TeleMedMail: Store and Forward Telemedicine System

Developed by MIT laboratory for Computer Science and Partners In Health

Under construction

Project director and designer Hamish Fraser

Programmer and assistant designer Darius Jazayeri

Advisors and co-developers

Lech Bannach Sean Doyle
Eduardo Marques Peter Szolovits
St John D McGrath Libby Levison
Agnieszka Szot


This system was conceived to provide a simple way for physicians and healthcare workers to send medical images over the Internet to specialists. In essence it automates a simple technique of store and forward telemedicine developed independently by physicians in South Africa, Ghana, USA, Britain, Norway and doubtless other sites. This involves photographing patients, their x-rays, pathology slides or documents with a digital still camera, and emailing the images with some textual descriptions. As typically practiced it requires 4 pieces of software in addition to the camera's own system. 1) a photo-editing program such as Photoshop, Paint shop etc., 2) an HTML editor to organize the case and images, 3) a Zip utility such as WinZip to make an archive of all the files, and  4) an email program. This process is shown here. While this method has been successful it is cumbersome, requires training in multiple programs and lacks important feature such as encryption for data confidentiality. We therefore decided to combine all these functions including security into one simple-to-use program "TeleMedMail". The system is currently operational and under testing in sites in South Africa, Peru and Brazil as well as the US. We also plan to keep it "Free Software" usable by any physicians or healthcare workers in non-profit institutions. We plan to make the program generally available in the fall of 2001 and start to release the source code after that. Please contact Hamish Fraser if you wish to use the system or help develop and test it.

Demonstration cases sent by the TeleMedMail program from Peru and Africa

1) Teleradiology of CXR in advanced TB

2) Dermatology referral from South Africa

3) Renal Pathology


Appropriate technology for telemedicine in developing countries
Hamish S. F. Fraser, Darius Jazayeri, Peter Szolovits, St John D McGrath MD
Presented at AMIA Fall Symposium, 2000, Los Angeles.
Online abstract       Online slides of the poster

Information technology and telemedicine in sub-Saharan Africa.
Fraser HS, McGrath SJ. (Editorial)
BMJ. 2000 Aug 19-26;321(7259):465-6.

TeleMedMail: free software to facilitate telemedicine in developing countries
Hamish S. F. Fraser, Darius Jazayeri BS, Lech Bannach, Peter Szolovits, St John D McGrath.
To be published in the proceedings of Medinfo2001, London, September 2001

Any questions or comments, mail Hamish Fraser