Médecins Sans Frontières , Paris , France ; Department of Medical Ethics and Legal Medicine (EA 4569), Paris Descartes University , Paris , France.
Médecins Sans Frontières , Geneva , Switzerland ; McGill University , Montréal, QC , Canada.
Front Public Health. 2014 Aug 26;2:126. doi: 10.3389/fpubh.2014.00126. eCollection 2014.
In 2009, Médecins Sans Frontières (MSF) started a pilot trial of store-and-forward telemedicine to support field workers. One network was operated in French and one in English; a third, Spanish network was brought into operation in 2012. The three telemedicine pilots were then combined to form a single multilingual tele-expertise system, tailored to support MSF field staff. We conducted a retrospective analysis of all telemedicine cases referred from April 2010 to March 2014. We also carried out a survey of all users in December 2013. A total of 1039 referrals were received from 41 countries, of which 89% were in English, 10% in French, and 1% in Spanish. The cases covered a very wide range of medical and surgical specialties. The median delay in providing the first specialist response to the referrer was 5.3 h (interquartile range 1.8, 16.4). The survey was sent to 294 referrers and 254 specialists. Of these, 224 were considered as active users (41%). Out of the 548 users, 163 (30%) answered the survey. The majority of referrers (79%) reported that the advice received via the system improved their management of the patient. The main concerns raised by referrers and specialists were the lack of support or promotion of system at headquarters' level and the lack of feedback about patient follow-up. Because of the size of the MSF organization, it is clear that there is potential for further organizational adoption.
2009 年，无国界医生组织（MSF）开始试行存储转发远程医疗，以支持外勤人员。其中一个网络使用法语，另一个网络使用英语；第三个西班牙语网络于 2012 年投入使用。这三个远程医疗试点随后合并为一个单一的多语言远程专家系统，专门为支持无国界医生组织的外勤人员而设计。我们对 2010 年 4 月至 2014 年 3 月期间所有转介的远程医疗病例进行了回顾性分析。我们还在 2013 年 12 月对所有用户进行了调查。共收到来自 41 个国家的 1039 例转介，其中 89%为英语，10%为法语，1%为西班牙语。这些病例涵盖了非常广泛的医学和外科专业。向转介人提供第一份专家意见的中位数延迟时间为 5.3 小时（四分位间距 1.8，16.4）。该调查发给了 294 名转介人和 254 名专家。其中，224 人被认为是活跃用户（41%）。在 548 名用户中，有 163 名（30%）回答了调查。大多数转介人（79%）报告说，通过该系统收到的建议改善了他们对患者的管理。转介人和专家主要关注的问题是总部层面缺乏对系统的支持或推广，以及缺乏关于患者随访的反馈。由于无国界医生组织的规模，显然还有进一步在组织内采用的潜力。
