A novel approach in telemedicine – bringing hybrid, contact- and telemedicine-based mobile healthcare services in rural Hungarian areas

Ábel Perjés, Rita Kovács, Márk Virág, Gergely Marovics, Luca Tóth, Barbara Sándor, Veronika Győri-Dani, Ferenc Nagy, János Sándor, Anita Pálinkás, Szilárd Redneki, Péter Maróti, Ferenc Vincze

Keywords: telemedicine; rural health; underserved population;

Background:

Limited access to healthcare is one of the main problems effecting rural, socioeconomically underprivileged areas, such as the municipalities in the “Emerging settlements program” in Hungary.

Research questions:

We aimed to prove the feasibility of telemedicine-assisted care for underprivileged populations.

Method:

The Hungarian Charity Service of the Order of Malta operates a mobile healthcare program (MHP) in 30 “Emerging Settlements” in 5 clusters. MHP consists of 12 Mobile clinics: vans that are equipped with broadband internet connection, a high-resolution teleconference platform, devices enabling certain aspects of the physical examination via telemedince, and additional diagnostic tools, such as point of care lab testing devices. A mobile clinic is operated by a trained nurse and a driver who meet the patients in person, while the medical doctor perform the consultation using the teleconference platform. The care focuses on screening for cardiovascular (CV) risk factors, manifest CV diseases and diabetes, and provide chronic care for those diagnosed. The mobile ultrasound clinic and the telespecialist network extend the delivered care beyond the realm of primary care.

Results:

We examined the care delivered at MHP in the period from 01.04.2023 to 31.10.2023. The 30 settlements had a total population of 15,294. 1889 people (1429 adults and 460 children, 12.35 % of the overall population) had at least one consultation in this period. The average number of care events was 2.44 for adults and 1.36 for children. Blood pressure and glucose levels of 1430 patients were checked, resulting in 105 new hypertension and 26 new diabetes daignoses. 987 patients received a total of 2177 referrals (1024 within Maltese telemedicine providers and 1153 to external healthcare providers). A significant, 10% decrease in relative referral frequency was detected (RR change: 0.9 [0.86;0.95]).

Conclusions:

MHP can effectively deliver medical care, improve chronic disease management and enhance definitive treatment in the patients'vicinity in underprivileged regions.

Points for discussion:

Limits of telemedicine in general.

What part of primary care cannot be delivered in MHP?

Sustainability of MHP

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