AMPATH Surgery Uses Teleconference to Improve Care
The AMPATH surgery team has been using teleconference to improve surgical education. The team has introduced regular bilateral case conferences between Moi University and Indiana University in which surgical trainees at each location teach and learn from each other.
Physicians and medical trainees in Kenya participate in a teleconference with colleagues in Indiana.
Dr. Connie Keung, AMPATH surgery team leader, started the conferences in partnership with the IU/Eskenazi Hospital trauma team in September 2017. Once a month, surgical trainees present interesting and/or difficult cases from their respective hospitals. The cases are supplemented with a review of pertinent peer-reviewed literature. These discussions serve to stimulate dialogue on patient presentation and management differences between our partner institutions. The conferences have been well-received and popular with both American and Kenyan surgical trainees.
Beyond education, the surgical team has also leveraged telemedicine to improve surgical care at Moi Teaching and Referral Hospital. Each week, a surgical oncology tumor board is held in the teleconference rooms in the AMPATH Chandaria Cancer and Chronic Diseases Center. This multidisciplinary meeting includes surgeons, oncologists, radiation oncologists, pathologists, and radiologists. The use of telemedicine has allowed the hospital to partner with nearby Tenwek Hospital in Bomet, Kenya. Beyond the sharing of expertise and experience, this has improved referral of oncology patients between the two institutions.
Additionally, when burn surgeons from Indiana came for a two-week clinical trip this past October, many patients remained in the hospital requiring ongoing wound care. In order to provide comprehensive follow-up for these patients, the Indiana team met once a week with the AMPATH surgery and Moi Teaching and Referral Hospital (MTRH) burn care teams to discuss each patient’s progress. The interdisciplinary meetings included surgeons, registrars, nurses, and physical therapists. The AMPATH surgery team feels that follow-up with the care teams which come to Eldoret from our North American partners is vital to providing effective and ethical surgical care for our patients. They envision that such follow-up will become a standard component of all short-term surgical efforts.
The team has recently expanded on the use of long-distance surgical education. The first case conference between pediatric surgeons at IU Health’s Riley Hospital for Children and MTRH and Shoe4Africa (children’s hospital) took place in February. The discussion centered on the surgical management of gastroesophageal reflux disease in infants. Patient cases were presented by Dr. Britney Grayson, the senior pediatric surgery fellow at Riley and Dr. Vivian Cheboiwo, COSECSA pediatric surgery registrar at MTRH. The pediatric surgery teams at both institutions hope to continue these conferences on a bimonthly basis.
Kyle Carpenter, MD, is a general surgery resident at IU School of Medicine spending the year in Eldoret as a Fulbright recipient.
Physicians and trainees in Indianapolis learn from teleconferences with colleagues in Kenya.