Expertise center on ehealth and telemedicine

In Mali health personnel is poorly spread between the capital and the other regions, and between the urban and rural zones. More than half of the socio-sanitary staff of Mali is concentrated in Bamako: 57% of the doctors, 41% of the nurses and 64% of the midwives (MSSPAS, 1998).

The health system counts with a pyramidal organization, which goes from the periphery to the centre: it goes from the central level of community health, passing through the health reference centre, the regional and secondary hospitals, to the tertiary and university hospitals. It is characterised by a shortage of specialists, which are all concentrated in the capital city. The demand for specialised healthcare of the population is significantly increasing.

The center's aim is to coordinate, support and promote the use of ICT for better health services.

Current status

The center is currently supporting two new projects - the IICD-financed E-PACT Sante with the National federation of Community Health Centres FENASCOM, and the IDRC financed research project EquiRhesus - that are doing well. Furthermore, a series of interesting new activities - a national e-learning programme, a pilot study on Frontline SMS as a tool for Health Information, and an e-learning programme on diabetology - are also ongoing. The core activity of the center itself evolves towards medical distance education.

The e-health activities reference centre follows the pilot experience on two other projects, REIMICOM and teleradiology IKON. REIMICOM focussed on the setting up of a health information portal for health practitioners and the general public, offering a few telemedicine tools to health practitioners and interconnecting about ten health institutions. The teleradiology project focussed on enabling the exchange of X-ray images between the regional hospitals of Gao, Kayes, Timbuktu, Mopti, Segou and Sikasso with the university hospital of Point G in Bamako. At the end of the first phase, the REIMICOM objectives were partially reached. The health portal was technically set up but regular content production remained a problem. About six institutions were interconnected. Regarding telemedicine tools, an E-learning and E-consultation platform was made available to the health practitioners. Using those tools is still experimental or demonstrative in most health institutions. Te teleradiology project demonstrated a real interest at the level of regional hospitals in the use of teleradiology (particularly in the far away or isolated regions). It also demonstrated that technically, no big investments were needed. However, the integration of the service in the daily administrative functioning of hospitals is still to be realised. In addition, several initiatives were developed in parallel, independently from each other.

The E-health (telemedicine-E-health) activities Reference Centre will be a tool to unite many Information and Communication Technology (ICT) for Health projects in Mali. The centre will enable telemedecine and E-health services to be effectively operational on the ground and put them at the disposal of health practitioners and the general public.

- Develop telemedicine and other e-health activities
- Set up a real time control centre for e-health activities
- Develop action research on the most adapted tools for e-health
- Test, develop and/or experiment with software for telemedicine and e-health
- Develop and offer e-services via a health portal
- Develop local content related to e-health
- Sensitise on the potential of e-health for the health system
- Promote synergy between all existing telemedicine and e-health activities

Goals

• 29 health staff have been trained on ICT and ICT4health
• installation of a training centre with 10 computers
• 19 e-courses on different themes have been disseminated
• e-learning programme on 9 specialisations well attended
• 1 research project on the use of Frontline SMS for health

One of the main challenges of the center is to position itself in relation to the Ministry of Health, and the National Agency on telemedicine and e-health (ANTIM) in particular.