Innovations in Medicine
by Marcia Erskine
Print this articleEveryday, across the globe, countless new discoveries are made which have the potential to benefit our lives in ways too numerous to count. It would be easy to take for granted that these discoveries are exclusive to the more developed nations of the world. But what a misconception that would be. In our very own Caribbean corner, scholars and researchers attached to The University of the West Indies too, either working independently or in partnership with cross University teams or external institutions, are unearthing new knowledge and pioneering innovative solutions to some of the most challenging issues threatening our very existence.
1. telehealth & paediatric care/management
Last year (2005), after four years of collaboration between herself and colleagues at SickKids Hospital, Toronto, Canada, she saw the launch of her brainchild – the UWI Telehealth Programme.
Telehealth allows doctors at the Telehealth facility based at the Eric Williams Medical Sciences Complex and the SickKids Hospital to have consultations via a live videoconference link.
The programme uses live interactive videoconferencing technology and high speed telecommunication to link two distant partners in real time thus facilitating patient consultation and professional medical education, without need for overseas travel.
Relevant medical data such as x-rays, CT Scans, angiograms, and ultrasound scans are transferred electronically from the Children’s Hospital, Eric Williams Medical Sciences Complex, to the health care team at the SickKids Hospital during telehealth consultations.
Professor Ali, initiator of the programme and who serves as Director of UWI Telehealth says she started it to “help bridge the gaps in paediatric care and management in Trinidad & Tobago”.
She noted that despite public sector commitment to healthcare, diagnosis and treatment for complex illnesses is still a challenge for many who cannot access or afford such management. This is exacerbated, when that care is not available in Trinidad & Tobago.
The UWI Telehealth Programme, Professor Ali said, “facilitates referral consultations in sub-specialized areas such as congenital diseases and child development. When a child is diagnosed with an illness, for example, a heart condition, via live two-way video conferencing with the SickKids Hospital, the child receives expert consultation from specialist doctors”, she explained.
Professor Ali praised the many supporters who helped to fund the project including the Herbie Fund, Hospital for SickKids International Health Programme, Toronto, Canada; the Atlantic For Childrens Fund, Atlantic LNG Company, of Trinidad &Tobago; the Ministry of Health of Trinidad & Tobago and The University of the West Indies.
Trinidad & Tobago President, His Excellency Professor George Maxwell Richards, who with his wife Her Excellency Dr. Jean Ramjohn Richards are patrons of the programme, said “The UWI Telehealth Programme envisages access to good health services and timely, less costly medical consultations for families in Trinidad & Tobago and the region many of whom are faced with limited or no resources to access such services.”
“It is definitely a great boon that the burden of overseas treatment will be diminished because of audiovisual links that are being set up for diagnostic consultations for the critically ill”, President Richards said.
Meanwhile, UWI St. Augustine Campus Principal Dr. Bhoendradatt Tewarie said, “this is the sort of initiative we value and encourage: where academic staff take initiatives that have an important research component but which also have direct application to the needs of the wider society.”
The Telehealth Programme has already begun to bring relief to families in Trinidad & Tobago.
Jacqueline Juman, mother of six year old Natalia Juman, the first recipient of paediatric care via the UWI Telehealth Programme, calls it “a lifeline”. Natalia was diagnosed with a complex illness which affected most of her intestines. The Telehealth Programme saved the family an estimated TT$19,000 (US$3,166) for the initial consultation. Natalia has had surgery at SickKids through the generous support of the Herbie Fund which has saved her approximately TT$250,000.
5 benefits of the UWI Telehealth Programme:
- Improvement in access to high quality paediatric healthcare.
- Elimination of the need for families to travel overseas to seek subspecialty care - especially to those families who may not be able to afford the overseas treatment.
- Provision of an opportunity for patients and their families to access one-on-one consultation with overseas specialists in real-time, without having to ever board a plane.
- Enhancement of information sharing, continuing medical education and reduction of professional isolation.
- Availability of subspecialist diagnosis & care facilities for local and regional doctors at considerably reduced costs to the patients.
2. The Telemedicine project
Telemedicine is a high-tech solution to the universal problem of access to healthcare and this “is the most modern comprehensive telemedicine solution for the healthcare needs of Jamaica,” explained Dr. Davidson, Head of the Telemedicine Research and Development Unit at The University of the West Indies.
Employing information technology – computers, related software, telephone lines, fibre-optic cables and satellite link-ups, the “telemedicine project is helping medical personnel in delivering healthcare quickly and at lower costs.”
According to Dr. Davidson, “distance is no barrier to better diagnosis and management of a patient with this technology and essentially, this is remote telemetric healthcare – a means of providing health services at a distance, using telecommunications technology, medical expertise and computer science.”
The Telemedicine Project makes remote monitoring, consultation and intervention more accessible to healthcare providers and patients and contributes to enhanced work efficiency, improved timely decision-making and reduced healthcare costs, Dr. Davidson said.
It spans all branches of healthcare from emergency medical systems to hospitals, medical specialty consultations, invasive and or surgical procedures and home care.
A web-based electronic health record system (HER) UNIMEDICS, developed by the project, facilitates the health data management of patient’s records on the internet and in the global domain. The system has the capacity for the portability of millions of patient files globally while satisfying the principles of the Health Insurance Portability & Accountability Act (HIPAA) compliance of the United States of America and requisite security standards.
Dr. Davidson noted that, “already, telemedicine is being increasingly utilized by a growing number of medical specialties including dermatologists, oncologists, psychiatrists and home healthcare providers.”
The technology is also expected to improve the overall management of healthcare and resource allocation for remote healthcare emergency programmes by allowing for the transmitting of images to medical centres for long distance evaluation by the appropriate medical personnel.
Continuing medical education is also being facilitated through the linking of several community hospitals together with sponsoring medical institutions.
Telemedicine is being regarded as an essential and necessary platform for the survival of the Jamaican health sector presenting an opportunity for the exporting of services – such as health tourism – to the global marketplace.
Telemedicine: “The Jamaica Project”
To establish a national health service information technology network, dedicated to deliver health service made available and affordable to Jamaicans at home and abroad; later expanding to the wider Caribbean and West African territories.
To provide an affordable national telemedicine and tele-health information technology platform including digital health TV content, for the delivery and export of health services from Jamaica reaching clients including tourists where ever they are, at home or abroad.
To facilitate the development of a Caribbean Health Tourism market as part of the process of diversification and expansion of Caribbean Tourism.
To enable the full participation of health professionals from Jamaica, the Caribbean and Africa, in accessing the global IT marketplace, so that these professionals may export their services in the global domain to facilitate national and regional health development.
© Copyright Dr. W. Davidson
3. paediatric & perinatal HIV/AIDS
The UWI graduate was the 2002 recipient of the Elizabeth Glaser International Leadership Award, for her work in implementing a Paediatric & Perinatal HIV/AIDS Leadership Initiative in Kingston, Jamaica. Partially sponsored by the Pfizer Foundation, the programme was developed and implemented in close collaboration with UWI and the Ministry of Health, Jamaica.
Under the programme, Professor Christie-Samuels is leading a team of academic and government healthcare professionals in a “Town and Gown” programme to address the paediatric and perinatal HIV/AIDS epidemic in Kingston.
This, against a background of 1-2% of pregnant women in Jamaica being diagnosed as HIV-positive. The programme team includes paediatricians, obstetricians, public health practitioners, nurses, microbiologists, data management and information technology personnel. All are involved in implementing the 5-point plan of action designed to address this health emergency by reducing mother-to-child transmission of HIV/AIDS while improving the quality of life for those already living and affected by HIV/AIDS.
The plan comprises leadership and training of a core group of paediatric/perinatal HIV professionals to serve the greater Kingston/St. Catherine areas and is expected to be a model for the rest of Jamaica.
Mother-to-child transmission of HIV/AIDS is prevented by counselling and HIV testing women in the antenatal clinics, giving azidothymidine (AZT) to HIV pregnant women beginning at 28 weeks gestation, throughout labour and to HIV-exposed infants for the first six weeks of life.
A unified parallel programme for identifying the HIV-infected infant and delivering paediatric HIV care at the major paediatric centres has also been implemented.
Dr. Christie-Samuels is happy with the progress of the programme to date. In three years, over 30,000 pregnant women have been tested for HIV; 600 HIV-exposed babies identified and about 140 paediatric HIV infections prevented.
The infrastructure is now in place to access clinical trials of antiretroviral (ARV) drugs and vaccines for mothers, their HIV-exposed infants and HIV-infected children and adolescents.
Dr. Christie-Samuels is particularly pleased at the collaborations which she credits with the success of the programme to date.
Among these she notes, “the wide availability of antiretroviral drugs through the Ministry of Health’s procurement of US$23-M from funding provided by the Global Fund for AIDS, TB and Malaria and the invaluable role being played by “UWI-hired clinical staff placed to work in government hospitals and clinics”.
Dr. Christie-Samuels said that the team is finding that “once women are found to be HIV+ and are counselled, compliance with programme participation approached 90-100%.
She said that the women (and their infants) are all grateful and appreciative for the support and care offered by the programme, especially through the help of the specially trained and accessible HIV-trained perinatal/paediatric nurse counsellors and paediatricians.
“This is a successful model, which could be implemented in HIV management and care programmes throughout Jamaica as we work to reduce and eventually eliminate perinatal mother and child transmission of HIV in Jamaica”, she declared.
The plan is now being expanded across Jamaica.
