R. Latifi1, R. Merrell1 1New York Medical College,Surgery,Valhalla, NY, USA
Introduction: Following the successful implementation of the Telemedicine Program of Kosovo (TPK) in 2002, the International Virtual e-Hospital Foundation (IVeH) established the award-winning Initiate-Build-Operate-Transfer (IBOT) approach in creating two additional nationwide telemedicine programs, the Integrated Telemedicine and e-Health Program of Albania (ITeHP-AL) and the Integrated Telemedicine and e-Health Program of Cape Verde (ITeHP-CV). Based on IBOT strategy and its time line the ITeHP-CV was transferred to the Ministry of Health of Cape Verde in August 2014 and the ITeHP-AL to the Ministry of Health of Albania in January 2017. The aim of this paper is to review the impact of these two programs on increasing access to care using telemedicine programs and identifying the most common clinical disciplines used by telemedicine, in order to predict the needs for further country investment medical healthcare system.
Methods: Review of processes of implementation of IBOT and analyses of clinical applications of telemedicine in each country with different clinical specialty needs.
Results: During the study period (2009-2018) two national telemedicine programs became independent of the initial funding sources, with 44 telemedicine centers covering the two countries (30 Al and 14 CV). During this time, 4,524 patients were managed via telemedicine (Albania: 2,366), Cabo Verde: 2,158). The most common clinical disciplines in Albania were teleradiology (677), teleneurotrauma (677) and telestroke (498), while neurology (599), cardiology (319), dermatology (173), orthopedic surgery (160) and general surgery (160) in Cabo Verde. 1809 (76.45%) patients (Albania) and 1630 (75.53%) (Cabo Verde) were not transferred to tertiary centers of the country. Furthermore, teleconsultation that the number of such events has remained stable or has increased since transfer to the national counterparts was completed.
Conclusion: The IBOT model of telemedicine has advanced the quality and availability of necessary medical services in in Albania and Cabo Verde. By studying the clinical disciplines that used telemedicine mostly, the countries can predict the healthcare needs in the future. We conclude that IBOT represents a mature and field-tested implementation approach for establishing telemedicine programs in developing countries, as form of sustainable surgical volunteerism