• J. Am. Coll. Surg. · Jan 2020

    WhatsApp Mobile Health Platform to Support Fracture Management by Non-Specialists in South Africa.

    • Ntambue Jimmy Kauta, Johann Groenewald, Delroy Arnolds, Benjamin Blankson, Abbas Omar, Priyanka Naidu, Megan Naidoo, and Kathryn M Chu.
    • Department of Surgery, University of Cape Town, Cape Town, South Africa.
    • J. Am. Coll. Surg. 2020 Jan 1; 230 (1): 37-42.

    BackgroundTraumatic fractures are common in sub-Saharan Africa, a region with a shortfall of orthopaedic surgeons, and can result in morbidity if not appropriately managed. WhatsApp is an encrypted smartphone application and ubiquitous in sub-Saharan Africa. The objective of this study was to assess the use of WhatsApp as a mobile health platform to support fracture management by non-orthopaedic doctors in Cape Town, South Africa.Study DesignA WhatsApp orthopaedic referral group was created between non-orthopaedic doctors from community health clinics and the orthopaedic team from a first-level hospital to manage traumatic fractures. Non-orthopaedic doctors posted cases on the orthopaedic referral group and the orthopaedic team provided advice. Traumatic fracture data from January 1 to June 30, 2018 were analyzed and outcomes included response time, management advice, and treatment by facility level.ResultsSeventy-two non-orthopaedic doctors posted 731 cases of traumatic fractures to the 5-member orthopaedic team. Six hundred and sixty-one (90%) cases were responded to within 1 hour. Three hundred and fifty-four (48%) patients were treated successfully by non-orthopaedic doctors at community health clinics, 288 (39%) were treated by the orthopaedic team at the first-level hospital, and 89 (12%) were referred directly to an orthopaedic subspecialist at a third-level hospital.ConclusionsThe WhatsApp orthopaedic referral group provided a free telementoring platform for non-orthopaedic doctors to successfully manage traumatic fracture cases at community health clinics. This type of mobile health platform can be applicable to other resource-limited settings if disease burden is high and specialists are scarce.Copyright © 2019 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

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