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OBJECTIVEDemonstrate the feasibility of deploying portable ultrasonography with remote assistance to improve the diagnostic capabilities of isolated physicians in Africa.METHODSThe approach is based on the training of general practitioners for the use of ultrasonography, and the remote support by radiologists using dedicated tools for image transfer over low-bandwidth internet connections.RESULTSOur early results in a pilot project in Mali show that this approach is feasible, and that isolated physicians can productively use ultrasonography to improve diagnosis and management decisions such as the need for a medical evacuation towards a reference hospital.CONCLUSIONThese encouraging early results must be confirmed by larger-scale studies, in order to better understand the organizational requirements and demonstrate outcomes and return on investments for such telemedicine services. This scale-up project will start in 2010 in collaboration with the International Development Research Center of Canada.

Deploying Portable Ultrasonography with Remote Assistance for Isolated Physicians in Africa: Lessons from a Pilot Study in Mali