1. Tele-Ophthalmology Eye-Health system deployment in Kolda, Senegal Jaume Benseny e-Health and e-Dependence Department i2CAT, R+D Non Profit Foundation A. Carolina Rivas Prantte ILO, Lleida Ophthalmologic Institute From Eye-Health Project to Open Window to Senegal

2. Eye Health ProjectOpen Window to Senegal Project Tele-Ophthalmology Eye-Health system deployment in Kolda, Senegal

3. Main goal is to make specialized eye health available in rural zones as in the urban zones Born in 2006 Cover unattended ophthalmologic demand in the remote villages of the Pyrenees mountain range Deployment of a tool to make the GPs (general physicians) able to cooperate with the ILO ophthalmologists Eye-Health Project / Introduction

4. Eye-Health Project / Justification Catalan High Pyrenees description area High mountain range Dispersed population Difficult access Big distances Lack of ophthalmologist Catalan Health Care stressing factors Progressive population ageing Chronic diseases Sedentary lifestyle 2005 2020 The introduction of telemedicine is a cost-effective solution to help the health care unsustainable economic situation

5. Ophthalmologic reality in Kolda According to the: Programme National de Lutte contre la cécité au Sénégal Blindness prevalence = 1.4 % - 150 000 blind people - 450 000 people with serious visual disabilities

6. ILO NGO (Ferreruela Sanfeliu Foundation) Eye health field improvement trough specific actions : 1.Cataract surgery 2.Fight against Trachoma and Trichiasis 3.Children Refraction Defect Detection Program 4.Set up a cooperative optic shop cooperatively managed 5.Deploy the Telemedicine system based on the Eye- Health Open Window to Senegal * In concordance with the National Program Against the Blindness Minister de Santé, Conseil de la Region Medicale

7. Flow diagram GP in the Village GP takes eye fundus images GP writes a report ILO Ophthalmologists in the city Specialist analize Specialist diagnose remotely

8. Eye-Health Project

10. System components Easy access and management of patient information Web Interface GP is able to manage the ophthalmologic appointments independently Appointment Manager Able to prioritize between cases Emergency case procedure Ophthalmological history of the patient Personal Health Record Eye fundus Data Base Image Repository

11. Technical Platform & Difficulties 1.Bandwidth problem Different Health Care Systems Public Health Care (GPs around little villages) Private Health Care (ILO Ophthalmologists) 2. Interoperability problems Translation Interface

12. First stage (delayed until 2010) Kolda Hospital visit to collect technical requeriments Deployment of a Videoconference System based on bandwith mesures [BCN - KOLDA] Start of E-Learning process based in videoconference Second stage Full Eye-Health features deployed Capacity to remotly diagnose Kolda cases from Catalonia Capacity to remotly diagnose Kolda countryside cases from Kolda Hospital Open Window to Senegal

13. Senegal ICT Overview ICT Regulatory Entities DERPT is the regulator of the telecommunication sector. Open competitive market SONATEL is the private operator owner of the main ICT infrastructure.

14. People have Internet access in the TeleCenters Main Hospital is connected trough SONATEL network. Iperf real bandwidth measurements [BCN – KOLDA] to ensure videoconference requirements. 300 kbps TCP 50000 kbps UDP Kolda ICT Infrastructure

15. Tele-Ophthalmology – Benefits Ophthalmologic care AFTER Eye-Health Project GPs became the patients guide against an ocular affection GPs are under e-learning process (80% of GP diagnosis coincided with the ophthalmologist) Practical way for eye fundus- pathology screening and treatment Easy access to specialized medical attention Ophthalmologic Electronic Record Reduce Ophthalmologic waiting lists Public Health Care global economic savings

16. Conclusions New services and products based in the Information Society tools can improve basic services while reducing its costs. The Information Society and its benefits can not be applied everywhere due to the digital gap. The establishment of NRENs and permanent relationship between research groups increases its capacity to success in the objectives pursued.