Impact Factor 2.031 | CiteScore 1.50
More on impact ›

Original Research ARTICLE Provisionally accepted The full-text will be published soon. Notify me

Front. Public Health | doi: 10.3389/fpubh.2019.00226

Experience of supporting telemedicine networks with the Collegium system: first six years

  • 1University Hospital of North Norway, Norway
  • 2Université Paris Descartes, France

The Collegium system was first made available in 2012 to support organisations conducting humanitarian or non-commercial work in low resource settings. It provides the technical infrastructure necessary to establish a store-and-forward telemedicine service. During the subsequent six years a total of 46 networks were established, based on the Collegium infrastructure. The majority of the networks were set up to provide a clinical service (33), with six designed for education and training, and the remainder for test or administrative purposes. Of the potentially operational networks which were set up (i.e. those established for clinical or educational purposes), 15 networks (38%) were stillborn and did not handle a single case after being established. In contrast, the two most active networks had handled almost 12,000 cases. The average case rate of the five most active clinical networks operating in low-resource settings (i.e. the total number of cases divided by the length of time for which the network had been established) ranged from 0.5-29.4 cases/week. Across the networks there was little evidence of sigmoidal growth in activity, which is consistent with reports of other telemedicine activity in North America. A brief survey was sent to 49 network coordinators, from 31 networks. Responses were received from 9 coordinators (18% of those invited to participate). The median satisfaction with the system was 8 (on a scale from 1=not at all satisfied to 10=very satisfied). The free text comments were mainly technical suggestions regarding image transfer, the mobile application or other modes of communication. The results of operating the Collegium system demonstrate that supporting telemedicine work in low resource settings can be successful, since the networks handled a very wide range of clinical cases, and at activity levels up to several cases per day. However, approximately one-third of the networks that were established did not handle a single clinical case. Nonetheless, this might represent a form of success in the sense that it prevented the waste of resource involved in an organisation purchasing a telemedicine infrastructure only to find that it was not used.

Keywords: Telemedicine, Low-resource settings, tele-expertise, Education, Humanitarian

Received: 14 Apr 2019; Accepted: 29 Jul 2019.

Edited by:

William E. Aaronson, Temple University, United States

Reviewed by:

Deborah E. Seale, Des Moines University, United States
Pradeep Nair, Central University of Himachal Pradesh, India  

Copyright: © 2019 Wootton and BONNARDOT. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Prof. Richard Wootton, University Hospital of North Norway, Tromsø, Norway,