An integrated approach of tele-consultation with mobile laboratory service delivery; learnings from a pilot project at a telemedicine clinic in Kampala, Uganda.

BACKGROUND

In resource limited settings like Uganda, empirical medical decision making is a common challenge due to the lack of availability and access to quality and affordable laboratory services. Advances in digital technologies present a feasible avenue for a patient-centered laboratory services delivery that break geographical barriers and foster patient data storage and continuity of care at scale. We describe our experience in running a telehealth-enabled mobile laboratory service in Uganda.

METHOD

The Medical Concierge Group (TMCG), a digital health company headquartered in Kampala-Uganda runs a 24/7 call center service where clients can access medical services via voice call-in, SMS, WhatsApp and Skype platforms. This pilot project ran from 7th December 2018 to 31st January 2019 in Kampala with awareness about these services done via the company’s social media pages and distribution of flyers. Information including demographics and clinical data was collected using an electronic medical records system (EMR) and where a laboratory test request was completed electronically and shared with the laboratory for sample collection from the client’s location by the laboratory technician and then analysis. Results were electronically
shared with the client accompanied with a doctor’s follow up call or chat explaining the findings and making recommendations.

RESULTS

13(35%) male and 24 (65%) female patients with a median age of 27 years utilized the service. The socioeconomic strata of the users were 60% corporate/working class, 5% businessmen, 16% students and 19% were children. Client preferred pickup locations were 51% home, 24% workplace, 11% student hostels and 14% public shared spaces. The categories of tests performed were 25% hematology, 16% clinical chemistry 24% microbiology, 28% serology, 7% endocrinology. The most commonly requested individual test was urinalysis. Platforms used were 70% WhatsApp chats and 30% voice calls. The laboratory tests requested were completed within an average turnaround time of 1hr 50 minutes. Patients on follow up, valued the convenience and quick turnaround time of the service in addition to quality lab results.

CONCLUSION

Incorporation of a mobile laboratory service to patient teleconsultations showed potential for improving convenient access to quality diagnostic testing for a wide range of users from different socio-economic backgrounds, age groups and sample pick up locations. There is need for wider evaluation to generate evidence for a scale up of the service.