Case Study: Reaching People in Need

April 12, 2004

By Scott Hays

The Teleconsulta project extends the reach of doctors in Puebla, Mexico.

The shortage of professionals in the medical field affects all people, but it is especially hard for children with physical disabilities. Many of these children require weekly or even daily therapy to lead happy, active lives. Although many physicians and therapists do everything they can to provide this service, they can help only a limited number of people.

For the doctors at Central Hospital in Puebla, Mexico, this was a familiar problem. To reach all of their patients, they had to send their therapists on a traveling rotation that sometimes took three weeks to complete. Because of travel times and the limited number of doctors available, many children in the area weren't able to receive the therapy they needed.

"In order to treat all of these patients, the doctors eventually requested that they all travel to the hospital for their therapy," says Claudia Martinez, representing the technology partner for this project. "This created a problem for the patients, many of whom were unable to travel to the city because they lacked transportation."

The hospital, in conjunction with the Desarrollo Integral de la Familia (DIF), the Mexican government's division of family services, decided to implement a telemedicine program in which doctors at the hospital could communicate with remote branches via video and phone. They felt that they could effectively reach their patients this way without placing the burden of travel on them. They soon began researching how to implement a system.

"Other states had already attempted to develop similar initiatives to deal with similar problems, but there were cost and efficiency problems with all of them," Martinez says. "One state tried to establish a network using a satellite system, but it was too expensive. There were also problems with transmission delays, so it was inefficient."

The DIF explored other options, and eventually decided that a broadband network was required to support the service. They tried at first to build the network on frame relay technology, but that proved too costly and inefficient.

"They were having problems with the video transmissions using the frame relay system," Martinez says. "The transmissions weren't clear and were difficult to understand. The system also proved costly because many of the locations didn't have access to fiber lines, so there would have been additional infrastructure costs to consider had they gone that route."

The DIF contacted Gemtel, an ISP in the Puebla area. Gentel had experience implementing broadband wireless networks with the same wireless broadband equipment used by Clear Wireless. Gemtel began working in conjunction with the DIF and the doctors from the hospital to assess the needs of the program and quickly built the network. The program, called Teleconsulta, went into effect in summer 2003.

"The doctors wanted the system to let them sit in via a video camera and watch the therapy sessions that the patients were having with the therapists at the remote locations," Martinez says. "They worked closely with the people at Gemtel to develop the network to their specifications, and that's one of the main reasons it works so well."

The network provides voice and data service to the remote therapy locations. Gemtel was able to build the network quickly due to the ease of deployment and cost-effectiveness of the wireless broadband platform. Doctors are now able to access patient records, view therapy sessions in realtime and collaborate with other physicians using VoIP technology via the network.

Teleconsulta currently serves 25 remote locations, with plans to expand to 45 by the end of the year. Thanks to the program, an additional 250 handicapped children receive therapy from doctors at Central Hospital.

"The system has worked wonderfully so far," Martinez says. "The doctors are extremely pleased with it, but, more importantly, people that couldn't ordinarily receive treatment are now able to … for that reason alone, it's been very rewarding to be involved with this project."

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