Carta Magna de jóvenes en la escuela de la esperanza

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The synchronous ""poct of1luTI. i.e. the voice calls enabled via VoIP. was used mainl)' betwIJCn June""" September as seen in Figure 22. Thlth the clinic and the hospital made a number of call aU.empt5 during thi6 p<>riod. In fact. the clinic made a total of 12 call attempT.S and the h06pital made a total of 20 call attempts. By 'call attempt'. we mean a call that w"" made but which WlIB

nOl'.~r answered by the callee. In faM;, from an examination of the log files, it was evident that. only one synchronous communication occulTed during April and October_ This occurred ^<Il 14 July during what is presumoo t.o be a pre-arranged telmnedicine cOll"ultation between the doctur ""d the nurse.

The c~nic placed two calls to the hospital on this day and the hospit.al placed one call t.o the clinic on the same day. All the call" here were answcmd by the calk", and at !eMt 2 minut"" of connection time WM rocorded. TId" slam'S that a synchronous telemedicine consultation is possible u"ing 11uTI and that the doctor and (.he nurse ""re "ufficiently motivated to uoo MuTI for this purpose on at least one occMion. The short duration of the call indicates that the consultation may have been cut "hurt or the participants may have 6,dt~bed to using the CSIR VoIP phon"", the laUe. point will be elaborat.ed on later in Soction 6.2.4.

In all, the total number of call attempts made indkate that voice CRUS"'" an essential pRrt of 1IuTI which bolh partidpan~ were eager to llSC. The"" results a100 indicate that a synchronous voke communication may be po-eferable to an asynchronous ~A)mmunicat>On. This may be because it i" often e-asier to communieate informatiOll ""rbally, if both p""ties "peak the "aIne language.

Syn~bronous rumrillmications would Ollly work if there are sufficient personnel in both the hospit a1 and the clink - meaning less fr""tic work 8Chedul"" ""d more time to 8Ch<.'<iule synchronous appointments - and if the network is reliable_ If the network and power in this project "we not problematic aJ; all and if there were no perOOlllllll filiortage", we f~d that this ""pod; of 11uTl may have been utilised more exl,ensiYely.

In comparison to the feelings expressed about the CSIR telemedicine system, "'uTI ^was seen as a po5itive "tep to improve telemedicine in the Tsilitwa-Sulenkama area. The interview data confirmed the trace data about the 11uTI VoIP component as we dii!COVered that both participants liked the idea of the synchronous aspect of MuTL Both the doctor ""d the nur", ciaim<.'<i the call feature in !'IiuTI enaiJk,d them to call each other if they had the time to have a synchronou6 telemedicine run6ultation.

In the- logs, we fouoo only one day where a full 6yncbrol>ous communkation OC(',urred nsing

!I[uTL However, the data we collected still suggested that the synchronous aspect of 1IuTI was valuable, since many attempts to call each other were made even though almost none of the calls

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CHAvnm G. DISCUSSION OF RESULTS _{1 21}

made wpte mlswered by the callee. Thereforc, tdemcdicine systems should aim to prcrddc "' syn-chronous avenue of communication if possible. III the foIlowiug section. we disc\c% the results we obtailled with respoct to the store and forward component of ),,!uTI, i,e., the asYllcilronous aspect or exchanging of :'II uTI record~.

6.2.::> Asynchronous Aspects of I\IuTI Paticnl Hccords

With the asynchr()llOUS aspect of :'IIuTI, Le., creating patient records ,,~th text, voiremail fI.nd image8. the Iesults wp;re positive, During the evaluation period, the dinic created a total of 35 reoords mId the llOiipital created a total of 11 reoords, as Secll ill Figme 23. Out of the records created, only about half were actually sent to the other party in the project as seen in Figure 24.

This may be because records were c,""ated to edit later or to send at a lateI str<ge. From the tIfl.ce file>; and the database, it was evident that alm()flt all of thase patient records oontained a voicemail and only a smill proportion contained textual information. Tlli>l again indicates that com·eying information verbally waH found to l:>e quicker amI easier thall typing.

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Figure ^2:), This grfl.ph shows the number ^of records crcated per momh by the clinic and the hospital during the project, From the graph, it is clear that both the clinic and the h()l;pital created records mainly during the June to September period before the declill€ in October, Al"O, we can see that the clinic was mOre proactive in creating re<:ords tlmll the hoopital.

Unfortlmately, the tr"-OO reJuit, regarding the inc1wion of images in Iecords u'"" IlIinimaland

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CHAPTER~. DlSCI}SSlO:'; OF I(ESVLTS

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Figure 24: Thi, graph "how, the number of recocds ^'-'lIlt per month by the dinic and ,he hoo;pital during thc project. Thcrc i; a largc disparity betwcen thc number of record, that were created hy cach party (""",n in Figure 23) and thc number of records actually wnt off to l.he oL.her party. For inotll:ncc, the clinic only ""nt a total of 11 wxmk M.d thc hospilal sent off a !0t~1 of ~ reo::Jrds_

However, the clinic created well over 7 record, and tllC hoopital created aver 6 records. Thi, may h"yc been due i,o Lhe panicipanL., experimenting with creating reconl" in ordm to bocome familiar with making a record. It may also be a\l-ribUL..,d ^(.0 the fae, that record" may have been crcated

3.. a electronic h!l.('kup ~nd not for referral purJX'5"'J. OL.her f~cLors alfecL.ing the number of record;;

><ent might havc 1x'<Cn network and powcr failures where pal"lies did not at.\empl, to "",nd record;;

boc= thc ~y.;\cm ,;howed the other party"., 'ofllinc'.

inconcluoivc_ The clinic only had ^II: working digital Camera bctwren September and October and during; thi, onc month period. thc nur:;c participating in the project was away for two weeks.

Addition1llly, thc nctwork ^Will< not functioning for large portions of the l~~t one month cyaluation period. We do know that the nurse did take sever~l piciures of paL.ient ailmcnt:; betwecn Septcmber and October when ,he was pro;ided wilh a digital camera. Howe,",r, mc did not attach or send Blly of the"" piciures to the doctor.

In the interviews, both parlicip8JlL.' indical.-ed tha, L·hcy would prefcr higb quality ~till images over- low resolution vidco_ Thi~ "ugg;c5t~ that il may not be necessary for teJemedicine sy:>tems to offer video confcrcncing iilllce high resolution oL.ill illlilgeo ~nd voice alone Ill"y be ~ufficicnt to convey t.he data required for remote teleco",>nl,alion_ Overall. tllC intcrv:i= confirmed th~t the asynchronous aspec\ or '>[uTI ,",cas helprul t<S illmtratcd by the nurse'" response to the queM.ion

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