Rationale and objectives: The authors sought to create a simple, versatile, and effective store-and-forward telemedicine system to facilitate consultation between medical students pursuing elective study at remote locations in the developing world and specialists at the central institution.
Materials and methods: A trial telemedicine system was established between Gizo Hospital (Gizo, Solomon Islands) and Emory University Hospital (Atlanta, Ga). At Gizo Hospital, the system consisted of a commercially available digital camera and a locally available personal computer with a modem providing low-bandwidth (dial-up) Internet access. A visiting British medical student at Gizo Hospital used this equipment to relay digital photographs of patients, as well as the results of relevant tests, such as electrocardiograms, radiographs, and ultrasound images, to Emory University Hospital via the Internet for review by a specialist.
Results: The medical student, who had received minimal training (approximately 1 hour) in the use of this telemedicine system, used it successfully to perform eight referrals during the elective course period. Following the student's return home, his local preceptors at Gizo Hospital and a physician at Helena Goldie Hospital on New Georgia Island used the same system for more than 60 additional referrals.
Conclusion: The telemedicine system is a low-cost, robust, and sustainable means of providing expert support to medical students and other health care providers in remote locations.