Care and Education Scenarios

	European university	Developing countries
Level 1: Patient first level reception	By a medical student: Extended anamnesis and examination Preliminary assessment of the health issues = 1 hour	Anyone willing to help, maybe only a nurse in remote areas.
Level 2: First review	By an young assistant, a few more questions and improvement of the report. = 10 minutes in next room	A GP at a distance of one day walking.
Level 3: Review of some cases having critical problems	By senior, may be a specialist in a given domain. = 5 minutes a few room further	If possible second opinion in an university of the same country
Level 4: A few very difficult problems	By the professor = 15 minutes on next floor	Expert 5000 Km away

Sustainability means that problems should be solved at the nearest level possible and that education should be better distributed.
The goal is to emphasize the potential of learning people at local level.
When not possible go to the next level, but this require a report about what is already known.
This requirement define how we should structure the patient record.
Contextual teaching will flow back to the above learning persons.
To some extend the scenarios are similar in developed and developing regions.
Bringing only a lot of very sophisticated equipments, would not at all help before implementation of solutions dealing with these real goals of care and education.
That said a minimum of technology is necessary i.e. mainly telecommunication and affordable note books or mobile device.
Moreover maybe a standard microscope with camera, ultrasound device, basic X-ray, ....