Telemedicine in French Guiana: Implementation and Emergency Care Perspectives
Abstract
Background: Telemedicine is practiced in Emergency Departments (ED) and Intensive Care Units (ICU) worldwide. It remains either underutilised or experimental, particularly in areas of advanced practice. French Guiana is a French territory in South America. The population is a mix of several nationalities, with 44% living in a high state of precariousness due to poverty, unemployment and crime.. The density of medical professionals is the lowest in France, and is essentially concentrated on the coastal part of the territory with 20% of the population living in remote areas over 100 km from the nearest ED. Aim: This paper reports the development and effect of equipping remotes health facilities with videoconferencing on emergency care delivery Methods: Recent technical improvements in the country provided the means to set up an efficient IT system and strengthen the emergency care offered. The approach consists of several axes of development to secure first-aid in remote sites and improve our territorial and international medevac organisation. Due to the lack of skills, a specific programme for non-emergency health professionals has been designed to allow this advanced practice. Tele-expertise is used to connect the only ICU team in the country to all ED by video, and maintain a permanent link with long-haul medical evacuation flights. It is an opportunity to build medical and scientific cooperation within the Caribbean area by using block chain technology. Results: For one year, equipment has been deployed into the main remote sites and secondary hospitals facilities. It allowed a better management of medevacs since the beginning of the recent epidemic of COVID-19 it reinforced the links into the hospital network. Conclusion: Even though telemedicine is included in emergency care organisations worldwide, its use depends on the available technical setting, and is still subject to experience that requires scientific validation.
Downloads
References
Rademacher NJ, Cole G, Psoter KJ, et al. Use of Telemedicine to screen patients in the emergency department: matched cohort study evaluating efficiency and patient safety of telemedicine. JMIR Med Inform 2019;7(2):e11233. DOI: 10.2196/11233
Arné J-L. Ethical and legal aspects of telemedicine. Bull Acad Natl Med 2014;198(1):119–130. PMID: 26259291
Ekeland AG, Bowes A, Flottorp S. Effectiveness of telemedicine: A systematic review of reviews. Int J Med Inform 2010;79(11):736–771. DOI: 10.1016/j.ijmedinf.2010.08.006
Demougeot L, Baert X. La population guyanaise à l’horizon 2050 : vers un doublement de la population ? - Insee Analyses Guyane - 36. Available at: https://www.insee.fr/fr/statistiques/3902223. Accessed 08 August 2020.
Baert X, Charrier R, Kempf N. L’accès aux soins à l’épreuve des grands espaces guyanais - Insee Dossier Guyane - 6. Available at: https://www.insee.fr/fr/statistiques/3181903. Accessed 08 August 2020.
Duplan H, Cazaux S, Hurpeau B. Accès aux soins hospitaliers en Guyane : derrière un constat encourageant, de fortes disparités - Insee Analyses Guyane - 2. Available at: https://www.insee.fr/fr/statistiques/1285646. Accessed 08 August 2020.
AMA XpertEye - Digital Accelerator. AMA XpertEye. Available at: https://www.amaxperteye.com/. Accessed 08 August 2020.
Langabeer JR, Gonzalez M, Alqusairi D, et al. Telehealth-Enabled emergency medical services program reduces ambulance transport to urban emergency departments. West J Emerg Med 2016;17(6):713–720. DOI: 10.5811/westjem.2016.8.30660
Griffin M, Melby V. Developing an advanced nurse practitioner service in emergency care: attitudes of nurses and doctors. J Adv Nurs 2006;56(3):292–301. DOI: 10.1111/j.1365-2648.2006.04025.x
Ministère des Solidarités et de la Santé. Promotion de la télémédecine. 2021 Available at: https://solidarites-sante.gouv.fr/archives/archives-presse/archives-communiques-de-presse/article/promotion-de-la-telemedecine. Accessed 08 August 2020.
Pujo JM, Kraiem H, Omri M, et al. Work-related stress assessment in Emergency Departments: Are we missing something? Br J Nurs 2021:13;30(9):540-546. DOI: 10.12968/bjon.2021.30.9.540.12.
Prabhakaran K, Lombardo G, Latifi R. Telemedicine for trauma and emergency management: an overview. Curr Trauma Rep 2016;2(3):115–123. DOI: 10.1007/s40719-016-0050-2
Resiere D, Resiere D, Kallel H. Implementation of medical and scientific cooperation in the Caribbean using blockchain technology in Coronavirus (Covid-19) Pandemics. J Med Syst 2020;44(7):123. DOI: 10.1007/s10916-020-01589-4
Song X, Liu X, Wang C. The role of telemedicine during the COVID-19 epidemic in China-experience from Shandong province. Crit Care 2020;24(1):178. DOI: 10.1186/s13054-020-02884-9
Binks S, Benger J. Tele-education in emergency care. Emerg Med J 2007;24(11):782–784. DOI: 10.1136/emj.2005.033795
O’Doherty D, Dromey M, Lougheed J et al. Barriers and solutions to online learning in medical education - an integrative review. BMC Med Educ 2018;18(1):130. DOI: 10.1186/s12909-018-1240-0
Barteit S, Guzek D, Jahn A, et al. Evaluation of e-learning for medical education in low- and middle-income countries: A systematic review. Comput Educ 2020;145:103726. DOI: 10.1016/j.compedu.2019.103726
Copyright (c) 2021 Jean Marc Pujo, Rémi Mutricy, Hajer Kraiem, Majdi Omri, Nadia Sabbah, Raphael Blanc, Dabor Résière, Alexis Fremery, Hatem Kallel
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
