Telemedicine: A Tool for Investigation, Research and Treatment of Eczema at Remote Beneficiary in Punjab

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1 Telemedicine: A Tool for Investigation, Research and Treatment of Eczema at Remote Beneficiary in Punjab Mirza Abdul Qadir Department of Telemedicine, Mayo Hospital Lahore, Pakistan Dr. Ali Hasnain Department of Dermatology, Mayo Hospital Lahore, Pakistan

2 Need for the system Pakistan The doctor to Population Ratio 1: 1,436 Specialist to Population Ratio 1:14,800 Developed Countries Doctor to Population Ratio 1: 400

3 Introduction Dermatology Department KEMU/ Mayo Hospital, Lahore is actively contributing to provide free of cost telemedicine services since April 2009 Up till now more then 31,000 patients in 14 specialties were provided consultations Connected through DSL to 7 remote District Headquarter Hospitals (DHQs) 17,424 patients of Dermatology were provided consultations

4 Dermatology consultations

5 Objectives Highlight importance of Telemedicine academically in health structure showing epidemics & outbreaks Look for common coetaneous manifestations in patients Using the data to create awareness among local population, policy making and research Train primary care physicians & paramedics

6 What is Eczema? Intensively itchy problem with oozing of fluid from skin and propensity of patient to itch more and more Eczema is a term which describes a wide range of non contagious conditions of skin, involving inflammation. In most of the patients eczema appears as dry, red itchy patch or series of patches which occur when body s immune system overreacts to an irritant. Doctors often refer to eczema as the itch that rashes

7 Types of Eczema consulted through Telemedicine Eczema is a general but broad term which clinically encompasses a variety of different Endogenous and Exogenous types. Endogenous ones are mostly caused by genetic background, aggravated by environmental factors importantly infections, drug allergies and hypersensitivity to environmental allergens Exogenous ones are mostly environment related amongst which there may be person to person variation in having genetically Increased sensitivity towards environmental allergens

8 Types of Eczema consulted through Telemedicine Atopic dermatitis Seborrheic dermatitis Asteatotic eczema Discoid eczema Pityriasis Alba Pompholyx eczema Gravitational dermatitis or venous eczema Lichen simplex chronicus Contact dermatitis Infective eczema

9 Eczema Patient Consulted through the system

10 Eczema Patient Consulted through the system

11 Sample Selection Inclusion Criteria Patients of all ages & both sexes presented at the District Headquarter Hospitals (DHQs) Patients assessed by primary healthcare provider at DHQ needing tertiary care Exclusion Criteria Patients needing further examination referred to tertiary care

12 Eczema consulted (Male & Female) Female Male

13 Materials & Methods From , > 2061 Eczema patients were consulted Beneficiary network from Gujrat, Jhang, DG Khan, Khushab, Sahiwal, Attock & Rajan Pur Patients examined via telemedicine system and equipment & relevant treatment prescribed Patient s name, age, sex, area, diagnosis & prescribed treatment duly recorded

14 Eczema Consultations (All stations) Total Total Attock DG Khan Gujrat Jhang Khushab Rajanpur Sahiwal

15 During Consultation

16 Materials & Methods Study Design Descriptive Case Series Processes and Procedures Physician consultation, Patient medication (prescription & referrals)

17 Materials & Methods Sample Size A total of 17,424 Dermatology patients seen from Eczema Patients were consulted through the system Patients names, ages, location & sex noted & treatment prescribed Patients socio-economic status along with audiovisual quality noted Severity level of the problem was recorded Data entered into SPSS 15.0 p-value of <0.05 considered statistically significant

18 Attock DG Khan Gujrat Jhang Khushab Rajanpur Sahiwal Attock DG Khan Gujrat Jhang Khushab Rajanpur Sahiwal Attock DG Khan Gujrat Jhang Khushab Rajanpur Sahiwal Attock DG Khan Gujrat Jhang Khushab Rajanpur Eczema Patients(social classes) Total Total 0 Lower Middle Class Middle Class Poor Rich

19 Eczema consulted (Social groups) Female Male Lower Middle Class Middle Class Poor Rich

20 Types of Eczema consulted (Severity levels) Asteatotic Atopic CD Discoid Gravitational Infective LSC P. Alba Pompholyx Seborrheic Mild Rare Occurrence Severe

21 Conclusion Telemedicine approach unattended areas Squeeze the gap between rural and urban health provision system Patients are gaining trust on the system Increased awareness among the population towards their common and complex health problems Concept of quality consultancy System is helping in eradication of quackery from the rural health system of the province Best coordination with physicians at remote work station Every social class can achieve good quality consultancy. The data produced through the system helps in advance research and policy making

22 Thank you