1. Remote HIV/AIDS consultations in resource-limited settings Maria Zolfo Institute of Tropical Medicine, Antwerp, Belgium

2. BACKGROUND  Telemedicine is a way to deliver health care in remote areas  E-mails have been used for years as a low cost telemedicine support for colleagues working in low resource settings, by the Institute of Tropical Medicine, Antwerp (ITMA)

3. BACKGROUND  In 2003 the ITMA set up a computer aided training project to guide doctors in the implementation of antiretrovirals (ARVs) and AIDS care in developing countries

4. AIMS (I)  To facilitate the introduction of high- quality ARV care for HIV/AIDS patients, living in resource limited settings by providing adequate technical support for ARVs and management of opportunistic infections (OIs), to clinician from the South

5. AIMS (II)  To provide continuous medical education in the field of HIV/AIDS for doctors following Short Course on Antiretroviral Therapy ( SCART), through a discussion forum on a medical web site, supporting and guiding medical decision making and management of difficult clinical cases

6. Method of working  Expert advice from HIV/AIDS specialists is offered to colleagues in the field through a discussion forum on http://telemedicine.itg.be http://telemedicine.itg.be

7. Initial partners in the field :  Sihanouk Hospital Center of Hope, Phom Penh, Cambodia  Central Hospital, Kigali, Rwanda  Institute of Tropical Medicine Alexander Von Humboldt, Lima, Peru  MSF-Belgium projects in South East Asia

9. Receiving cases/questions: E-mail

10. Receiving cases/questions: E-mail Web interface

11. Receiving cases/questions: E-mail Web interface E-mail (alerts)

12. Receiving cases/questions: E-mail Web interface E-mail (alerts)

13. 1 st year activity

22. 2 nd year evaluation 257/342 clinical cases 85/342 open questions 24/342 166/342 152/342

23. 24/342 152/342 166/342 2 nd year evaluation details

24. ARVs details

43. What is iPath  iPath - an open source software to build telemedicine platforms. Developed at University of Basel  ipath.ch - an association to promote telemedicine and to support projects in developing countries

44. User Interface  Group Display - case list

45. Case Display - Description & Images User Interface - Comments/Diagnosis New comments:  automatic email alert

47. General perception from the field E-mail/discussion forum support is considered important for:  patient management  increased knowledge of medical staff  avoiding referrals  access to medical literature

49. SURVEY

51. Off line function for posting ! A hybrid web and email solution!

52. http://telemedicine.itg.be Thank you!