World Journal of Surgery

, Volume 30, Issue 6, pp 1128–1134 | Cite as

Telemedicine and Electronic Health Information for Clinical Continuity in a Mobile Surgery Program

  • Francisco Mora
  • Stephen Cone
  • Edgar Rodas
  • Ronald C. MerrellEmail author



An intermittent surgical services program in rural Ecuador was able to benefit from close collaboration between surgeons and primary care physicians through the use of telemedicine technologies.


Inexpensive telemedicine workstations capable of patient documentation, imaging, and video-conferencing at extremely low bandwidth were established in collaborative primary care sites in rural Ecuador. Patients were screened for intermittent surgical services by primary caregivers according to the surgeons’ guidelines. Real-time and store-and-forward telemedicine allowed appropriate collaborative, informed decision-making. Surgery was performed, and postoperative care was similarly handled by on-site, familiar primary caregivers.


To date, this system has been used in more than 124 patient encounters (74 preoperative and 50 postoperative visits). The system allowed advance screening of patients on the part of the surgeons, leading to cancellations for 9 patients. Postoperatively, the system allowed 100% concurrence in postoperative diagnoses between the primary caregivers and the surgeons.


Inexpensive, low-bandwidth telemedicine solutions can support intermittent surgical services by providing patients to have contact with specialist care through their familiar, local primary caregivers.


Gross Domestic Product Primary Care Physician Electronic Health Record Postoperative Evaluation Primary Care Center 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



The authors thank all members of the staffs of Hospital Pio XII in Sucúa, Ecuador, and the Santa Maria de Fiat Foundation in Manglaralto, Ecuador for their assistance with this project. Specifically, we thank Drs. Isabel Freire and Monika Steffel for their dedication to this project. We also thank Ms. Chasity Roberts for her editorial assistance. This work was funded in part by a grant from NASA.


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Copyright information

© Société Internationale de Chirurgie 2006

Authors and Affiliations

  • Francisco Mora
    • 1
  • Stephen Cone
    • 1
  • Edgar Rodas
    • 2
  • Ronald C. Merrell
    • 1
    Email author
  1. 1.Medical Informatics and Technology Applications Consortium, Department of SurgeryVirginia Commonwealth UniversityRichmondUSA
  2. 2.Fundación CinterandesUniversity of Azuay, Medical SchoolCuencaEcuador

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