Supporting hospital doctors in the Middle East by email telemedicine: something the industrialized world can do to help.

Background: Since 1999, the Swinfen Charitable Trust has operated an email referral system between doctors in the developing world and specialists in the industrialized world. Since 2001, it has expanded its operation into the Middle East, in particular Iraq, an area of considerable conflict.

Objectives: The aim was to compare referral patterns to the Trust from the Middle East with those received from the rest of the developing world and to look for qualitative evidence of health gain.

Referral patterns in a global store-and-forward telemedicine system.

We examined the nature of the referral patterns in the email telemedicine network operated by the Swinfen Charitable Trust with a view to informing long-term resource planning. Over the first six years of operation, 62 hospitals from 19 countries registered with the Trust in order to be able to refer cases for specialist advice; 55 of these hospitals (89%) actually referred cases during this period. During the first six years of operation, nearly 1,000 referrals were submitted and answered, from a wide range of specialty areas.

Prospective case review of a global e-health system for doctors in developing countries.

The Swinfen Charitable Trust has managed email consultations for doctors in developing countries since 1999. The process was handled manually for the first three years and then subsequently using an automatic message-handling system. We conducted a prospective review of email consultations between referring doctors and consulting specialists during six months of automatic operation (December 2003 to May 2004).

A review of the first year's experience with an automatic message-routing system for low-cost telemedicine.

The Swinfen Charitable Trust has used email for some years as a low-cost telemedicine medium to provide consultant support for doctors in developing countries. A scalable, automatic message-routing system was constructed which automates many of the tasks involved in message handling. During the first 12 months of its use, 1510 messages were processed automatically.

Low-cost telemedicine in the developing world.

The Swinfen Charitable Trust uses digital cameras and email to provide specialist advice to doctors in developing countries. The first telemedicine link was set up in July 1999. By the end of a year there were three links to hospitals in Bangladesh, Nepal and the Solomon Islands.