[When and how is medical teleconsultation to doctors practising in remote areas of developing countries convenient and reliable? About eight clinical cases]. / Affidabilità della diagnosi assistita per via telematica in un'area remota della Cina. Otto casi clinici esemplificativi.

ABSTRACT

A poorly equipped internal medicine doctor (IMD), practising in remote areas of developing countries, can be assisted with expertise teleconsultations by using the common analogical telephone lines. By that way, the clinical cases he challenges became multidisciplinary and the success of the treatment enhanced. Eight cases are reported as examples. The expertise is made up by eight remote-access experts on different medical fields. The effectiveness of the support of the consultants is compared one to the other. In laboratory, dermatology and, partly, cyto-pathology fields the teleconsultations are reliable and not time-consuming, for the key tool is the digital picture sent by e-mailing. In cardiology (heart ultrasound scan) and radiology fields both effectiveness and benefit-cost ratio are disputable. Heart ultrasound scan is a dynamic test and filming is needed to provide the consultant with good records. In radiology field, the upper digestive tract X-ray scan is usually carried out with few shots, due to the unsustainable charges on the patient. That matter impairs the consultant's effectiveness to support. Although the black-outs of the transmission were common throughout IMD-consultant videoconferences, the physical examination of the patient, performed by the IMC under consultant's direct supervision, is highly supportive both in neurology and paediatric fields. The physiotherapist's show of physical rehabilitation exercises by videoconference is highly supportive as well.