Telemedicine applications in developing countries

Teleconsultation and Videoconferencing in Malta

Malta :state of 316 km² between Africa and Europe, composed of several islands, the greatest are Malta and Gozo.

Objectives are :

The Health Division of Malta government has these objectives for telemedicine development:

to further enhance the Malta health care system,
to reduce costs and
to acquire experience and competence, which can be used for exploiting future business prospects in the region and sub-Sahara Africa.

Background

The BDT (ITU Bureau for Development of Telecommunications) requested Telia Swedtel to assist Maltacom and the Health authorities in Malta to define, plan and implement a telemedicine system for Malta. Telia Swedtel undertook to support this project by assigning expertise for studying the feasibility, determining standards and specifications for a system and assisting in the overall planning and implementation of the telemedicine pilot project.

The main component of this project is to connect St. Luke's Hospital in Malta with the General Hospital in Gozo, a separate island a fewkilometres north of Malta with about 30,000 inhabitants. The aim is to provide dedicated services for high speed data communication between the hospitals.

A videoconferencing system is to be established between Gozo and Malta allow different medical disciplines in Gozo to have peer consultations with St. Luke's Hospital in Malta.

Another component of the project is a telemedicine link between the Special Care Baby Unit at St Luke's Hospital and Great Ormond Street Hospital for Sick Children in London. This link should provide off-line consultations by transmitting moving images from a colour Doppler Echocardiography machine for expert interpretation in London.

The third component of the project is a telemedicine link between St. Luke's Hospital and a University Hospital in Sweden. This shall provide interactive case discussion and education and training regardingdiabetics, by utilizing either PC based or small studio based video conference terminals.

Demonstration

Videoconferenceing links will be set up by Maltacom between the demonstraton area at the Mediterranean Conference Centre in Valletta and St. Luke's Hospital. Delegates will be able to follow practical examples of the use of the telemedicine links between Malta and Gozo and possibly between Malta and Sweden. The link between the Special Care Baby Unit and Great Ormond Street Hospital may be demonstrated by means of a video.

The physicians in Gozo General Hospital would like to consult with their peers in different clinics and departments in St. Luke's Hospital in Malta.

Among the expressed needs for telemedicine at Gozo General Hospital were the following:

Medical education: to link with the regular activities held at St. Luke's Hospital
Consultation regarding ENT, dermatolgy and psychiatry - Clinical telemedicine (radiology, pathology)
Access to Internet
Access to different databases
Access to other telemedicine networks

Sending ecocardiograms to Great Ormond Stret for interpretation is expected to lower the threshold for consultations, allowing for better clinical planning, timing and decisions for surgery. This might not lower the number of referrals from Malta for open heart surgery in London. The aim however is to raise quality of care by improving the planning and timing of the individual referrals.

Partners

The Health Division will finance the investment cost for the telemedicine system, including the associated software.
Maltacom is responsible for the arrangements necessary to demonstrate the telemedicine project at the WTDC. Maltacom will ensure the provision of all the necessary transmission installations, including the link between the two hospitals participating in the pilot project, as well as the linking up to the Conference Centre.
Telia Swedtel will provide all the necessary expert assistance and the international telecommunications capacity for a link between St. Luke's Hospital in Malta and a University Hospital in Sweden.
Malta Information Technology and Training Services LTD. will assist in the purchase and implementation of the system components and all supplementary equipment required for the existing hospital LANs.