Past, present and future: experiences and lessons from telehealth projects

Elder, Laurent; Clarke, Michael

In Indonesia, the Development of ICT-based Telemedicine System for Primary Community Health Care in Indonesia project used existing Internet technology to enhance PC-based medical stations and pilot-tested a telemedicine application. The pilot network consists of six medical stations within community health centres and a station for each referral hospital, health office and test laboratory. The pilot found that human resource capacity-building -in particular, training to facilitate the adoption of computer and telemedicine technology -required significantly more time than expected. The project therefore demonstrated the important role that human resource development plays in the sustainable implementation of ICT-based telemedicine systems. However, as before, no findings were documented on the actual effect the pilots had on people's health or on health systems. 2 What parameters were to be used for evaluating programs? Textbox 1 lists those factors that were felt to be relevant and important according to a report, commissioned by IDRC, that unfortunately ranked all projects "low" with respect to demonstrated health benefits. Common deficiencies included a lack of planning and health needs assessment, a need for sustainability planning, difficulty in the management of change, and a need for better evaluation, dissemination of findings, and knowledge transfer to influence policy-making. A comparison of respondents from the two countries showed, as expected, that most received information on antiretroviral treatment (ART) from traditional media. However, increased access to information technology in South Africa resulted in 30% of respondents receiving information from cellphones (versus 10% of respondents in Tanzania). Hence the assumption is that, as access to mobile telephony and the Internet rises in Africa, so will the number of people accessing health information through these technologies.