Swinfen P, Swinfen R, Youngberry K, Wootton R
Swinfen Charitable Trust, Canterbury, UK.
J Telemed Telecare. 2003;9 Suppl 2:S63-5. doi: 10.1258/135763303322596309.
The Swinfen Charitable Trust has used email for some years as a low-cost telemedicine medium to provide consultant support for doctors in developing countries. A scalable, automatic message-routing system was constructed which automates many of the tasks involved in message handling. During the first 12 months of its use, 1510 messages were processed automatically. There were 128 referrals from 18 hospitals in nine countries. Of these 128 queries, 89 (70%) were replied to within 72 h; the median delay was 1.1 day. The 39 unanswered queries were sent to backup specialists for reply and 36 of them (92%) were replied to within 72 h. In the remaining three cases, a second-line (backup) specialist was required. The referrals were handled by 54 volunteer specialists from a panel of over 70. Two system operators, located 10 time zones apart, managed the system. The median time from receipt of a new referral to its allocation to a specialist was 0.2 days (interquartile range, IQR, 0.1-0.8). The median interval between receipt of a new referral and first reply was 2.6 days (IQR 0.8-5.9). Automatic message handling solves many of the problems of manual email telemedicine systems and represents a potentially scalable way of doing low-cost telemedicine in the developing world.
斯温芬慈善信托基金多年来一直将电子邮件用作一种低成本的远程医疗媒介，为发展中国家的医生提供顾问支持。构建了一个可扩展的自动消息路由系统，该系统可自动执行消息处理中涉及的许多任务。在使用的前12个月中，自动处理了1510条消息。有来自9个国家18家医院的128次转诊。在这128个咨询中，89个（70%）在72小时内得到了回复；中位延迟为1.1天。39个未得到回复的咨询被发送给后备专家进行回复，其中36个（92%）在72小时内得到了回复。在其余3个案例中，需要二线（后备）专家。这些转诊由来自70多名专家小组的54名志愿专家处理。两名系统操作员，位于相隔10个时区的地方，管理着该系统。从收到新转诊到将其分配给专家的中位时间为0.2天（四分位间距，IQR，0.1 - 0.8）。收到新转诊与首次回复之间的中位间隔为2.6天（IQR 0.8 - 5.9）。自动消息处理解决了手动电子邮件远程医疗系统的许多问题，代表了在发展中世界开展低成本远程医疗的一种潜在可扩展方式。
