

  22. Outline • Colombia Case • Topcare • Brazil Case • Ultrasound Teleconsultation • Preliminary Results • Sustenability and Dissemination • Conclusion

  23. Sustenability and Dissemination • Business plan for Santa Casa Hospital in Rio Grande do Sul • Wants to offer the service after the project • Measure the cost-effectiveness of tele-consultation • Compare with all the costs of patient transference for central hospitals • We have the goal to make it feasible • Exchange the 2 technologies between Brazil and Colombia and make a network

  24. Sustenability and Dissemination

  25. Sustenability and Dissemination • ESA – European Space Agency • AMAZONAS Satellite of Hispasat group launched in 2004 • Covers North America, South America, Brazil and Europe • AmerHis technologie, with goal to provide high performance interactive multimedia services • Alcatel 9343 DVB processor • Multiplexing • Bidirectional transmission

  26. Outline • Colombia Case • Topcare • Brazil Case • Ultrasound Teleconsultation • Preliminary Results • Sustenability and Dissemination • Conclusion

  27. Conclusion • Innovative on the applied research field • Contributes to reduce the disparity level in medical services using ultrasound images • Improve quality and provide access on ultrasound examitations to rural and undeserved areas • Reduce presence examinations in Rio Grande do Sul, Espirito Santo, Bogota e Cali • High practical application

  28. Conclusion • Starting the Pará Pilot regarding ultrasound • Establish a tele-consultation network in Brazil and Colombia

  29. Conclusion • Portable ultrasound in Pará with Satellite comunication and in Rio Grande do Sul State with fast internet (ANVISA certification)

  30. Questions? abinotto@inf.ufrgs.br http://www.senairs.org.br/ceta www.alis-telemed.net

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