Implementation of a telementoring program for recently graduated physicians working in rural areas of Peru: A first approach and lessons learned (Preprint)

Abstract

Telementoring seems to be a promising strategy to deliver training and counselling to physicians in remote areas. However, in order to be sustainable, its logistics and processes must be thoroughly assessed. In Peru, a university deployed a telementoring program for its graduated physicians to provide them help with difficult cases. This is an interesting opportunity to explore what worked and what can be improved.

To evaluate the response and perceived experiences about the implementation of a telementoring system for recently graduated physicians working in rural areas of Peru.

Mixed methods study exploring the process and utility of a telementoring program implemented by a university. Recently graduated physicians from a public university working in rural areas as part of a social health service (known as SERUMS in Spanish) participate in the telementoring program, which uses a dedicated medical messaging application to facilitate communication between rural family doctors and other medical specialists for clinical case resolution guidance. We assessed some characteristics of the telementoring program (logistics, utilization, performance) and we conducted some in-depth interviews with the physicians to explore the perceived utility, acceptability, ease of use of the messaging app, and reason for non-utilization of the mentoring program.

The telementoring program was implemented for one year. 74 physicians (mean age 25, 51.4% women) were advised to use the app and ask for help if they have to deal with a difficult case. At the end of the program only 12 (16.2%) physicians performed a total of 27 queries, which received response in an average time of 5.4 ± 6.3 hours. In the interviews, users stated the app was a useful tool for receiving guidance for some pathologies, while non-users declared their queries were “general” or “not complex” thus, they did not need professional support. Also, limited internet access in rural areas and the expectance of slow response-time were reasons for not using the telementoring service.

In Peru, the implementation of a telementoring system sought to provide guidance to recently graduated physicians working in rural areas. Low use rates and slow responses show that administrative and process-related deficiencies in the implementation need to be improved.