The Addis Clinic

The World Health Organization (WHO) estimates that there is a shortage of nearly 18 million health workers globally, with Sub-Saharan Africa having a critical deficit. As a result, many remote and underserved communities are served by a single FHW not properly equipped to manage patients with complex and chronic illnesses. By bringing clinical education and physician consultations through telemedicine, they improve the quality of care provided to patients while bringing much needed support to FHWs and increasing their ability to care for local patients. Reducing out of community referrals, travel, and cost to patients and organizational partners, while increasing critical technology skills and clinical knowledge for health workers. A sustainable and culturally appropriate way to bring specialty care to areas of the world where it is needed most.
The International Telemedicine Technician Training Program will properly prepare FHWs to utilize asynchronous telemedicine to bring specialized care to their local patients. Individualized consultations with experienced physicians allow community health workers, nurses, and other clinical staff to provide care for patients that would otherwise be referred to medical providers outside of their community, which is often not an option due to cost, travel, or lack of a provider. Once a FHW has completed the course, they are prepared to implement and manage a local telemedicine program, using a smart phone or tablet to submit patient cases, track progress, and communicate with physicians from around the world to bridge the health equity gap without supplanting local personnel. Combining expert knowledge with local expertise.

The Addis Clinic utilizes an asynchronous telemedicine platform designed to work in low-connectivity and remote areas – allowing us, to deliver specialty medical expertise to Frontline Health Workers in a timely and cost-effective manner. Asynchronous or “store and forward” telemedicine incorporates the use of information and communication technologies, such as mobile phones, to exchange pre-recorded data between two or more individuals at different times. Three key components of their program model allow them to support FHWs providing care for patients in their communities.
– The first component is their technology. They utilize a platform built by Collegium Telemedicus – the same platform utilized by other organizations such as Médecins Sans Frontières working in remote environments. Studies have shown the positive impact of using “store and forward” technology, to support decision-making in the field and to improve the primary-specialty care interface in a timely manner. The telemedicine platform can be accessed on a smartphone or tablet through the offline-first mobile app. Their physician designed templates within the platform assist in guiding health workers, through patient data collection and increase the quality of consultations.
– The second component is their network of volunteer physicians. They have close to 100 physicians representing a wide range of specialties. Many of their volunteers are affiliated with world-renowned academic institutions providing tertiary care such as Harvard, Duke, and University of California at San Francisco. To date, their physicians have volunteered over 1,300 hours of their time supporting FHWs through virtual learning and mentorship. While they utilize a wide range of specialists, 80% of their cases are assigned to Family Medicine, Internal Medicine, Dermatology, and General Pediatrics.
– The third component is their partnerships. Establishing strong partnerships with local organizations embedded in their communities is critical to ensuring that their recommendations are effectively implemented on the ground. They have partnerships with organizations across Ethiopia, Kenya, Tanzania, Ghana, Cameroon, Belize, and Haiti. To date, their partners have submitted over 550 patient cases culminating in over 800 teleconsultations.
An extensive partner survey completed by local staff at each partner location provides important information to their consulting physicians on available medications, testing facilities, and other medical resources located in the referrer’s area. In providing telemedicine consultations over the past several years, they have concluded that a more comprehensive training program is needed for FHWs, giving the education and tools needed for local staff to implement and manage their telemedicine program. Bringing greater knowledge and ownership to local organizations while increasing their ability to access specialized consultations through technology. They are developing an eLearning certification course for FHWs, appropriate for use in remote settings and specifically meets the learning needs of health workers providing care without local physician support. The International Telemedicine Technician Training Program include modules on the background of telemedicine, technology use, patient interaction and information collection, remote physician interaction, follow up, and local telemedicine implementation and management. This course is at no cost to their partner organizations, including all their services.

With their focus on supporting and empowering local organizations and healthcare workers, their model adds value to the existing health structure as opposed to replacing it. They reduce the need for short term clinicians and expand the capacity of the local workforce. Enforcing the confidence of local patients by leaving all direct care in the hands of local providers. They provide a virtual referral network of physicians that emulates the support offered at a large hospital, but brought to the most remote areas of the world. By partnering with existing organizations, they bring quality care at a low-cost with a focus on advanced training for the local health staff. The International Telemedicine Technician Training Program prepare clinicians to maximize the use of asynchronous telemedicine, within their existing health workflow. Creating an environment that combines the appropriate use of technology, while keeping the care and patient management in the hands of the local staff.