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The literature search further included searching of WHO regional indexes including African Index Medicus (AIM); the Eastern Mediterranean Region Library Network (EMLIBNET); Latin American and Caribbean Health Sciences (LILACS) produced by the Pan American Health Organization (PAHO) Institutional Memory Database; the WHO Library Database (WHOLIS); and the Western Pacific Region Index Medicus (WPRIM) using the WHO Global Health Library platform (www. globalhealthlibrary.net), and hand-searching of the telemedicine journals Journal of Telemedicine and Telecare and Telemedicine Journal and e-Health using terms corresponding to those listed above. It also included a limited search of references from retrieved articles. However, it did not include extended searching of Internet web sites and conference abstracts or contacting authors for unpublished data. Duplicate articles were excluded. Selection of studies Retrieved full-text studies were appraised to identify those to be included in the review. Full publications subsequently found not to meet the inclusion criteria were excluded. Review results included 108 articles. Based on the criteria detailed above 27 of these were found not relevant and thus excluded from the review. The final number of articles included was 81. Telemedicine in developing countries: framing the survey findings. Opportunities for developing countries The literature reports that while telemedicine offers great opportunities in general, it could be even more beneficial for underserved and developing countries where access to basic care is of primary concern. One of the biggest opportunities telemedicine presents is increased access to health care. Providing populations in these underserved countries with the means to access health care has the potential to help meet previously unmet needs and positively impact health services.
Telemedicine applications have successfully improved the quality and accessibility of medical care by allowing distant providers to evaluate, diagnose, treat, and provide follow-up care to patients in less-economically developed countries. They can provide efficient means for accessing tertiary care advice in underserved areas. By increasing the accessibility of medical care telemedicine can enable patients to seek treatment earlier and adhere better to their prescribed treatments (28), and improve the quality of life for patients with chronic conditions.
Telemedicine has been advocated in situations where the health professional on duty has little or no access to expert help (30); it is able to offer remote physician access to otherwise unavailable specialist opinions, providing reassurance to both doctors and patients. Telemedicine programmes have been shown to directly and indirectly decrease the number of referrals to off-site facilities and reduce the need for patient transfers. Remote care and diagnosis via telemedicine in less-economically developed countries thus benefits both patients and the health care system by reducing the distance travelled for specialist care and the related expenses, time, and stress. Furthermore, telemedicine programmes have the potential to motivate rural practitioners to remain in rural practice through augmentation of professional support and opportunities for continuing professional development. Telemedicine networks in developing countries could also offer secondary benefits. Telecommunication technologies, such as those used in telemedicine initiatives, have shown to be effective tools for connecting remote sites. By opening up new channels for communication telemedicine connects rural and remote sites with health-care professionals around the world, overcoming geographical barriers and attempting to reverse ‘brain drain’ or flight of human capital.
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