Telemedicine in South Africa: success or failure?

A national telemedicine system for South Africa was planned in 1998. In the first phase, starting in 1999, 28 pilot sites were established in six prov inces. The initial applications were teleradiology, tele-ultrasound for ant enatal services, telepathology and tele-ophthalmology. Telemedicine equipme nt was connected by ISDN at 256 kbit/s. From January to September 2000, 266 3 radiographic studies were performed at the three Northwest Province teler adiology transmission sites, of which 264 studies (10%) were selected for s pecialist radiologist reporting by teleradiology. From June to August 2000, nine antenatal care tele-ultrasound consultations were performed in the No rthern Cape Province and four transfers were avoided through the use of tel emedicine. One area of concern is the relatively low usage of the telemedic ine system, which raises questions about its cost-effectiveness, The experi ence of telemedicine in South Africa confirmed, as others have found, that common problems relate to the technical and organizational challenges of in troducing telemedicine.