Telemedicine and e-health

the South African

experience

DR L.M MOLEFI
United Nations/Zambia/ESA Regional Workshop
26-30 JUNE 2006, LUSAKA
 SA NATIONAL TM PROGRAMME
z Started in 1999
z Phased approach
z National coordination
z Currently provinces have TM in their workplan

7/6/2006 2
 THE NEED

z First world v/s third world medicine.

z Inequalities of the past.
z SA governments commitment to healthcare for
all.
z Primary Healthcare focus.
 DELIVERABLES
z Clinical services to remote communities.
z Improved efficiency.
z Tele-education and Training.
z Medical Research.
 SOUTH AFRICA: 1999 TELEMEDICINE
SITES

Telemedicine Sites
Remote sites
Referral sites Northern Province

Gauteng Mpumalanga
North West

Free State KwaZulu-Natal

Lesotho
Northern Cape

Eastern Cape

Western Cape 0 150 300

MRC Kilometers
Produced by: Health GIS Centre, MRC
Source: MRC Telemedicine Programme
 Telemedicine Research Centre
Established as a joint project by the Department of
Health and the MRC with a mandate
z To evaluate existing and planned TM systems to
ensure improved delivery
z Coordinate national TM activities

z Investigate new technologies and practices

z To establish TM standards in TM

z Establish Tele-Education for health care

proffessionals
 projects
z Clinical Telemedicine- about 40 sites
radiology,dermatology,ultrasound,
neurosurgery,opthalmology ,pathology etc
z Teleeducation 34 sites KZN,
40 sites FS
z Mindset Health Channel >100 sites
z R & D projects mobile lab
Workstation development
 Mpumalanga
Witbank & Maputo
Mangweni
Clinic

Mbuzini
Clinic
Pretoria
Tonga Hospital
WORKSTATION
 Challenges Identified in the
Projects

z Connectivity Issues
z Human Technology Interfaces
z System integration
z Affordability
z Standards
 Telecommunications infrastructure
z Most projects use ISDN lines
z Health channel uses satelite
z Teleeducation in FS uses satelite
z GSM/GPRS
z POTS
 Connectivity Issues
z Cost
z Installation
z Ongoing Cost
z Bandwith
z 384 kbps if video conferencing is required
z Identified solution
z WiMax / WiFi
z Low maintenance cost
z Offer other opportunities
z VOIP
z Internet and e-Mail
z Challenge Licensing
 e-Mail

Store and forward

Image attachment
<500 kb
<3/4 pics max
 e-Mail
Local experience

>85% of all images

are adequate

>80% patients saved

unnecessary transfer
Primary Health Care Telemedicine
Workstation (SA innovation)
 VIRTUAL HOSPITAL
African Health System SMMES

Public/Private
Partnership

Public Tech Patners

Clinicians Know-how
Facilities Technology
Primary Healthcare Systems
Patients

Technology Platform
Clinical Guidelines
Telemedicine Systems MRC
Private Research
Clinicians Communication Systems
Software Appropiate technology
Facilities Training
Finance Patient Information System

Patient Pool Funders

Multi-Lateral
Global Bi-Lateral
Primary Specialist Nepad Agencies
Time Zone
Healthcare Services Private Sector
 Way forward

z Wireless technologies for Africa telehealth

z Negotiate for free bandwidth for health and
education
Contact details
z Dr Moretlo Molefi
z Moretlo.molefi@mrc.ac.za
z www.mrc.ac.za/telemedicine
11th ISfTeH International Conference
26 29 November 2006

International Convention Centre

Cape Town, South Africa
Thank You!