Internet-Based Continuing Medical Education in Remote Areas of China: WebMEd: Economical PC-Based Tele-Education and Telemedicine 1999-01-2019

China and other areas of the planet share the unfortunate reality that their rural populations have limited or no access to specialty health care personnel, expertise or facilities. A simple, cost-effective web-based Continuing Medical Education program is presented that allows even some of the most remote areas of China virtual access to medical information, medical specialists and teams of medical consultants, regardless of their location. The proposed project suggests a grassroots approach in improving widespread medical education using the existing telecommunication infrastructure, with minimal equipment requirements that would act as a backup to future systems. For the purposes of this paper, the presented system is termed WebMEd (Web- based Medical Education) and hopefully will be considered for immediate implementation as a feasibility study for future satellite based systems. WebMEd is a simple, grassroots and sustainable project that can represent future advanced systems, while remaining economical.

The medical consultation process and CME are blended together here to include tele-education, tele-presence and telemedicine. This paper will focus on the possible implementation in China as a model for other countries in need for remote continuing medical education. This paper will also attempt to show how Internet assisted consultation process can facilitate patient care while educating providers. An interesting case report published on the Internet that resulted in saving the life of an actual patient in China is presented as a successful model for virtual case presentation and education.

Several internet-based medical educational and consultation techniques were evaluated during the course of this study. These ranged from simple e-mail consultations and virtual case presentations to inexpensive Video Teleconferencing (VTC). The case presentations consisted of e-mailing information about patients (known as cases without associated names) with interesting or unusual diseases to groups of physicians in various specialties throughout Northern California. The cases would often include x-rays or digital photographs as attachments for evaluation of quality and acceptance, while determining the actual etiology of their condition.

Virtual rounds were complemented with references to applicable Internet sites embedded in the email text, with attached supporting documentation when helpful. A web site was created as an example of one way of coordinating such discussion groups from scratch. It is concluded that WebMEd (with the exception of the VTC initially) will make a viable platform for a feasibility study in China or other remote areas of the world. The advantages of the low-cost and ease of implementation of the system presented seem to make this option the most feasible, however, alternative scenarios should be addressed. Cost comparisons can be made during proposal presentations and development phases as to facilitate the best system for the goals set.