BOGOU

The world’s largest medical deserts are Sub-Saharan Africa and Southern Asia: the World Health Organization estimates that two million healthcare professionals are required there to be able to develop functional healthcare systems. Looking more closely, doctors are concentrated in the capitals of these countries, even when they may not have enough work, and wish to emigrate to the North rather than setting up their services in rural areas. Consequently, the patients need to head for the big cities, when they are able to, taking roads that are often long and challenging.

“Bogou” is a tele-expertise or remote diagnostic tool that allows health professionals to request a second opinion or decision-making support from other, more specialised health professionals who may be located some distance away. The description of the health problem or disease is posted on the “Bogou” platform. This platform is organised in the form of secure circles, and categorised by structure or speciality. The software allows users to post a new case in a discussion circle, specifying the essential information about the patient (minimum medical history), along with a description of the case. Users may also attach a photograph to illustrate the problem (dermatology cases for example), as well as test results or analysis performed, or even an ultrasound (images or video sequences). When the case is posted, the members of the circle are notified by email and can offer their opinion. When the requester is satisfied with the answers he can change the status of the case to “resolved”, which notifies users that comments have been closed for that particular case.Each circle can have one or more moderators. The moderator holds administration rights for the circle. He or she can invite a new user to join the circle and contribute to the discussion of the cases. The user is identified with an email address and password. In terms of computer security, the data is decrypted on the server and sent to the client via an encrypted connection (https). “Bogou” is available in 4 languages: French, English, Spanish and Portuguese. Finally, “Bogou” can be directly interfaced with portable ultrasound scanners that process images or video clips in real time. It can then compress them into a suitable format to make them easier to send to specialists over low-speed Internet connections. It also allows the transfer of electrocardiogram (ECG) exams. “Bogou” is currently being used by several French-speaking countries in Africa that are members of the African Francophone Network for Telemedicine (http://raft.g2hp.net). These include the following countries: Burkina Faso, Côte d’Ivoire, Cameroon, Congo-Brazzaville, Niger, Mali, Madagascar, Senegal, etc. It is also used by organisations such as the Red Cross and the “Second Chance” association.

Bogou makes it possible to share expertise remotely without moving the patient, which prevents unnecessary and costly medical travel.