Care and Education Scenarios

	European university	Developing countries
Level 1: Patient first level reception	By a medical student: Extended anamnesis and examination Preliminary assesment of the health issues = 1 hour	Maybe only a nuse
Level 2: First review	By an young assistent, 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 assistant,maye 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.
When not possible go to the next level, but this require a report about what is already known.
This requitement define how we should structure the patient record.
To some extend the scenarios are similar in developed and developing regions.
Bringing only a lot of sophisticated equipements, would not help before implementation of solutions dealing with the real goals of care and education.
That said a minimum of technology is necessary i.e. telecommunication.