Operations and Implementation

ePoster Presentation

(EP-134) BRICS a New Dawn for International Telemedicine?

Sunday, April 23
4:15 PM - 4:30 PM
Location: Experience Zone - ePosters

BRICS is an association of five of the largest emerging economies, Brazil, Russia, India, China and South Africa. Formalised in 2006 as BRIC, South Africa joined in 2010. BRICS is home to 43% of the world's population, 37% of world GDP and 17% share of world trade. The agenda of BRICS is wide-reaching. Telemedicine has been identified as an area of co-operation with the opportunity to become a leader in the field.
The BRICS telemedicine experts' group has proposed several goals based on improving universal access to care across the countries through income generating local and international telemedicine. These include the development of 'complex compatible telemedicine systems', opening an international BRICS telemedicine educational center, developing uniform standards and specifications for telemedicine, and harmonizing national legislation in this area.
The proposed international telemedicine project is ambitious and deceptively complex. There are 16 official languages in the five countries, with 65 other recognised languages and over 600 regional dialects. English is not necessarily the lingua Franca of the patients or their local or international doctors. There are at least 12 different scripts widely used, like Cyrillic, Hanzi and Devanagi. In what language and script will notes be shared and kept? Russia has a 10 hour difference between east and west. Brasilia is 5 hours behind Cape Town and 11 hours behind Beijing, so time will influence availability of telemedicine services.
Cross border international telemedicine raises legal, clinical, ethical and cultural issues. Currently international, cross border telemedicine is limited to the European Union and countries and institutions with bilateral agreements. Harmonisation of legislation makes the assumption that legislation for telemedicine exists. Brazil has a Telemedicine law which allows only for consultation between health practitioners without the patient being present. Russia has only just submitted a Bill to its State Duma. In 2014, the National Health and Family Planning Commission of the People's Republic of China published interpretations and associated guidelines regarding telemedicine services in China and a 2015 document outlining a national telemedicine network raises issues of data security and storage. A draft Telemedicine Bill tabled in 2013 in India was not approved. South Africa has no specific telemedicine regulations but aspects such as privacy, data security and confidentiality are covered by other laws, as is the case in the other countries.
Issues of licensure, responsibility, liability, and continuum of care pertain. Discipline specific clinical guidelines set standards for quality of care. These will need to take into account different treatment and diagnostic algorithms imposed by availability of technology, medications and human resources. Ethical standards, while universal, differ in their implementation and perceived importance, eg. informed consent. Cultural issues such as patients' beliefs and acceptance of different local forms of medicine like traditional Chinese medicine, ayurveda, medicina indegina, and complementary medicine and their delivery by traditional healers, divinators and herbalists are frequently overlooked.
The BRICS consortium must overcome many identified and unidentified obstacles facing their ambitious project, and political instability in some countries. Achieving this will establish a new model for international telemedicine.

Learning Objectives:

Maurice Mars

Professor of TeleHealth
Nelson R Mandela School of Medicine, University of KwaZulu-Natal

Mars is a medical practitioner, with a Doctorate in Medicine and a background in orthopaedics, vascular surgery, sports medicine and physiology. He has been working in eHealth for over 20 years and is Founding President of the South African Telemedicine Association, Editor of the Journal of the International Society for Telemedicine and eHealth, Chair of the eHealth sub-committee of the Ministerial Advisory Committee on Health Technology, Chair of the Education Committee of the International Society for Telemedicine and eHealth, Chair of the International SIG of the American Telemedicine Association, and member of the Telemedicine Working Group of the International Medical Informatics Association.


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Richard E. Scott

NTC Consulting - Global e-Health Inc., Calgary, Alberta, Canada

Dr. Richard E. Scott is CEO of NTC Consulting - Global e-Health, Calgary, Alberta, Canada (http://www.ntcehc.ca/), Professor at the University of KwaZulu Natal, Durban, South Africa, and Adjunct Professor, at the University of Calgary, Calgary, Alberta, Canada. Dr. Scott has over 30 years of research and healthcare experience as a medical laboratory technologist, biochemist, clinical chemist, clinical and forensic toxicologist, director of research, and for the last 20 years as a telehealth/e-health researcher. He was a founding member of the Canadian Society of Telehealth (CST) in 1998, President of the CST (2004-2006). Richard is a member of the ATA's International Special Interest Group, Associate Editor of the Journal of Telemedicine and Telecare, and Editor of the Journal of the International Society of Telemedicine and eHealth (JISfTeH; http://www.jisfteh.org/).


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(EP-134) BRICS a New Dawn for International Telemedicine?

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