Television White Space (TVWS) telemedicine implementation in Botswana: Challenges and opportunities




Poster session 2 Thursday: Evidence synthesis - methods / improving conduct and reporting


Thursday 14 September 2017 - 12:30 to 14:00


All authors in correct order:

Rodriguez O1, Chavez A2, Williams V3, Ndlovu K4, Kovarik C1
1 University of Pennsylvania, United States
2 Brown Univeristy, United States
3 Botswana UPenn Partnership, Botswana
4 University of Botswana, Botswana
Presenting author and contact person

Presenting author:

Victoria Williams

Contact person:

Abstract text
Background:Television white space (TVWS) refers to previously unused TV radio-frequency channels that can be leveraged to obtain broadband internet access. When set up and maintained properly, TVWS technology has the potential to provide high-speed connectivity to remote areas. TVWS has been piloted globally within the education, agriculture and commerce domains. We describe the first effort to utilise TVWS for improving healthcare access within poorly connected regions of Botswana. Because this technology is so new, implementation faces many challenges. We seek to share our experiences to increase awareness of TVWS and help organisations understand the challenges and opportunities that come with this technology.

Objective:To evaluate the challenges and opportunities of implementing TVWS technology in Botswana to improve access to point-of-care medical information and care in clinics with limited access to healthcare.

Methods: Prior to implementation of TVWS technology in several remote clinics in Botswana, TVWS access was installed and clinicians were trained to use the electronic medical record (EMR) system for patients’ data capture and transfer. TVWS connectivity was evaluated by collecting data on network outages, internet speed tests, and overall network utilisation across various sites.

Results: Internet speed tests and network outages indicate that TVWS connectivity bandwidth varies significantly across sites, often outperforming existing government internet. However, TVWS connectivity was slower than the recommended 10Mbps for supporting high-quality, live telemedicine consults. Despite the bandwidth challenges, a total of 161 cases were registered on the EMR platform and shared with specialists for review using TVWS.

Conclusions:TVWS technology has the potential to strengthen healthcare delivery and telemedicine practices in resource-poor settings; however, this opportunity cannot be fully realised without proper systems in place. Initial implementation of TVWS in Botswana demonstrates that without reliable maintenance of rapid upload/download speeds, user confidence may be compromised, thus making the utility of TVWS questionable.