Delivering health care in rural Cambodia via store-and-forward telemedicine: A pilot study

Heather A. Brandling-Bennett, Iris Kedar, Daniel J. Pallin, Gary Jacques, Graham J. Gumley, Joseph C. Kvedar

Research output: Contribution to journalReview articleResearchpeer-review

Abstract

Since 2001, a monthly telemedicine clinic has helped provide health care to residents in a remote region in Cambodia. Physicians at Massachusetts General Hospital and Brigham and Women's Hospital in Boston, Massachusetts, and Sihanouk Hospital of HOPE in Phnom Penh, Cambodia, provide consultations via e-mail to a mobile nurse in the district of Rovieng, Cambodia. We describe the operations of the monthly clinic and report the results of a retrospective case review of the first 28 months of consultations. We also report the results of a satisfaction and willingness to pay survey. A total of 264 visits were made during the 28 monthly sessions. Mean duration of chief complaint at initial visit declined from 37 months to 8 months during the first and last 6 months of the study period, respectively. Thirty-six percent (n = 76) of new patients complained of abdominal pain. Nine percent (n = 20) of new patients were given an empiric diagnosis of goiter. The percent of patients requiring referral to a hospital outside of the village decreased over time. All patients surveyed were either "very satisfied" or "satisfied" with their care, and most patients were willing to pay for a visit, with a median amount of USD 0.63. We conclude that store-and-forward e-mail consultative support for mobile nonphysician health care workers is a feasible model for delivering care in the developing world. Further research is needed to demonstrate improvement in health status, cost effectiveness, and sustainability.

LanguageEnglish
Pages56-62
Number of pages7
JournalTelemedicine Journal and e-Health
Volume11
Issue number1
DOIs
Publication statusPublished - Feb 2005
Externally publishedYes

Fingerprint

Cambodia
Telemedicine
Health care
Delivery of Health Care
Referral and Consultation
Postal Service
Goiter
Cost effectiveness
General Hospitals
Health Care Costs
Abdominal Pain
Health Status
Cost-Benefit Analysis
Sustainable development
Patient Care
Nurses
Health
Physicians
Research

Cite this

Brandling-Bennett, Heather A. ; Kedar, Iris ; Pallin, Daniel J. ; Jacques, Gary ; Gumley, Graham J. ; Kvedar, Joseph C. / Delivering health care in rural Cambodia via store-and-forward telemedicine : A pilot study. In: Telemedicine Journal and e-Health. 2005 ; Vol. 11, No. 1. pp. 56-62.
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Delivering health care in rural Cambodia via store-and-forward telemedicine : A pilot study. / Brandling-Bennett, Heather A.; Kedar, Iris; Pallin, Daniel J.; Jacques, Gary; Gumley, Graham J.; Kvedar, Joseph C.

In: Telemedicine Journal and e-Health, Vol. 11, No. 1, 02.2005, p. 56-62.

Research output: Contribution to journalReview articleResearchpeer-review

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