Fondation Pierre Fabre

Making specialised health services available to isolated populations without patients having to travel

Main beneficiary countries:
Mali - Senegal - Côte d’Ivoire - Madagascar

About the sponsor

Réseau en Afrique Francophone pour la Télémédecine ( RAFT)

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.

In 2000, a group of young doctors in Mali who were prepared to go to rural areas, set us a challenge: use your digital tools to support doctors who want to set up their practices, so that they can remain in contact with specialist doctors and their colleagues, to continue receiving training and advice when they encounter a difficult case, to decide if a patient really does need to be transported to the city. Help us to move our expertise, rather than moving patients or doctors. After pilot projects in Mali and Mauritania, the Francophone African Network for Telemedicine (RAFT) began in 2003. The name is evocative of a rather basic undertaking, but one that enabled us to overcome an obstacle, to reach another horizon. And this is the chosen approach: using simple, resilient computer tools that are adapted to local conditions to facilitate communication, collaboration and distance learning, to “de-isolate” health professionals and improve their working conditions and their effectiveness, and as a result, the quality of patient care. Up to 2014, more than 1,000 professionals had participated in RAFT in some 20 African countries: continuing education courses, help with remotely interpreting an X-ray, an ultrasound image, an electrocardiogram, a photo of a skin lesion, or to obtain advice for handling a difficult case.

Sector: Health: Healthcare professionals and structures

Country of origin: Switzerland

The organisation has:

4
Full-Time Equivalents
3
Employees
12
Volunteers
4
Service providers

Initiative overview

Healthcare themes targeted

  • Mother and child health
  • Primary healthcare
  • Malaria/paludism
  • Infectious diseases
  • Sexual and reproductive health
  • Cardiovascular illnesses
  • Dermatology
  • Mental health
  • Ophthalmology
  • Emergency services

Stage of development:

  • Routine project/operational

Area where initiative is utilised

  • International (in several countries)

Initiative start date

  • 09/01/2007

Financing

Financing method

  • Public (grant/subsidies, call for proposals/call for tender, etc.)
  • Private (private investors, crowdfunding, philanthropy, etc.)

Economic model(s)

  • The economic model is organised by each group of users by a distribution key based on the revenues of specialised consultations: 1/3 for the specialist, 1/3 for the health centre and 1/3 for the technical structure that develops the tool

About the initiative

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

“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.

Fields of application:

Telemedicine (remote diagnosis and consultations) - Patient monitoring and medical data

Target audience

  • Healthcare professionals and structures (hospitals, healthcare centres/clinics, health networks)
  • Sick people

Initiative objectives

  • Decreased mortality
  • Decreased morbidity
  • Reduced suffering
  • Improved treatment

Key figures

7000 Number of beneficiaries since launch

300 Number of users per Year

Materials used

  • Smartphone
  • Tablet
  • Computer

Technologies used

  • Internet
  • Mobile app (Android, iOS, Windows Phone, HTML5, etc.)

Offline use

Yes

Open Source

Yes

Open Data

No

Independent evaluation

No

Partners

Université de Genève

Academic entities: Universities, research laboratories, etc.

Canton de Genève

Organizational: Communities, public authorities, NGOs, associations, foundations, etc.

RFI

Organizational: Communities, public authorities, NGOs, associations, foundations, etc.

Partners

Collaborators

startupBrics