Telemedicine Leveraged by Smart Glasses to Improve Primary Healthcare Services in a Remote Rural District, Kingandu, Drc, 2019–2020

Abstract

Background: Telemedicine enables new forms of medical consultation and is expanding worldwide. Patients in sub-Saharan Africa could potentially benefit substantially from telemedicine.

Objective: To improve primary healthcare services, especially referrals to the district hospital, for the population in three health centres in the rural district Kingandu in the Democratic Republic of the Congo (DRC) by introducing a telemedicine intervention leveraged by Smart Glasses.

Methods: The project involved the design and introduction of an intervention combining community engagement with technological innovation (Smart Glasses, communication equipment, moto-ambulances, and new diagnostic tests), and with staff training. Utilisation of the intervention, use of the health centres, and referrals to the hospital were monitored through the routine health information system and project-specific registers. Key stakeholders were interviewed and the project costs were analysed.

Results: The use cases for the intervention were defined in consultation with the stakeholders. Extensive training and troubleshooting were needed throughout the project period. The total number of consultations increased significantly in the intervention health centres. The number of referrals to the hospital remained relatively stable, but an increased proportion effectively arrived in the hospital. The Smart Glasses and moto-ambulance greatly facilitated emergency referrals, often requiring a potentially life-saving intervention in the hospital. All stakeholders involved highly valued the intervention.

Conclusion: Telemedicine can contribute to improving primary healthcare services in a remote rural area, as part of a more comprehensive intervention and with intensive participation of all stakeholders. It can increase acceptability and use of the existing services; improve diagnosis, treatment, and referral of patients; and can also facilitate on-the-job training and supportive supervision.

Keywords: digital health, smart glasses, PHC, DRC, health system, sub-Saharan Africa, digital health, referral, rural health