IICD supported project: Teleradiology via the Internet (IKON)

Countries: Mali [ML]
Sectors: health

Summary

Telemedicine is a relatively new development in the health sector whereby modern communication technology enables doctors in rural areas to call in the help of specialised doctors in larger, academic hospitals to give the right diagnose and to decide upon the right course of treatment. In Mali, IICD assisted SOMIM (Société Malienne d’Imagerie Médicale) with setting up internet connection between the hospital Point GP in Bamako and three hospitals in the rural areas of Timbuktu, Mopti and Sikasso to experiment with teleradiology. The teleradiology project provides a solution for the lack of trained radiologists in rural hospitals, by offering the possibility to send or receive x-ray scans and diagnosis over the internet. After a difficult start doctors from three rural hospitals now use the technology. The health care in rural areas has significantly improved as patients get a quicker diagnosis and better medical treatment. The project has even proved able to save people’s lives!

Update

Updated: 2008-03-10

During the first year of implementation (2004), the project had several setbacks, especially on the technical and organisational level: scanners proved more expensive than budgeted, software for the scanners was not supplied, connectivity and server problems at the level of Keneya Blow’n (another IICD supported health project in Mali) forced the project to migrate to a Canada based server. On the organisational side, it became clear that the project lacked dedicated staff for the execution part. Most of the work was done by the consultants of IDC and Reonet, two training partners of IICD. Nevertheless, approximately 150 hospital staff of the four involved hospitals were informed about the project during seminars, and 35 hospital staff in the four hospitals received basic training.

The very first real-life exchange of radio scans via the Internet took place in April 2005 between the regional hospital of Mopti and the national hospital Point G in Bamako, and immediately revealed its potential. An initial diagnosis by local staff in Mopti of a radio of a patient’s hand - potential bone cancer in one of the fingers - was dismissed by the experts in Bamako as a default error on the radio film, thus saving the patient from the premature amputation he himself had requested for!

In 2006, the project owner dr. Touré travelled to Tanzania to present the Teleradiology project to the participants of the IICD Roundtable workshop for the Health sector.

Introduction

During an IICD Roundtable workshop in Mali in 2002, many important actors in the health care sector in Mali were invited to discuss problems and potential solutions in the health care sector in Mali. The conclusion was that radiology is a big problem in Mali since all radiologists are located in Bamako. Dr. Mamadou Touré took the initiative to address this structural problem by using the benefits of Internet technology. He teamed up with medical student Romain-Rolland Tohouri - who wrote his thesis on the opportunities of tele-radiology for developing countries – to develop a computer network between the regional hospitals and the central hospital in Bamako. Initially a telemedicine link was only supposed to facilitate the exchange of x-rays, however the idea is that it can spread itself to other medical specialties in the long run.

Objectives

The project aims to reach the following objectives:

• Awareness creation on ICT for Health
• Capacity building of hospital staff
• Cost reduction for hospitals and patients

Planned outputs

The project activities/outputs are:

• to install equipment in four hospitals in Mali (Bamako – Point G, Ségou, Mopti and Sikasso) which should facilitate the production and exchange of radio scans via the Net;
• to capacitate hospital staff via awareness creation seminars and training workshops;
• to establish an organisational and financial system that guarantees the sustainability of the initiative; and,
• to embed the pilot project in the national Health policy.

Development Impacts

The direct beneficiaries of the project will be the related hospital staff and patients whose radios need to be submitted to expert diagnosis by a radiologist. The expected economic benefits are significant reductions on travel costs for patients, and improved use of local hospital facilities (less pressure on – more expensive - hospital facilities in the capital. The project also will contribute to the understanding of the possibilities of ICT for Health by hospital staff and to the development of general ICT-skills and/or specific ICT4Health skills.

Management and organisation

The project owner is the not-for-profit organization SOMIM (Société Malienne d’Imagerie Médicale), supervised by dr. Mamadou Touré, radiologist in Bamako, and the project is being implemented by the four hospitals involved. The acquisition and installation of equipment and software development is done by a specialised consultancy bureau, REONet. Awareness creation seminars and training workshops are delivered by the ICT training center IDC.

Market and finance

Revenues will be generated by charging the patients for the service. Normally, patients will be able to make a huge reduction on potential travel costs by utilizing this system.

Lessons learned

The teleradiology project in Mali proved to be very successful. Specialists use the technology and it is even proven that people’s lives are saved because of the possibility to set a proper diagnosis via the telemedicine link. What are the lessons learned from this project? In short, these are:

1. When introducing a technology such as telemedicine in a developing country, it is of vital importance that the innovation is need driven rather than technology driven.
2. A number of very motivated people constituted to the success of the project.
3. Training was not only a big part of the project, but also made small gradual steps. The training was focussed on basic ICT skills; how to work with a computer, how to use e-mail and how to use internet.
4. Awareness seminars can be very effective not only to raise awareness amongst potential users, but also to filter motivated people from people who are not willing to use the technology.
5. Very advanced and sophisticated telemedicine equipment is not a perquisite. Elementary equipment is initially sufficient and better to understand, use and maintain for the developing world.
6. The changes in governance in Mali over the past eight years (a tendency towards decentralization of authority) have contributed to the success of telemedicine in this context. This means that hospitals now have become more independent from governments.

Budget

The overall budget (€ 128.000) could be kept relatively low by directly involving the hospitals in the implementation, thus allowing a slim organisational structure. Most budget was spent on equipment and training.

Project Owner : SOMIM (Société Malienne d'Imagerie Médicale)

Project Partners : IICD, keneya Blown, the involved hospitals.

Project Contact : IICD