Design of Architecture and Implemantation Issues for a Terresterial and Vsat Based National Telemedicine Network

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Addis Ababa University


For a developing country such as Ethiopia with a difficult mountainous terrain and limited transportation infrastructure coupled with one of the lowest patient-doctor ratios anywhere in the world (almost 30,000 to 1), telemedicine offers a costeffective health-care system. This awareness is slowly gaining traction in the country with a pilot program entering a trial stage. Looking forward, however, we argue that telemedicine should play a more prominent role in the national healthcare plan mainly due to its cost-effectiveness and the availability of a substantial number of Ethiopian physicians living abroad - in some accounts more Ethiopian physicians live outside Ethiopia than inside - whose expertise can be tapped. To study the past and current effort on the application of telemedicine in Ethiopia, a survey of government, public and private hospitals was conducted. The survey included stakeholders of the health care system of the country through interviews and questionnaires. The result of the survey indicated that there have been few attempts to introduce telemedicine in Ethiopia. These efforts were found to be effective in creating awareness about the benefits of telemedicine; but with a limited scope. The study also investigates interests of the growing number of private hospitals that may have sufficient funds to implement telemedicine systems and identifies the specific area of telemedicine the private hospitals would be interested. Further, we propose a comprehensive design of network architecture for a nationwide telemedicine network that connects all regional hospitals and health centers with the urban public and government hospitals. Specifically, we propose a high level telemedicine network architecture, which can be implemented over the existing/emerging ICT infrastructure in Ethiopia to. The network connects all regional clinics with public/government urban hospitals for the purpose of data transmission in the form of text and images, as well as instantaneous access to patient information. We also propose a web based telemedicine system, which provides basic services for medical tele-consultation. The system can be used by health care providers to store and retrieve patient information, to write referrals and give feedback to referrals, by using a web based Graphical User Interface. Since implementation of telemedicine could be challenged by factors such as medical ethics and medico-legal issues as well as user's resistance, we have presented these challenges. In the long run, we propose that the success of telemedicine efforts in the country will depend on its financial and operational sustainability. Commercialization, as one possible vehicle of financial sustainability is investigated.



Architecture; and Implemantation