Out of 7 billion people, two third live in low resource developing countries where more than 50% live in rural areas which is isolated in the rest of the medical world. Lack of up to date reference materials, lack of consultation possibilities led to poor diagnosis in rural areas. Patients take a long, difficult and health threatening journeys to cities for their health care at enormous cost.
The ideal modal of health care concept was adopted in the declaration of the international conference of primary health care in Alma Ata, Kazakstan 1978. from there it became a core issue to WHO goal “Health for All.Currently in developing countries, we are unable to provide total primary health care in rural areas. Secondary and tertiary health care are not well distributed in suburban and urban areas. Incentives to specialist failed to entice specialist to practice in suburban areas. After all professional isolation would lead to mediocrity which is one step ahead from entering the Jurassic park. Health for All may be a slogan even in 2030.
For many years it was difficult to document the clinical works of the patient until when the revolution in the medical devices began e.g. X-Ray, MRI, CT-Scan, Echo-cardiography, ECG, ultrasound, otoscope and ophthalmoscope etc.More researches are done in reducing the size of medical and nonmedical devices e.g. Currently we have Portable ultrasound and ventilator etc there researches are more supported by American military.- Think of the first computer with the size of the room, have a storage capacity of 1 MB and reboot after 7 days and a tremendous change to portable, more efficient and have more capacity.Increase in the internet capabilities both wireless and cable have tremendously changed the health system in developing countries by easing transfer of data in a secured channels for consultations
People living in the remote area in Australia were using a double radio system which was powered by a dynamo, driven by a set of pedals to communicate with Royal Flying Doctors of Australia, this was how telemedicine started. Later it moved to USA. In developing countries it started very late, e.g. In China, telemedicine started in 1980 where in 1988 the video conferencing was done with German discussing about neurosugery case. Other developing countries like India, Apollo Hospical – Chennai had the same video conferencing system with Japan 2001.In our country (TANZANIA), ELCT has 20 hospital and all were linked using care2X applications as well as within the hospital – This was 2006MNH also use the same system but only with the hospital, allowing the communication between the ER, deparments, wards, labs, and Pharmacy
CME – Continuing Medical EducationGP – General Practitioners
VIRTUAL HOSPITALS OF FUTURE IN DEVELOPING COUNTRIES
TAMSA 6th INTERNATIONAL CONFERENCE
THEME: IMPACT OF GLOBAL HEALTH IN AFRICA, ITS TIME TO
FACE THE CHALLENGES!
Sub Theme: Technology in advanced Medicine
Title: VIRTUAL HOSPITALS OF FUTURE IN DEVELOPING
MUHIMBILI UNIVERSITY OF
HEALTH AND ALLIED SCIENCES
Source: Developing country accessed from
• Growing Double Burden of diseases in
Health for All
..some objectives for which Telemedicine has
• To make high quality healthcare available to traditionally
under privileged population - In developing countries,
there is a large rural based population separated by large
distances, which need access to regular quality medical
care. Telemedicine can enhance citizen’s equality in the
availability of various medical services and clinical health
care, despite these economic and geographic barriers.
• Save the time wasted by both providers and patients (from
long, difficult, often health-threatening journeys from one
geographic location to another to avail services on time 
• Reduce costs of medical care.
Ground realities of the Present state of
health care in developing countries:
I. Approx. 3.1 Billion live in rural area (0ut of 5.6 billion
people - 2009).
II. Bed-Population ratio 0.3 per 1000 people to 0.7 per 1000
people (2011) VS. Ideal of 1:500 people.
III. Only 1.9 – 4.1% of GDP for health (WHO recommends at
IV. 5 - 9% of annual family income spent towards curative
V. Doctor to patient ratio is still high (the average doctor to
patient ratio in developing countries is 1 doctor for every
VI. Specialists and super specialists located in urban areas
and their number dissatisfy the needs.
Advancement of Technology/ Driving forces
– Trend of technology
– Internet capabilities
Source: Yale Journal of Medicine and Law, using Telemedicine to address
doctor shortages; accessed from
“…..the delivery of healthcare services, where distance is a critical factor, by
all healthcare professionals using information and communication
technologies for the exchange of valid information for diagnosis, treatment
and prevention of diseases and injuries, research and evaluation, and for the
continuing education of healthcare providers, all in the interest of advancing
the health of individuals and their communities” WHO 1998
Advantages of Telemedicine
• Doctors licensed to practice all over the Nation/country
• Maximum utilization of limited resources Saves travel,
time and money
• Enormous CME potential for GP, urban trainee and
• International grand rounds, Web casting conferences
• Motivation for computer literacy among doctors
• Reducing unnecessary referrals to specialists
• Useful in designing credits for re-certification of
Why Telemedicine NOW
• Health care providers coming under increasing pressure to improve
the quality of care delivered to patients while at the same time
decreasing the cost worldwide. Telemedicine has the potential to
address some of the pressing issues facing healthcare delivery in
• As the population ages and chronic disease explodes, the
healthcare delivery system will be forced to treat larger numbers of
patients with fewer and more limited resources.
• A fundamental and comprehensive change in the management and
delivery of healthcare is crucial to get the most cost effective and
efficient use out of limited healthcare resources. Telemedicine
applications and solutions are viable options that can be leveraged
to address such pressing healthcare issues.
Medical Legal Aspect
• There is wide spread concern regarding confidentiality and medical
information on the web.
• There are also potential legal issues regarding this and the limitation of
the medical advice without face to face consultation or clinical
examination. All information on patient (i.e. medical record, radiographs,
audiotapes, images, and real time sensor data) is presented in a web-
browser user interface, very strict access to control is used to prevent an
authorized access to medical information.
• As an example, a patient may bring a smart card with his access key, or the
finder print may be used as a basis for the access key.
• Exposure of the patient information may lead to loss of license, big fines,
Despite the growing enthusiasm for “Telemedicine”
the concept of virtual hospital still has many
limitations to overcome. Nevertheless,
telemedicine is beginning to have an impact on
many aspects of health care in the developing
When implemented well, telemedicine may allow
the developing countries to leap frog over our
developed neighbors in successful health care
• To witness a successful revolution in telemedicine, we need to bring this
array of activities together. Perhaps the slogan “Health for all by 2000”
which was forgotten towards the end of last century can still be achieved
by the year 2030 by making “The E-Medicine Revolution” happen in
developing countries. Time alone will tell whether Telemedicine is a
“forward step in a backward direction” or to paraphrase Neil Armstrong
“one small step for IT but one giant leap for Healthcare”.
Source: Webadmin, Telemedicine Continues to Transform
Healthcare (Part 1 of 2): Pharmaceutical Retail’s Next
: Accessed from:
Thank you for Listening.
“21st century medicine, think globally, think 3D”