ATA2007 US MA MReyna

Tele-Education in North Africa: A U.S.-Morocco Partnership for Children’s Health: 

Tele-Education in North Africa: A U.S.-Morocco Partnership for Children’s Health May 14, 2007 ~ ATA Annual Meeting Molly Reyna, BA¹, Craig Sable, MD¹, Philip Hopkins¹, Najia Hajjaj-Hasanni, MD², Nezha Mouane, MD³; ¹Children’s National Medical Center, Washington, DC; ²Faculty of Pharmacy and Medicine, Rabat, Morocco; ³Hopital D’Enfants, Rabat, Morocco.

Children’s National Medical Center: 

Children’s National Medical Center Top 10 United States Children’s Hospital Over 200 subspecialists provide highest level of patient care, education, advocacy, and research International program facilitates collaboration and patient referrals from Middle East, Africa, Asia, and South America Successful regional, national and international telemedicine and distance education programs

Background: Morocco : 

Background: Morocco Located on the Northwest coast of Africa Estimated population of 29 million, approximately half of the population is under the age of 20 (United Nations Population Division, 2003) Although Arabic is the national language, the preferred language of business/education is French Chronic diseases, such as asthma and bronchitis, rheumatic illnesses, malaria, typhoid, and viral hepatitis are prevalent

Slide4: 

Rabat Casablanca Marrakech Fes

Morocco Healthcare System : 

Morocco Healthcare System Selective, targeted training programs lack a comprehensive development for training healthcare workers Variable technology infrastructure across the country makes it difficult to collaborate within the Moroccan medical community Utilization of technology for training, education and patient care is the current focus of Ministry of Health

Foundation Support: 

Foundation Support The Mosaic Foundation is dedicated to improving the lives of women and children, while fostering cultural, educational, and professional dialogues between the peoples of the Arab world and the United States An American Charitable Foundation Sponsored by the Spouses of the Arab Ambassadors to the United States

Project Description: 

Project Description Establish an international Tele-education network for pediatric medical specialties of concern to health care providers, their patients and families in Morocco. Utilize distance learning to improve community and health care provider knowledge and practices related to significant children's health care issues. Our partnership with the Hospital Teaching Faculty in Rabat will focus on improving education, technology and healthcare staffing, all of which are critical components to improve the level of pediatric care available in the region.

Project Design: Year One: 

Project Design: Year One Objective 1: Activation Establish a partnership between CNMC & Rabat Children’s Hospital Develop Educational Content & Install Technical Components necessary for Distance Learning & Training Objective 2: Management Implement Distance education and medical consultation Live and computer based lectures (translation) Live and computer based consultation

Project Development: 

Project Development Visits with the Moroccan Ambassador to the U.S., and the U.S. Ambassador to Morocco Met with Moroccan Ministry of Health in Rabat Onsite visits at Medical University Centers and Children’s Hospitals in Rabat, Casablanca, Fes, Marrakech Met with medical school deans and hospital leaders Developed key physician and technical contacts Assessed technical/telemedicine equipment at each site Gave telemedicine lecture to students and faculty Identified educational priorities: nutrition, hematology, cardiology, infectious diseases

Telemedicine Applications: 

Telemedicine Applications ViTel Net MedVizer – IP and ISDN Incorporates main camera and multiple medical device cameras Supports live case presentation and store-and-forward consultation Live consultation at 384 – 512kbps Store-and-forward patient information is captured in an episodic record and transferred via IP connection to a server located at CNMC Software functions allow the referring site to push the information to CNMC and pull the record back once the consultation is completed.

Telemedicine Consultation - Rabat: 

Telemedicine Consultation - Rabat

Distance Learning Applications: 

Distance Learning Applications Live Distance Learning: Tandberg & Cisco IPTV Connects to CNMC and other sites via ISDN 512kpbs Cisco IPTV Streaming Product in implementation phase Video-On-Demand: Cisco Digital Media System Content edited with Mac FinalCut Pro Utilizes Cisco Portal for Content Access Currently connected to three sites in Rabat and Casablanca Launch three additional sites in 2007 – Faculty Buildings in Fes and Marrakech, MOH Rabat

Live Lecture - Rabat: 

Live Lecture - Rabat

Live Lecture - Rabat: 

Live Lecture - Rabat

Video-On-Demand Portal: 

Video-On-Demand Portal CNMC Portal Link

Video-On-Demand Content: 

Video-On-Demand Content

Lessons Learned: 

Lessons Learned There is a greater need for French translation than initially anticipated Technical support is lacking and inconsistent by location Telecommunications technologies are not easily accessed and are not 100% reliable More time on the ground was needed than originally anticipated.

Project Successes: 

Project Successes Installation of telemedicine and distance learning workstations in Rabat and training of approx. 40 physicians and technical staff. A telemedicine workstation, patient data server, streaming media system and content storage system was installed at CNMC; 50+ lectures available 15 live lectures and case presentations; progress towards connecting Rabat physicians with their colleagues in Marrakech, Fes, and Casablanca. MOH staff are developing community health modules and physician administrator training. Project efforts have increased communications between multiple physician groups within Morocco.

Year-Two and Beyond: 

Year-Two and Beyond Objective 3: Outcomes Evaluation Evaluate Tele-education Services to continually improve project performance Project partnership should improve treatment outcomes for Children with targeted health needs Objective 4: Sustainability Strengthen local partnerships to benefit Moroccan children and their health care providers Develop partnerships with other international groups who have tele-education initiatives in the region.

Foundation and Vendor Support: 

Foundation and Vendor Support Mosaic Foundation & Government Support Board of Trustees, Mosaic Foundation Mrs. Felicia Mekouar, Trustee from Morocco HH Mekouar, Moroccan Ambassador to U.S. Mr. Thomas Riley, U.S. Ambassador to Morocco Ms. Mona Hamdy, Executive Director Mosaic Foundation Project Vendors ViTel Net Cisco Systems Tandberg Visionality Intelsat Dimension Data Logicalis iDirect

Acknowledgements: 

Acknowledgements CNMC Telemedicine Team Craig Sable, MD, Telemedicine Medical Director Philip Hopkins, International Technical Coordinator Ron Dixon, Technical Support Sam Sabouni, Cardiology Technical Support Oussama El Baba, Director International Programs Peter Holbrook, MD, Chief Medical Officer Kate Paulsen, Director of Development Morocco Telemedicine Team Pr. Najia Hajjaj-Hassani, Dean Rabat School of Medicine Pr. Nezha Mouane, Chief of G.I. Rabat Children’s Hospital Dr. Kouhrassani, Director Rabat Children’s Hospital Mohammad Karra, Tech. Dir., Rabat School of Medicine Ms. Souad Jawhari, Minister’s Conseillere Morocco Ministry of Health Mr. Zouhir, Technical Support

Questions: 

Questions Molly Reyna CNMC Pediatric Telemedicine Program Washington, DC 202.884.3412 mreyna@cnmc.org