Using telemedicine with point-of-care testing to optimize health care delivery in Thailand

Our goals were to study telemedicine at Ao Luk Community Hospital, Krabi province, Thailand, and to collect information about point-of-care testing (POCT) used by primary care units (PCUs) registered with the telemedicine program. Surveys were conducted during 2 different periods: April 6-17, 2005 and October 18-20, 2005. Information sources included the Ao Luk Community Hospital database and interviews. Telemedicine started initially in 2004. There are 5 PCUs in the telemedicine program. Radios, telephone lines, internet access, and web video are used to view patients during interviews and for bidirectional voice communications. The POCT was used uniformly at each PCU and consisted of testing for glucose, hematocrit, urine glucose and protein, and pregnancy. Standard equipment included glucose meters, urine and protein test strips, pregnancy card tests, blood group analysis, spun hematocrit centrifuge, and blood pressure and body temperature measurements. As the first site developed in Thailand with direct patient contact and communications, the Ao Luk telemedicine system illustrates improved efficiency, cost-effectiveness, and logistics useful in rural health care delivery and wise demographic distribution of resources. Integrated POCT (eg, cardiac biomarkers) would help improve amphur (district) and province referral systems.