Design of Architecture and Implemantation Issues for a Terresterial and Vsat Based National Telemedicine Network
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Date
2004-11
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Addis Ababa University
Abstract
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.
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Keywords
Architecture; and Implemantation