iPath Telemedicine Platform and Experience of Its Implementation in Ukraine

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  • 1. iPath Telemedicine Platform and ExperienceUkrainian-Swiss Mother and Child Health Programmeof Its Implementation in Ukraine: Concepts, Strengths, and ChallengesGrigory NAUMOVETS ICT Coordinator Programme Implementation OfficeKiev, Ukraine Regional Workshop Health Technology Management Chiinu, MoldovaOctober 25-26, 2012

2. Ukrainian-Swiss Mother and Child Health ProgrammeUkrainian-Swiss Mother and Child Health ProgrammeImplemented in four regionsof Ukraine:Vinnytsia, Volyn,Ivano-Frankivsk, Crimea 2 3. ICT Tools implemented in Ukraine by the MCH Programme: iPath:Ukrainian-Swiss Mother and Child Health Programme a Telemedicine platform openMEDIS: medical equipment inventory software Perinatal registry: database of information related to pregnancy and childbirths 3 4. All these tools are: Open source software, no license fees required Web-based tools (Apache/PHP/MySQL) Ukrainian-Swiss Mother and Child Health Programmeaccessible via web interface Work for any operating system Simple, user-friendly, multilingual4 5. iPath Telemedicine Platform Developed at the University of Basel Designed for asynchronous telemedicine, notUkrainian-Swiss Mother and Child Health Programmefor urgent consultations in real time Does not require simultaneous availability of allparties for real-time communication A hybrid web- and e-mail-based system(cases and comments can be posted via webinterface or by email) Functionally - between a content managementsystem (CMS) and a groupware tool. 5 6. iPath Telemedicine Platform Simple and user-friendly web interface, multilingual;Ukrainian-Swiss Mother and Child Health Programme Integration of various file formats, e.g. documents,images, audio and video files; Integration of application-specific case forms forstandardized acquisition of clinical data; Automated e-mail alerts; Easily accessible and growing with demand; Low hardware requirements and compatibility with mostoperating systems and web browsers; 6 7. iPath:implementation in Ukraine Started in 2003 as part of the Ukraine-Swiss perinatalhealth project Ukrainian-Swiss Mother and Child Health Programme Pilot institutions: Ivano-Frankivsk Oblast ChildrenHospital and Institute of Pediatrics, Obstetrics andGynecology (Kyiv) Since 2009, the Ukrainian iPath platform has beenrunning on a server in Donetsk hosted and maintainedby Association for Ukrainian Telemedicine and eHealthDevelopment Used by more than 80 partner institutions in 4 regions and by many other users in Ukraine and abroad7 8. iPath Ukraine (telemed-ipath.org.ua) Ukrainian-Swiss Mother and Child Health ProgrammeUkrainian iPath server in Donetsk:> 1,000 users,> 10 groups,> 1,000 cases posted 8 9. iPath: Clients side iPath training in CrimeaUkrainian-Swiss Mother and Child Health ProgrammeiPath workplace at thePerinatal Center inIvano-Frankivsk9 10. Template for case presentation anddiscussion Textual description Gallery of images andUkrainian-Swiss Mother and Child Health Programme documents (authors are encouraged to fill standard forms developed for case description) Comments Cases and comments can be posted Online (via the web site) via e-mail10 11. Standard forms for case description:Newborns case form, Ob/Gyn case form, etc.Ukrainian-Swiss Mother and Child Health Programme11 12. Digest of a clinical case discussionhttp://motherandchild.org.ua/eng/resource/121Ukrainian-Swiss Mother and Child Health Programme12 13. Implementation of iPath requires Orders and regulations Software Positive attitude of bossesUkrainian-Swiss Mother and Child Health Programme Hardware Proper conditions for training and work Procedures and protocols Admin support Training Community Coordination Moderation Promotion of EBP, use of reliable sources13 14. Steps for implementation Introduction:work with health care administrators, chiefUkrainian-Swiss Mother and Child Health Programmephysicians, and doctors to win their positiveattitude; Admin support:issuing appropriate orders and other documentssupporting the project, appoint responsiblepersons, provide proper conditions for trainingand work14 15. Steps for implementation Technical basis:equip workplaces with computers, InternetUkrainian-Swiss Mother and Child Health Programmeaccess, digital cameras, scanners, diagnosticinstruments, etc.; staff training Regulations:for each medical institution, prepare protocolsthat regulate the use of telemedicine (who canuse it, when, how, and for what purposes)15 16. Problems and challenges(incl. a survey of ~260 doctors from 27 med institutions in 2009) Fear to demonstrate incompetence (esp. byUkrainian-Swiss Mother and Child Health Programmedoctors from rayon hospitals) Need to have more experts actively participatingin discussions Language barrier: limiting community to asmaller circle Few references to evidence-based sources, lackof skills for searching, analyzing, and assessingmedical information (further aggravated by thelanguage barrier)16 17. Problems and challenges Its very discouraging to receive no response atall to your case Ukrainian-Swiss Mother and Child Health Programme By design, iPath is an asynchronoustelemedicine tool but in many cases its veryimportant to get response fast enough On the other hand, it can be used for postfactum analysis of cases tool for distanceeducation. 17 18. Improve the efficiency Try to expand the circle of experts ToT workshops, development of training Ukrainian-Swiss Mother and Child Health Programmemodules both for trainers and students Monitor cases and responses, push experts, tryto make sure that all questions are answered Trainings on evidence-based medicine andmedical info searching techniques 18 19. iPath: Experience of implementation iPath is viable and effective in low resourcesettingsUkrainian-Swiss Mother and Child Health Programme Human issues may be more limiting thantechnical issues Implementation should follow a properly plannedprocedure, and requires administrative support Persistent efforts needed to improve andmaintain the efficiency19 20. Web resources Swiss TPH eHealth Toolboxhttp://www.swisstph.ch/services/ehealth/ehealth- Ukrainian-Swiss Mother and Child Health Programmetoolbox.html Ukrainian iPath Telemedicine server:http://telemed-ipath.org.ua iPath Moldova Telemedicine platform:http://www.ipath-network.com/moldova/ Ukrainian-Swiss Mother and Child HealthProgramme http://motherandchild.org.ua 20 21. http://mch.org.ua Contacts e-mail: GN@mch.org.ua Ukrainian-Swiss Mother and Child Health Programme21