Developing Countries, Diagnosis, Primary Health Care, Telemedicine, Therapeutics
Conditions
Keywords
Diagnostic concordance, Treatment concordance, patient satisfaction, physician satisfaction, Medical Outreach Clinics, Medical Brigades, Medical Missions, Telemedicine, Videoconference, diagnoses, treatments, Satellite Internet, VSAT, cross cultural telemedicine
Brief summary
Much of the basic general medical care and chronic disease management in rural Honduras comes from groups of volunteers setting up temporary clinics run by volunteers. These clinics, also known as brigades, or medical missions, are often criticized for their lack of quality and the lack of follow-up, both of which stem, in part, from understaffing with volunteer physicians. This study is designed to assess if it is feasible, safe, and acceptable to treat patients in short-term mobile medical clinics in rural Honduras using US physicians connected with patients by videoconference.
Interventions
OTHERTelemedicine
Patients undergo a detailed history and examination to the degree that is possible using the videoconference program, skype, a digital camera for high-resolution images, and an electronic stethoscope. A clinic volunteer aids with examination, translation and documentation.
OTHERIn-person physician interaction
Patients undergo a detailed history and examination by an in-person physician. A clinic volunteer aids with examination, translation and documentation, as needed.
Sponsors
Mayo Clinic
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
DIAGNOSTIC
Masking
TRIPLE (Caregiver, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Able to give informed consent * Non-emergent medical complaints * At least 18 yrs in age
Exclusion criteria
* Pregnancy * Mental Disability
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Clinical Diagnoses | Same Day as clinic visit (less than 6 hours) | The diagnoses resulting from the two physician visits will be compared and a cohen's kappa statistic will be calculated for diagnoses between the visits. |
| Recommended clinical treatments | Same Day as clinic visit (less than 6 hours) | After each of a patient's two physician visits, the physician's resulting recommended treatments will be gathered for comparison between the two visits. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Patient opinions of physician interactions | Immediately following physician interactions (less than 6 hours) | Patients will receive a survey following each interaction with a doctor. These surveys cover communication, comfort and satisfaction. |
| Physician opinions of patient interactions | immediately following volunteer activities with the clinic (less than 48 hours) | doctors will fill out a survey about their patient interactions after they complete their experience volunteering with the clinic. |
| Volunteer opinions of physician-patient interactions | immediately following experience with the clinic (Less than 48 hours) | Volunteers who helped with physician interactions will receive a survey about their experience concerning physician patient communication, volunteer educational value and perceived value of the experience. |
Other
| Measure | Time frame | Description |
|---|---|---|
| Cost | One year (from pilot to completion of study) | The costs of materials and services required to conduct the patient examinations will be collected to build an economic model and projected cost of scaling up the videoconference interventions. |
Countries
Honduras
Outcome results
None listed