Slides from an introductory lesson to the students of Medicine - University of Milano Bicocca - March 30, 2015

1. Roberto Polillo
Derpartment of Informatics, Systems and Communication,
University of Milano Bicocca
Intervento al corso elettivo “Promozione della salute infantile nei Paesi in
via di sviluppo” per studenti della Scuola di Medicina dell’Università di
Milano Bicocca – March 30, 2015
Internet & sustainable telemedicine for
developing Countries: an introduction
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2. 2

3. 3
Il server dell’amministrazione
Dell’ospedale Dipartimentale
di Chinandega (Nicaragua)

4. What is telemedicine
"Telemedicine is the delivery of health care services,
where distance is a critical factor, by all health care
professionals using information and communication
technologies,
for the exchange of valid information for diagnosis,
treatment and prevention of disease and injuries,
research and evaluation, and for the continuing
education of health care providers, all in the interest of
advancing the health of individuals and their
communities.”
WHO, Telemedicine, Opportunities and Developments in Member States, 2010
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5. Types of telemedicine applications
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DISTANCE
Synchronous or
asynchronous
communication

6. Types of telemedicine applications
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DISTANCE
Synchronous or
asynchronous
communication
Asynchronous:
•E-mail / SMS / WhatsApp
•Sharing docs, images, audio,
videos via social media
•Dropbox or cloud repositories
•Specific applications
Synchronous:
•Chat
•Tele-conferencing (audio, video)
•Virtual classes
•Virtual healthpoints

7. Example: HealthPoint (India)
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www.healthpoint.com

8. Types of telemedicine applications
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DISTANCE
Synchronous or
asyncronous
communication
 Teleradiology
 Telecardiology
 Telepathology
 Teledermatology
 Teleodontoiatry
 Teleaudiology
 Telepsycology
 …

9. The good news
Internet and mobile telephony
ALLOW NOW
to develop affordable and sustainable telemedicine
applications for developing Countries
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10. ”Affordable" telemedicine
 “Reasonable” technological infrastructure
 Low initial costs
 Sustainability
 Low operating costs
 “Reasonable” technical skills locally
necessary
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11. The “mobile miracle”
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CIS: Commonwealth of Independent States (ex Soviet Union)
Source: ITU Measuring teh Information Society Report, 2014

12. R.Polillo - Marzo 201314

13. And the Internet…
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14. The growth of the bandwidth
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15. Mobile broadband growth
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Source: Ericcson Mobility Report, June 2014

16. Types of telemedicine applications
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DISTANCE
Synchronous or
asyncronous
communication

17. Example: Store-and-forward
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Asyncronouscommunication
Examples:
•Teleradiology
•Teledermatology
•Telepatology
Query with
medical data:
•text
•images
•[video]
Answer

18. Example: Store-and-forward
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Asyncronouscommunication
Query with
medical data:
•text
•images
•[video]
Answer
Data
base

19. Example: Remote monitoring
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Comunicazionesincrona/asincronaAsyncronouscommunication
Without Internet access:
•SMS
•MMS
•Twitter
With Internet access:
•Twitter
Whatsapp
•Social media
•Mail

20. Example: Laptop + mobile for communication
via SMS (software: FrontlineSMS)
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VIDEO: http://www.youtube.com/watch?feature=player_embedded&v=hEK0dTWgqzQ#!
www.kiwanja.net
• Patient monitoring /
follow-up
• Vaccination campaigns
• Medical info
• Emergency management
• …
www.medicmobile.org

21. Example: Interactive telemedicine
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Comunicazionesincrona/asincronaSyncronouscommunication
No Internet access:
•Cellphone
With Internet access:
•Internet telephony (skype,
whatsapp)
•Video conferencing

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Know-how globalization

23. Example: www.cure4kids.org
 A free, global online medical education and collaboration
network
 A web-based education project of St.Jude Children’s Research
Hospital (Memphis, USA) to help health professionals in
countries with limited resources to improve survival rates of
children with catastrophic deseases
 Seminars, papers, oncopoedia,
interest groups, international
live online web conferences
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25. www.cure4kids.org: growth
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Oggi: 42.000 iscritti
in 160 Paesi
https://www.cure4kids.org/ums/home/public_area/c4k_user_stats/

26. Conclusions
 The evolution of the Internet, the “mobile miracle” and the
telephony / internet convergence open possibilities
untinkable until a few years ago for developing Countries
 Abilitating technologies:
 low cost asyncronous and synchronous communication,
 broadband,
 cloud computing
 software open-source
 low cost smartphone
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Substainability, delocalization

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Thanks!
www.rpolillo.it
roberto.polillo@unimib.it

28. EXAMPLE: Pediatric Hospital La Mascota,
Managua (Nicaragua)
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29. La Mascota and departmental hospitals
Policlinico
Milano
La Mascota
Managua
VPN
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• 1 central server (Managua)
• 1 PC for every remote
hospital (db and procedures)
• Internet connection
• Data are consolidated on the
central server
• Consultancy from Milano