Reliability of a telemedicine system designed for rural Kenya.

J Prim Care Community Health

The Pennsylvania State University, University Park, PA 16802, USA.

Published: July 2013

AI Article Synopsis

  • Access to health care in rural areas of developing nations is challenged by a lack of physicians and their preference for urban practice, leading to a telemedicine system called Mashavu being tested in rural Kenya.
  • The reliability of this system was assessed by comparing the medical advice given via telemedicine to that provided in person, with a study showing that 78.4% of the feedback was consistent between the two methods.
  • The results indicate that the telemedicine system can deliver similar quality care to traditional in-person consultations, easing logistical and economic barriers for rural patients seeking health care.

Article Abstract

Objective: Access to health care in rural areas of developing nations is hindered by both the lack of physicians and the preference of many physicians to practice in urban settings. As a result, rural patients often choose not to sacrifice wages or time to visit distant health care providers. A telemedicine system, Mashavu: Networked Health Solutions, designed to increase access to preprimary health care in rural areas, was field-tested in rural Kenya. This study aims to examine the reliability of the system compared to the traditional face-to-face method of health care delivery.

Method: Reliability of the telemedicine system was tested using a modified intraobserver concordance study. Community health workers operated the system in various remote locations. Patient health information including chief complaint, medical history, and vital statistics were sent via Internet to a consulting nurse. After patients completed the telemedicine consultation, they also met in-person with the same nurse. Subsequently, the nurse's advice during the in-person session was compared with his feedback provided through the telemedicine consultation.

Results: When comparing the nurse's advice given through the telemedicine system with the advice given through more traditional face-to-face, in-person consultation, the nurse provided consistent medical feedback in 78.4% of the cases (n = 102). The nurse's advice regarding patient action (eg, clinical referrals or no further care necessary) was the same in 89.2% of the cases (n = 91).

Conclusion: The study found that this telemedicine system was able to provide patients with approximately the same quality of care and advice as if the patient had physically travelled to a clinic to see a nurse. In rural areas of developing nations where there are high logistical and economical barriers to accessing health care, this telemedicine system successfully increased the ease and lowered the cost of connecting rural patients with nurses to provide preprimary care.

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http://dx.doi.org/10.1177/2150131912461797DOI Listing

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