Satellite-supplementation of Medical Outreach Clinics: a Feasibility Study

NCT01821014 | Completed

• 1 other identifier: 13-000132
• Study Type: interventional
• Target: 144
• Locations: 1 country
• Sites: 1

Brief Summary

Much of the basic general medical care and chronic disease management in rural Honduras comes from groups of volunteers setting up temporary clinics run by volunteers. These clinics, also known as brigades, or medical missions, are often criticized for their lack of quality and the lack of follow-up, both of which stem, in part, from understaffing with volunteer physicians. This study is designed to assess if it is feasible, safe, and acceptable to treat patients in short-term mobile medical clinics in rural Honduras using US physicians connected with patients by videoconference.

Conditions

Telemedicine; Primary Health Care; Developing Countries; Diagnosis; Therapeutics

Keywords

Diagnostic concordance; Treatment concordance; patient satisfaction; physician satisfaction; Medical Outreach Clinics; Medical Brigades; Medical Missions; Telemedicine; Videoconference; diagnoses; treatments; Satellite Internet; VSAT; cross cultural telemedicine

Outcome Measures

Primary Outcomes (2)

• Clinical Diagnoses

  The diagnoses resulting from the two physician visits will be compared and a cohen's kappa statistic will be calculated for diagnoses between the visits.

  Same Day as clinic visit (less than 6 hours)

• Recommended clinical treatments

  After each of a patient's two physician visits, the physician's resulting recommended treatments will be gathered for comparison between the two visits.

  Same Day as clinic visit (less than 6 hours)

Secondary Outcomes (3)

• Patient opinions of physician interactions

  Immediately following physician interactions (less than 6 hours)

• Physician opinions of patient interactions

  immediately following volunteer activities with the clinic (less than 48 hours)

• Volunteer opinions of physician-patient interactions

  immediately following experience with the clinic (Less than 48 hours)

Other Outcomes (1)

• Cost

  One year (from pilot to completion of study)

Study Arms (3)

Telemedicine First

EXPERIMENTAL

Patients whose first physician visit during the clinic was using videoconference, a form of telemedicine, and whose second physician visit during the clinic was with a physician in-person.

Other: Telemedicine; Other: In-person physician interaction

Telemedicine Second

EXPERIMENTAL

Patients whose first physician visit during the clinic was with a physician in-person, and whose second physician visit during the clinic was using videoconference, a form of telemedicine. This is the reverse order of visits of the "Telemedicine fist" arm.

Other: Telemedicine; Other: In-person physician interaction

Two physician visits

ACTIVE COMPARATOR

Patients who had two sequential visits with different in-person physicians.

Other: In-person physician interaction

Interventions

Telemedicine OTHER

Patients undergo a detailed history and examination to the degree that is possible using the videoconference program, skype, a digital camera for high-resolution images, and an electronic stethoscope. A clinic volunteer aids with examination, translation and documentation.

Also known as: Videoconference, Skype

Telemedicine First; Telemedicine Second

In-person physician interaction OTHER

Patients undergo a detailed history and examination by an in-person physician. A clinic volunteer aids with examination, translation and documentation, as needed.

Also known as: in-person visit, in-person examination, in-person consultation

Telemedicine First; Telemedicine Second; Two physician visits

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Able to give informed consent
• Non-emergent medical complaints
• At least 18 yrs in age

You may not qualify if:

• Pregnancy
• Mental Disability

Sponsors & Collaborators

• Mayo Clinic: lead

Study Sites (1)

Global Brigades

Tegucigalpa, Francisco Morazán Department, Honduras

Location

MeSH Terms

Conditions

Disease; Patient Satisfaction

Interventions

Telemedicine

Condition Hierarchy (Ancestors)

Pathologic Processes; Pathological Conditions, Signs and Symptoms; Treatment Adherence and Compliance; Health Behavior; Behavior

Intervention Hierarchy (Ancestors)

Delivery of Health Care; Patient Care Management; Health Services Administration

Study Officials

• Bart Demaerschalk, MD/MSc

  Mayo Clinic

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: TRIPLE
• Who Masked: CARE PROVIDER, INVESTIGATOR, OUTCOMES ASSESSOR
• Purpose: DIAGNOSTIC
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: PI

Study Record Dates

• First Submitted: March 20, 2013
• First Posted: March 29, 2013
• Study Start: February 1, 2013
• Primary Completion: June 1, 2013
• Study Completion: June 1, 2013
• Last Updated: May 12, 2014

Record last verified: 2014-05

Locations

HO (1)