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With telemedicine, no Nigerian should seek medical treatment abroad — LUTH CMD

TO facilitate govern ment’s efforts to actualizing the Vision 20: 2020, the Lagos University Teaching Hospital (LUTH), Idi-Araba recently  launched new ultra modern telemedicine equipment to improve the qaulity of health care.

Smarting from the result of the test run and practicals, the teaching hospital is already rating self in the league of choice hospitals in the world known for best practices.

In this interview with Emmanuel Elebeke, the Chief Medical Director of the hospital,  Professor Akin Osibogun, a renowned professor of public health justifies the huge sum sunk into the super technology project by the federal government.

You are the Chief  Medical Director, Lagos University Teaching Hospital, tell us what telemedicine is all about?

Telemedicine is using modern technology to improve the quality of care of patients, and also to promote medical education. Specifically, telemedicine is the use of  ICT to communicate among medical experts in Nigeria and abroad. It provides bridge between experts in Nigeria and experts in other countries, and specifically the telemedicine project in  LUTH enables us to exchange seminars with leading hospitals in India.

Also, we are able to facilitate teaching consultations with experts in India, that patients who want a second opinion from another specialist from one of the super specialty hospitals in India can come to us and we arrange the consultations on line real time.
In other words, the patient will be seeing the consultant and the consultant will be seeing the patient via ICT, and all the specification from the investigation done we will digitalize and send them also immediate to the consultant over there.

And with this, he is able to advise the patient on the next step.  This is what we have done for a couple of patients. So, they didn’t  need to go to India to get expert advice.
As a scientist, I recognize that knowledge is international. Knowledge is not restricted to a particular country, and scientists all over the world always collaborate to share experiences and knowledge.

The whole idea is that experts here want a second opinion on a particular patient, and therefore we have been able to use that second opinion to get what we want from experts in India.

Have you been doing all these since the launching of the equipment and what has changed?
Yes of course. In fact we have been able to handle many cases since the launching. Specifically, I mentioned that some patients have been leveraging on these facilities since the launching.

For example, there was one patient who have traveled to India. and  was operated by one of the hospitals in India. At a time, he could not condown and then the patient made his complains after which  the consultant looked at his results and gave him advice and he was very excited and satisfied.

Ordinarily, he would have traveled back to India for a follow up visit and with this technology he did not do that.

Nigerians are very much concerned about cost, does this technology add or reduce cost of health services?

Yes it reduces cost of health services. At least, the cost of  traveling and stay in abroad will be  put off using this technology.

Today,  LUTH is the only hospital with this equipment, are there plans to extend this services to other hospitals in Nigeria?

Yes, in fact there were some huge vans that were deployed by the federal ministry of health in collaboration with the federal ministry of science and technology that go from hospital to hospital. But those ones are mobile vans in addition to this facility.
They are  linked with this telemedicine facility and some other hospitals also have it on a smaller scale. We are aware that the federal ministry of science is planning  to link all the hospitals together in the no distant future, so that we can start exchanging  information amongst ourselves, and at the long run the general hospitals will be linked to the teaching hospitals. Under this situation, a patient does not need to come to us here but will remain in the local hospital and seek consultancy from us and it is only when there is a serious complication and specialized surgery is required, that he will have to come down here for the surgery.

But all the consultations can be done online and real time. This will save him more time and money. If the surgery can be done in Badagary for instance, we will advise the surgeon on what to do.

How soon do we expect this link ups, knowing fully well that life is off essence?
To apply technology requires training. This one has taken us about one year to be in place, while the other ones are still happening gradually.
Again some of the equipments have to be imported. The key thing however is to have plans to get it done. But, I know that the plan  is already ongoing in the 53 tertiary hospitals in the country.

So, those facilities are wide spread and to expand it further  we need to link the general hospital to those tertiary hospitals and link the tertiary hospitals to themselves, so that we can have all this exchange of  knowledge  and expertise.
Going by the technicalities involved in the application of these facilities, does LUTH have qualified personnel who can handle them efficiently?
I think that in the past four months we have been doing that with support from Indian government.

Challenges?

The willingness of patients to pay for these services is our  major challenge. Some people have the notion that services in abroad is cheaper than the local services, but by the time they travel and come back, they will be convinced that services are cheaper at home.
What other areas of health care delivery are you intending to leverage with technology?
You know telemedicine apart from patients consultation and other uses  can also impact on continuing medical education.

So, every month we have a time table of lectures that can be delivered either from the Nigerian end or from the Indian end. Here, somebody can prepare a slice, case  presentation and capture everything with cameras, then send it eletronically.

So, you can now have a patient sitting in a room and those interested even from the 33 African countries connected will watch the presentation. That way, we are learning.
The other day, a professor in India made a presentation from India on their finding on head injuries in India and  it was an opportunity for us to learn.

In the same way, a Nigerian professor  too can prepare something and present his Nigerian experience for other doctors  in other countries to learn. So, both sides we learn from one another.

There have been complains by some medical professionals about brain drain in the country,  do you think this kind of innovation as a solution to that?

The question of brain drain is a complex problem. Brain drain occurs because one  people are not  well paid here,then,  they decide to seek for opportunity elsewhere, where they can  work with more sophisticated tools. There are some people by virtue of being acclimatized with their environment, will not like to leave where they are for another place.
So, they  do it as an adventure. The most important thing  I think,  is the willingness to be on service to your own people and  uplift their own quality of living. Even  though your own life may reduce, but you need to see it as your own sacrifice for the good of your people.

I  found out that some of them who left some years ago, have come back, and I do not think we can legislate it as long as we run a democratic governance, since people travel for different  reasons. They are free to move to any place they want.

What are the prospects of telemedicine in Nigeria.?

The prospect is bright, because it is going to stimulate academic  intercourse among us, and doctors will improve in their learning and patience on the other hand will have opportunity to have first, second and third opinion on their problems without paying for an air ticket.
On the long run, when general hospitals are linked to the tertiary hospitals, then it becomes more interesting because, it means that expert services can now be rendered to people in distant and remote areas in the country, without traveling physically.
With this development, it is only the complicated and specialized cases that will be referred to teaching hospitals.


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