Global MedWeb Telemedicine Project

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Date(s) - Wednesday, August 14, 2013
12:00 pm - 1:30 pm

Flamingo Conference Resort and Spa

Global MedWeb Telemedicine Project

In July 2012 the Rotary Club of Sebastopol Sunrise launched an initiative to bring high quality health care to the underserved using affordable telemedicine technology. The concentration of medical specialists in big cities is a global issue that leaves large areas of the world underserved. Telemedicine is a way to address that issue that is very cost effective because it reduces travel for patients. It also enables specialists to expand their practice and build skills while avoiding the down time of travel.

The Global MedWeb telemedicine project started with a pilot site at Mary Johnston Hospital in Manila, the Philippines. It was begun in January 2012 by Dr. Gude and his team of medical specialists that provide services through a telemedicine service firm in the US named Off Site Care. They also donated software and several computers. (The electronic medical record system is hosted so the hospital does not need to acquire and maintain servers, but it does need a good Internet connection and reliable electricity.)


Dr. Gude at the telemedicine control center

The project involves using electronic medical records to capture clinical information and notes from medical staff, lab results and pharmacy orders. Having electronic medical records is a big help in making available accurate and reliable information which can be used for remote consultation.

Another key aspect of the project is using an iPad to have specialists communicate visually with patients and staff in real time using secure video chat. The service in US started off using a robot which you can see in the background of the picture. Now technology has evolved and an iPad can be used which is much more affordable. Dr. Gude has developed a panel of specialists that can be called on to consult any time of day. The plan is to expand the panel of medical specialists with specialists in other countries as the projects take hold and expand. Currently the medical specialist consults are provided gratis. Ultimately, the plan is to have the consults paid by insurance where possible so the project is sustainable.

 Global MedWeb is a newly formed non-profit set up by Rotarians who are familiar with the work in telemedicine begun by Dr. Gude. The proposed Rotary involvement would be to provide durable equipment – wireless networks, iPads and peripherals. We are gathering information about what further equipment is needed at each hospital or clinic that wants a telemedicine project.

Dr. Gude, the doctor who has been developing the system and advocating for using telemedicine, is on the faculty of UC San Francisco, a world class medical school and teaching hospital. He and his colleagues have formed a service that augments local staff for several hospitals in California and several pilot projects around the world. The panel of specialists now includes several dozen doctors in the US and in other countries. Together they have a broad range of specialties and can provide service 24X7.

The telemedicine system is a proven clinical tool. It has been used in California at over five small hospitals for over four years. The system is named HarmoniMD and is certified by a US Federal certification agency as meeting the criteria for a clinical computer medical record system. The telemedicine team has provided service in several countries in Africa, Haiti and now in the Philippines and India. For example, the system is in use at a hospital in the Congo where successful consults have been provided. In one case, a teenager was scheduled to have his spleen removed.

When the telemedicine team reviewed the case, they advised that the patient had a rare form of tuberculosis and recommended antibiotics. The patient was better in three days.

Other benefits: Palm Drive Hospital, our local 20 bed hospital was recently certified as a stroke center which is rare for a small hospital. It is possible because thanks to Off Site Care and telemedicine we can get a neurology consult within minutes of a patient arriving at the hospital which is less time that it would take to drive to the nearest bigger hospital.

The issue of having most specialists located in the major cities, remote from many patients, means you either have to bring the patient to the specialist or bring the specialist to the patient or just do without. Telemedicine overcomes the problem of distance and can make travel unnecessary. We think this a key to providing high quality care to the underserved in the future. Some hospital chains are using telemedicine already. Dr. Gude and Global MedWeb are working across boundaries between hospital affiliations and across countries. A key aspect of how we work is to engage with partners who live near the hospitals and clinics where we have a telemedicine project. We work with local Rotary clubs because Rotarians are well known members of their communities, share the value of service and the priority of prevention and cure of disease. Rotary clubs are good stewards of resources. Dr. Gude is a key partner because he has expertise in medicine as an intensivist who works with the sickest patients and he has over five years’ experience implementing telemedicine as a doctor. We seek partners with an established relationship with hospitals that serve the underserved. And we seek partners with expertise in telemedicine.

For more information contact: Mikel Cook (707) 827-1524, email:

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