mHealth: the developing world really needs it – a Telecare Aware special report

Since retiring, Victor Patterson, a consultant neurologist from Belfast, Northern Ireland, has been active in setting up an mHealth service in Nepal for people with epilepsy. In a special report for Telecare Aware he sets out why such services are so vital.

If you think telehealth/telemedicine is too easy in the UK and you’d like a real challenge, my advice is to try Nepal.

Its population is about 28 million people (only a few of whom are Gurkhas). About 80% of people live outside the capital, Kathmandu, where surprise, surprise, about 90% of the country’s doctors live.

Working in Nepal is difficult for a number of reasons: there is still a touch of political instability and there are electricity outages for 8 hours most days, but there are two more important reasons…

Road in Nepal

Nepali road – only 2 hours to go!

Center for Telehealth and e-Health Law (CTeL)

If you are not aware of it (well, it wasn’t on my radar screen, which needs some cleaning, but there it is), there is an organization called the Center for Telehealth and e-Health Law (CTeL) that was created in 2006 with a grant from the US Department of Health and Human Services (DHHS). Their focus is exactly that–regulatory, privacy and government facing issues. Their home page has a nifty news feed for telemedicine and telehealth, if you don’t.  One recent event they sponsored was their monthly ‘Washington Live! Brown Bag Telehealth Seminar’ (Wikipedia: Brown Bag Seminar), topic: Is there a role for Telehealth and Remote Monitoring?  [A bit of a headscratcher, as we have been presuming that for a while.] Nonetheless, the summary is dense reading. Telehealth was discussed as…

EMR implementation: the law of unintended consequences

This must-read ‘Gray Lady’ (New York Times) article by Pauline Chen, M.D. demonstrates, from the physician point of view, how even well prepared, eager and enthusiastic physicians, in the examining room, faced with patient and simultaneously inputting into an EMR across the room…..can resemble a ‘clown car.’ (or roller skating?)  The solution?  Memorizing and jotting notes while taking the patient’s information, then typing it all in the EMR later.  Efficient?  Good use of time?  It is a more standard workaround than anyone cares to admit. (see later comments). 

But more importantly:


‘…just because EMR improves information sharing and retrieval, it doesn’t necessarily follow that our communication with patients and colleagues will also be better.’