Preliminary Experience of Shared Clinical Management between Milan and Pointe Noire Using the INteractive TeleConsultation Network for Worldwide HealthcAre Services (INCAS): Telemedicine between Milan and Africa.

This paper describes preliminary experience in shared clinical management of patients locatedin Pointe Noire, Africa, and a referral center, Sacco University Hospital, located in Milan,Italy. The employed infrastructure INteractive TeleConsultation Network for WorldwideHealthcAre Services (INCAS) jointly developed by CEFRIEL (Center of Excellence For Research,Innovation, Education & Industrial Labs partnership) and ENI (Ente Nazionale Idrocarburi)is based on commercial off-the-shelf technology. This minimizes maintenance problems,while permitting a simple and friendly sharing of data using the telephone and e-mailfor store-and-forward applications. The critical aspect of the flow of events comprising theexchange of information is discussed. In 60% of cases, only one telemedicine consultationwas required. In the remainder 40%, a number of telemedicine consultations were requiredfor appropriate management of clinical cases. The project demonstrated flexibility as documentedby the wide range of pathologies that can be dealt with it. Finally the possibility ofusing shared clinical management as a learning tool is highlighted by the steep and risinglearning curve. We conclude, however, that the patient, although handled in a "virtual" manner,should be viewed as very "real," as some of them elected to close the gap physically betweenPointe Noire and Milan, and chose to be treated at the referral site. [ABSTRACT FROM AUTHOR]