Discussion
The preliminary evaluation of the results obtained in phase1 of TIM-TEM project allows some considerations. First the participation and the collaboration obtained from the authorities of the island both in the preliminary phase and during the collection of the data must be considered. Particularly important was the collaboration of medical and paramedical personnel of the island, able to speak english, for the collection of the data of the patients. The high rate of participation to the study of the island's inhabitants(more than 95 %) is undoubtefully superior to than expected. All inhabitants are perfectly conscious of their isolation and mindful of previous, tragic experiences in case of acute disease frequently observed on the island. Another element to be considered is the fact that to perform a medical examination (specialist consult, radiological examination, blood sample, etc..) the population needs at least three days for the transfer from Tilos to the main island(Rodi)with relative expenses. From a sanitary point of view, 2% of population showed pathologies at high risk of acute,
severe complications(aortic aneurysm, cardiac diseases) and more than 25 % of population showed minor pathologies(renal stones, biliary tree stones, etc..): patients with severe disease were immediately send to the the regional hospital to obtaine an adequate care. The main limits observed in this phase excluding the limited technology provided were represented by the very low level of technological equipment present on the island where it is not present ISDN phoneline and were there are not available until now hardware devices. As consequence it is not present on the island people trained in using computer and nobody knows the possibilities of communications using computer( internet,e-mail, teleconsult, etc...). To resolve this problem a collaboration with the Department of Informatics of the Aegean University was began in order to have some
computers on the island and to train the population, at least personnel involved in health services, to use them. Considering the actual structure of the emergency services of the Aegean area at the end of this preliminary experience we decided to
change the program of the project postponing the phase2 (Dispatch System)to the phase3 (Telemedicine implementation) that seems to be at the moment easier to realise.

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