Telemedicine is a
set of “medical activities involving distance, virtual presence of the medical
doctor to nearby patients to exchange valid information for diagnosis, clinical
management, treatment and counseling for both healthcare workers and patients.”1
The innovative way for delivering quality healthcare services in rural
healthcare settings is only possible by telemedicine as it can utilize experts
from different medical fields from urban center.

Providing quality healthcare services in Nepal is challenging
due to many reasons such as difficult geographic terrain, limited availability
of funding and many other issues. Within this context of constrained resources
and infrastructure challenges, the use of telemedicine has the potential to
increase access of poor, rural people to healthcare services: providers can
receive specialized guidance, and their patients can receive specialty care,
thus reducing the costs incurred for the transport. The existing literature
demonstrates that telemedicine successfully decreases the number of referrals
between emergency departments when specialty care is unavailable at the
originating hospital.

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B.P. Koirala
Institute of Health Sciences (BPKIHS), Dharan, Nepal has started the
rural-telemedicine and e-learning programme in 2015 at 3 rural health
facilities/district hospitals of Eastern Nepal with the aim of providing access
to specialized healthcare services. The main aim of e-learning service is to
update and upgrade the knowledge and skills of healthcare providers regarding
clinical management of commonly reported diseases at their facility. Teleconsultations
are provided by BPKIHS specialists via video conferencing or telephone.

The purpose of this
study was to compare the outcomes of health services utilized by the patients
in terms of pre-hospital care and referral to tertiary care hospital before and
after the implementation of telemedicine programme. This study also explored
the existing opportunities and challenges of telemedicine faced by the patients
and their care takers. 


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