1 October 2002

Makeshift medicine at a distance

In the October Journal of Telemedicine and Telecare Australian doctors describe a unique case study of a boy in a remote part of Queensland who was badly burnt and needed specialist care from a burns centre over 1100km away. Using a desktop scanner hooked up to the family computer, the boy's mother was able to take pictures of his injuries and send them by email to doctors in Brisbane who were able to give advice.

The cost of 'traditional' medical care
Under Australian guidelines, all children with full-thickness burns must be referred to a specialist unit. For families in remote areas of Queensland, this means they have to fly thousands of kilometres to the single paediatric burns centre, situated in Brisbane. The state health department pays for the costs of flights and accommodation, and if a child has to stay in hospital for any length of time, the family is disrupted and the parent or guardian with the child risks losing wages. Follow-up care, which can take weeks, often means repeat visits at enormous cost.

The costs of telemedical care
In the case study, the fourteen year old boy only had to be flown to Brisbane once over a treatment time of more than four months. Doctors gave him two skin grafts and were able to monitor his care by viewing the emailed images that the family sent and giving advice by telephone. The boy's local hospital team also received advice and were able to ask the specialists questions in scheduled videoconference sessions. The family was not disrupted, neither parent had to lose income taking the child back and forth to the hospital, and extra living costs and transport expenses in Brisbane were avoided. The boy's burns, caused by a motorbike exhaust, healed successfully.

The authors point out how valuable digital images and email can be to medical staff working with patients in remote areas. The advantages are not just seen in the developed world, but increasingly in less developed countries such as Bangladesh, where local doctors can access (via email) treatment and clinical management advice from specialists situated elsewhere around the world.  

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