Association for Ukrainian Telemedicine and ehealth Development

Association for Ukrainian Telemedicine and ehealth Development REPORT OF ACTIVITY IN 2010 2011 Anton V.Vladzymyrskyy President of AfUTeHD, M.D., Ph.D., professor

ASSOCIATION FOR UKRAINIAN TELEMEDICINE AND ehealth DEVELOPMENT is NATIONAL MEMBER of INTERNATIONAL SOCIETY FOR TELEMEDICINE AND EHEALTH (ISfTeH) Since 2006

Official Association s Platforms

Since 2003 (first telemedicine journal in Ukraine) Officially approved Free full text access via web Cited by Index Copernicus Med e Tel media partner Official Journal of the Association

V VI International Conference «Telemedicine Experience@Prospects» supported by International Society fortelemedicine and ehealth 2009 2010 180 participants Ukraine (12 regions), Russia, Belgium 170 participants Ukraine (10 regions), Russia, Germany

VII VIII International Conference «Telemedicine Experience@Prospects» supported by International Society fortelemedicine and ehealth 2011 2012 180 participants Ukraine (14 regions) Postgraduate course 210 participants Ukraine (14 regions), Belgium, Korea, Poland, Russia

New telemedicine technologies trials

First testing of the teleassistance system during arthroscopy surgeries in Ukraine Telesurgery Arthroscopy device Image Capture Device IP/VoIP Expert s PC

First telearthroscopy Patients (male/female 50:50), age 19 39 years Diagnosis: injuries of meniscus or/and collateral ligaments of of left or right knee, chronic unstable joint

Association s support of telemedicine initiatives in low resource settings

town Snegnoe Founded in 1784 Area 87,2 square km Population 72900

Mammography examinations in 2010 2011 180 160 140 120 100 80 60 40 20 0 январ февра март апрел май июнь июль август сентя октяб ноябр декаб январ февра март апрел май июнь июль август сентя октяб ноябр декаб Series1 ь ль ь брь рь ь рь ь ль ь брь рь ь рь 116 91 154 165 103 149 0 101 80 32 0 0 0 0 0 51 84 80 7 0 0 0 44 64

AfUTeHD role: learning of basic telemedicine skills general recommendations about network organisation bridge between industrial and state hospital members DICOM, PACS and more secured protocol implementation

Mammography examinations in 2010 2011 180 160 140 120 Teleradiology 100 80 60 Doctor quit Another one also 40 20 0 январь февраль март апрель май июнь июль август сентябр октябрь ноябрь декабрь январь февраль март апрель май июнь июль август сентябр октябрь ноябрь декабрь Series1 116 91 154 165 103 149 0 101 ь 80 32 0 0 0 0 0 51 84 80 7 0 ь 0 0 44 64

Anonymous BMP via email Since November 2011: 4 7 examinations per day large screening examinations (~100 200 persons per one) Pathology were founded with digital mammography and teleradiology Pathology were founded with digital mammography (BIRADS 2) 6,2% BIRADS 2 6,1% (BIRADS 3) 4,4% BIRADS 3 4,9% (BIRADS 4) 2,65% BIRADS 4 2,1% In 2012 more secure PACS have to be installed

Learning for Telemedicine and ehealth

Joint action of Association and Donetsk National Medical University Official Postgraduate Course emanagement (telemedicine and ICTs) in Health Care System

Postgraduate Course emanagement (telemedicine and ICTs) in Health Care System Program Methodology guideline Handbook CME credits FIRST OFFICIALLY APPROVED TELEMEDICINE HANDBOOK IN UKRAINE

Postgraduate Course emanagement (telemedicine and ICTs) in Health Care System Lectures and seminars Videoconferences Workshops Distant learning During first year 110 students from 11 regions of Ukraine

Special chapter: Tele ECG in Ukraine (1935 2012)

AfUTeHD role (2010 2012): WG on tele ECG development of guidelines for implementation and service organisation historical research made by Association s members situation monitoring and R&D researches supervision

Polska Gazeta Lekarska 27 by 1937 year (Polish Medical Newspaper) in the description of the L viv general hospital says: «during the last two years the Department of Infectious Diseases conducted teleelectrocardiographic investigations on a regular basis. The signal was transmitted via specially designed 500 meter long cables from the Department to the nearby Institute of Pathology. These investigations were carried out in collaboration with prof. Franke»

A.V.Vladzymyrskyy, O.M.Stadnyk, M.Karlińska Association for Ukrainian Telemedicine and ehealth Development, Donetsk National Medical University named after M.Gorky, L viv Regional Clinical Hospital, kraine, Warsaw Medical University, Poland 1. Albert Z. Lwowski wydzial lekarski w czasie okupacji hitlerowskiej 1941 1944. Wrocław: Wydawnictwo Zakład Narodowy im. Ossolińskich, 1975. Режим доступу: http://www.lwow.home.pl/lek/albert1.html. 2. Biblioteka Narodowa. Режим доступу: http://www.bn.org.pl. 3. Bibliografia Polska 1901 1939 / Ed.Federowicz G., Machnik H., Maziarz I. Warsawa: Biblioteka Narodowa,2006. T.8. 662 s. 4. Biogramyuczonychpolskich,CzęśćVI: Naukimedycznezeszyt1 / Podredakcją A.Śródki. Wrocław: Ossolineum, 1990. 500 s. 5. Franke M., Lipiński W. Zmiany elektrokardjograficzne w chorobach zakaźnych // Polska Gazeta Lekarska. 1936. R.15,N9. 1 11 s. 6. Franke M., Lipiński W. Zmiany elektrokardiograficzne w chorobach zakaźnych. Cz. 2 // Polska Gazeta Lekarska. 1936. R.15,N42. 1 9 s. 7. Franke M., Lankosz J. Obraz elektrokardjograficzny u starszej młodzieży szkolnej, oddającej się sportom // Polska Gazeta Lekarska. 1935. R.14,N51. 1 5 s. 8. Franke M. O zwojach wtrąconych gałęzi sercowej nerwu błędnego u psa. Lwów : Tow. Naukowe, 1923. 7 s. 9. Franke M. Djagnostyka chorób narządu krążenia : podręcznik dla lekarzy i uczących się. Lwów: H. Altenberg, 1921. 256 s. 10. Franke M. Skrypta patologji ogólnej i doświadczalnej według wykładów Marjana Frankego we Lwowie. Cz. 2, Gorączka, patologja krwi, przemiany materji i nerek. Lwów : Samopomoc Wydawnicza Twa Wzajemnej Pomocy Medyków U.J.K., 1923. 209 s. 11. Kogo szukasz? Informator lwowski na 1932 r. Nakoadem Targow Wschodnich we Lwowie. Lwow: Drukiem Artura Goldmana, 1932. S. 41. 12. Ksiega adresowa krol. Stol. miasta Lwowa.Rocznik siedmnasty 1913. Wydawca: Franciszek Reichman. Drukiem Augusta Olbrucha w Stryju, 1912. S.114. 13. Musée virtuel de l'électrocardiographie. Режим доступу: http://sites.estvideo.net/cardioaf/pages/simple_2_colors_index.html. 14. Oddzial Zakazny Panstwowego Szpitala // Polska Gazeta Lekarska. 1937. N27. S. 515. 15. Polish thread in the history of circulatory physiology. Режим доступу: http://www. jpp.krakow.pl/journal/archive/04_06_s1/articles/01_article.html 16. Polska Gazeta Lekarska. 1937. R.16,N27. S.507. 17. Skalski J. Myocardial Infarction and Angina Pectoris in the History of Medicine on the Polish Soil. Режим доступу: http://www.intechopen.com/source/pdfs/21314/intech Myocardial_infarction_and_angina_pectoris_in_the_history_of_medicine_on_the_polish_soil.pdf. 18. Sklad towarzystwa naukowego we Lwowe. Режим доступу: http://www.lwow.com.pl/tnwelwowie/sklad1937.html. 19. Zwozdziak W. Historia wydialu lekarskiego uniwersytetu Lwowskiego // Arhiwum historii medycyny. 1965. T.XXVIII,N4. S. 223 225.

Introducted telemedicine (tele ECG) in Ukraine in 1935 Professor Marjan Franke (1877 1944) Profesor Witold Lipinski (1886 1955)

Building of the Department of Infectious Diseases of the L viv general hospital (1941 1944) where the tele ECG system of prof.franke and prof.lipinskiwas introduced (courtesy by I.Kotlobulatov) Building of the Medical Faculty of L viv University (1910 1912) where receiver station was established (courtesy by I.Kotlobulatov)

ECG machine by F.Hellige&Sons, model of 1937 year* Franke M., Lipiński W. Zmiany elektrokardjograficzne w chorobach zakaźnych // Polska Gazeta Lekarska. 1936. R.15,N9. 1 11 s. * - Musée virtuel de l'électrocardiographie.-http://sites.estvideo.net/cardioaf/pages/simple_2_colors_index.html. Last visit 01.01.2012.

n=109

M.Franke: «Keeping the patient in one a place [while performing tele ECG the note of authors] allowed to avoid the adverse events associated with transportation» Tele ECG allowed to described a variety of ECG changes (delays of conductivity, miocarditis, rhytm disorders, changes of an electric axis of heart etc.) characteristic for different infectious changes Tele ECG used in IC conditions

1969 1990xx analogous tele ECG Courtesy by dr.g.kirzhner

More than 210 000 tele ECG consultations in Ukrainian telecardiology networks since 2005 till 1/1/2012

Ukrainian digital tele ECG systems Telecard and UNET 12 channel ECG high noise immunity (even at parallel phone lines) one call teleconsultation easy to operate (one button) ECG+Holter+Telemedicine 12 channel ECG in build telemedicine unit wireless transmission in SCP ECG (EN 1064) standard LCD and printer memory www.tredex company.com www.utasco.com.ua

Call centers based on usual PCs, special modems and EHR

TELECARD work places

UNET work places

SCP-ECG External access SCP-ECG GRID storage National Technical Science Academy

For the first time we use tele ECG system UNET in neonatology practice (Donetsk Municipal Hospital N6)

TELECARD Network 100% of regions (24) 100% of Regional Cardiology Hospital (24) 23 sub networks based on secondary hospitals (~10 transmitters per each call center) 5 municipal Emergency hospitals (ambulance cars services in 3 region centers and 2 towns) N number of involved regions and regional hospitals in ambulance cars/emergency hospitals

UNET Network 4 regions 3 municipal Emergency hospitals (ambulance cars services in capitol and 2 region centers) Pilot project Wireless Teleneonatology N number of involved regions and regional hospitals in ambulance cars/emergency hospitals

More than 210 000 tele ECG consultations in Ukrainian telecardiology networks since 2005 till 1/1/2012

Official methodological guideline made by Association and approved by Ministry of Health Service 2010 1. General part 1.1. Lawful base 1.2. Terminology and glossary 2. Tele ECG Network organisation and management 2.1. Aims and functions 2.2. Structure 2.3. Indications to tele ECG consultations 2.4. Policy for call center organisation 2.5. Policy for ECG sending point 2.6. Documentation 3. Manual of tele ECG device 4. Efficiency of tele ECG

Clinical reasons for tele ECG teleconsultations Myocardial infarct or chronic ischemia 11 63% Different arrhythmias or conductivity disorders 14 57% Other cardio vascular pathology 3 14% After ECG transmission Tele ECG allows to treat patient at local hospital 76,5 99,5% Transportation to the III level center after tele ECG 0,3 1,8% Transportation to the III level center after tele ECG and Expert travel to the patient 4,7 18,5% Failures For n=7002 and n=2444 tele ECG failures was in ~ 3,0 3,2%

www.telemed.org.ua

THANK YOU VERY MUCH! Welcome to Donetsk for EURO 2012! doctelemed@gmail.com Skype: anton251977