In early 2007, UCSD Associate Professor and craniofacial surgeon, Dr. Amanda Gosman, joined the Multidisciplinary Cleft Palate and Craniofacial Team at the Hospital Infantil de las Californias in Tijuana Mexico. Dr. Gosman and the team leader, Mexican craniofacial surgeon, Dr. Alicia Sigler have developed a collaborative partnership which has resulted in the development of advanced international educational programs, performance of state-of-the-art surgical procedures, and the establishment of an innovative international telemedicine network to expand the scope of the educational and clinical programs. With the expert assistance of Dr. Zia Agha, UCSD Associate Professor of Medicine and Telemedicine Research Director for the Veterans Administration Medical Center in San Diego, ConnectMed International established a viable telemedicine videoconference network between the Hospital Infantil in Tijuana and University of California in San Diego. The ConnectMed telemedicine network has enhanced the multidisciplinary team treating children with cleft palate and craniofacial deformities in Tijuana. Connected by a camera, microphone, and speakers on either side of the international border, live interactive videoconferencing is used during the bi-monthly cleft palate/craniofacial team clinics so that patients can be evaluated by a full team of doctors and specialists who participate in this team clinic either in-person from Tijuana or via videoconference from San Diego.
The international gold standard for the treatment of cleft palate and craniofacial deformities is by a multidisciplinary team because these conditions are very complex and require collaborative long-term management by multiple specialists to optimize the outcomes of speech, hearing, nutrition, and normal growth. Multidisciplinary team members include surgeons, speech therapists, geneticists, psychologists, audiologists, social workers, dentists, orthodontists, and nurses. For example, children born with a cleft palate require frequent (weekly) speech therapy during their developmental years so that they can speak clearly and be understood. The Hospital Infantil provides the full spectrum of multidisciplinary team care to its patients and ConnectMed International has the privilege of participating in these clinics through telemedicine. Children who are not treated in specialty centers like the Hospital Infantil may rely on visiting surgical teams that only perform surgery and do not provide follow-up care, which frequently results in poor outcomes. This was the case for Jose. ConnectMed has worked with speech therapists at the Hospital Infantil and in San Diego to evaluate the effectiveness of providing speech therapy via videoconference. Patients like Jocelyn, who was born with a cleft of the lip and palate, has benefited from speech therapy at the Hospital Infantil and via videoconference.
Surgical care for patients from the team clinic at theHospital Infantil in Tijuana is provided through the organization of surgical jornadas (working day) approximately every 2-3 months. ConnectMed volunteers join the Hospital Infantil surgical team to perform multiple surgical cases at the Hospital Infantil facility in Tijuana. Surgical care is provided through the generous support of the Foundation for the Children of the Californias and Smile Train. ConnectMed International is dedicated to the provision of long-term, sustainable multidisciplinary care for patients and also to the development of innovative educational programs to promote the exchange of knowledge at multiple learning levels. Telemedicine is used during the surgical jornadas to create a live interactive educational program that is transmitted to a conference room at the UCSD Telemedicine Learning Center. Students and doctors on both sides of the border are able to interact, evaluate patients, observe complex procedures and learn from expert visiting professors. Participants in the Telemedicine and International Health educational videoconferences have the unique opportunity to learn about telemedicine, cleft lip and palate/craniofacial surgery, and humanitarian global health initiatives.