A study of a rural telemedicine system in the Amazon region of Peru.

Voice and data communication facilities (email via VHF radio) were installed in 39 previously isolated health facilities in the province of Alto Amazonas in Peru. A baseline study was carried out in January 2001 and a follow-up evaluation in May 2002, after nine months of operation. We measured the reliability of the technology and the effect the system had on staff access to medical training and information. We also measured the indirect effects on the general population of access to better health-care. The experimental data were collected from 35 of the 39 sites in face-to-face questionnaire interviews. Before installation of the system, the mean consultation rate was 3 per month per facility (95% CI 1.5 to 4.5). At the end of the study, the mean consultation rate was 23 per month per facility (95% CI 14.7 to 31.5). There were 205 emergency transfers from the 39 health facilities. The system was employed in all these cases to alert the referral centre. The mean time required for evacuation was reduced from 8.6 h to 5.2 h. Health-care personnel reported that in 58 of the emergency cases (28%) the use of the system saved the life of the patient. The study shows that the use of communication technologies appropriate to local needs solves many problems in rural primary care, and that voice and email communication via VHF radio are feasible and useful for rural telemedicine.