Telemedicine and electronic inventory: experience of the regions

Oksana Maniukh

Head of the Regional Methodological and Organisational

Center for telemedical consultations of the Ivano-

Frankivsk regional children’s hospital.

Kyiv, 23rd of April, 2015

ICT tools implemented by the Swiss-Ukrainian

Project

• Telemedical platform iPath

Start - 2003

• OpenMEDIS software for medical equipment inventory

Start - 2010

Terminology definitions

TELEMEDICINE is a set of organisational, financial and technical

measures ensuring operation of a consultative and diagnostic health

care system which allow a patient or a doctor seeing a patient to

receive a remote consultation from another specialist using high-tech

medical equipment and modern ICT technologies.

Telemedical station: Computer

Internet

Possibility to use digital diagnostic images (photocamera,

scanner, diagnostic equipment)

Specialist responsible for organisation of the telemedical

services in the clinic

The goal of the

telemedicine is

to ensure access to the

most actual information and

possibilities for experience

and expertise exchange

using modern ICT

technologies

to improve professional

knowledge and clinical practice

Effective implementation of the telemedicine in Ukrainian health care system

Development and testing of a model of telemedical technologies’ effective application in the daily operation of Ukrainian health care institutions.

Support and further development of the telemedical component of the Project.

Development and implementation of the i-Рath protocol in the Project‘spilot facilities .

The goal of the TELEMEDICINE

project

Telemedical platform iPath

http://ipath.ukma.kiev.ua

• iPath was an open professional telemedical platform “ for medical information maintainance and transfer” supported by a group of experts from the Basel Universtty, Switzerland

Since 2006 its’ server was located in Donetsk.

• iPath provided opportunities for exchange of textual, visual, audio and other information, as well presenting and editing of clinical cases for simultaneous consultations.

• Telemedical platform iPath was one of the first programes to teach Ukrainian specialists the principles of working in the telemedicalenvironment, was useful for specialists’ skill upgrading in various fields, allowed the doctors and patients to feel the advantages of telemedicalconsultations .

Main achievements in the area of telemedicine

• Regulation: telemedicine

protocols were developed

• The MoH Order as of

26.03.2010 № 261 “On

telemedicine introduction in

health care facilities”

and local governments’

orders on telemedicine

development were issued

• Telemedicine rooms were

created in all regional health

care institutions.

• Over 1000 users and 10 specialised

groups in Ukraine were registered in

the iPath platform and used it for

consultations.

• In 2007-2014 consultations were

provided in 1200 cases of mothers

and newborns’ deseases

• Since 2014 telemedical consultations

are provided via the website of the

MoH State Clinical Scientific and

Practical Center www.esemi.org.ua

Telemedicine allows to transfer photos, case records,

X-ray photographies, US examination fragments,

magnetic resonance images

One of the cases presented at the telemedicine

portal www.esemi.org.ua

A child was consulted via the telemedicine

platform by professor V.P. Prytula and a

surgeon of the reconstructive and plastic

microsurgery unit of Ochmatdit national

specialised childrens’ hospital and received

surgery as scheduled.

The state after the surgery

Аденома язика

Telemedicine in Crimea

Conditions for conducting

telemedical consultations were

created in all Crimean districts.

All important events in the

Perinatal Center (conferences,

discussions of difficult cases)

are broadcasted online to all

districts.

Round-the-clock online

consultations for local

specialists.

Telemedicine in Volyn region

• A telemedical network including16 district facilities and 2 regional clinics is created in Volyn region.

• Health care facilities are equipped with computers and have internet access.

• Health care workers improved theircomputer skills.

• Health care personnel is trained in using the telemedical platform.

• A regional consultative working group is created.

• Outcome: Doctors have opportunities to exchange experience and consultations with their colleagues at different levels which allows to improve health care quality

Telemedicine in Ivano-Frankivsk

regionOver 200 doctors are registered at iPath

In 2011-2014 124 real-time telemedical

consultations were conducted involving 56 clinical

specialists.

40 videoconferences involving 214 doctors were

conducted.

On 24.09.13 an official opening

of the telemedicine unit for real-

time video-consultations for

children with cardio-vascular

anomalies was held.

A meeting with the regional

facilities’ chief doctors on

expanding possibilities of

telemedicine consultations was

held.

Near and far perspectives

Video: searching in the telemedical portal www.esemi.org.ua and registration information and some presented cases in the Help section

One telemedical platform – many

opportunities: consultations,

diagnostics, learning, case

monitoring, video-conferences etc.

Create efficient consultant teams,

involve more doctors in telemedical

consulting and not to leave a single

case without an answer, so much

awaited by both a doctor and a patient.

Why it makes sense to introduce

telemedicine throughout Ukraine?

Advantages 5 in 1

Elimination of geographical borders in

health care

Reduce total expenses

Reduce time of service provision

Increasing access to tertiary medical

assistance

Simple and convenient

openMEDIS

special software for electronic medical

equipment inventory

• A simple, flexible and standardized tool for collecting,

processing and analyzing information on health care

technical infrastructure.

• Can be used for medical equipment data generation and

management decisions either in a single institution or in

a health care system as a whole.

openMEDISFeatures:

• The classification is based on the international standard

nomenclature of medical equipment UMDNS;

• The program provides easy access to entered data and

possibility to generate required reports.

• The program supports different languages: Ukrainian, English,

French, Romanian etc. with the possibility of adding translation

into other languages.

• During the previous stage of the Project the program was

implemented in 22 district and regional partner health care

facilities , over 8000 equipment units were entered in the data

base.

• Currently the program is being implemented in over 50

institutions in 4 partner regions.

openMEDISspecial software for medical equipment inventory

• The program provides key

information on equipment stock

in the form of tables, graphs and

diagrams, very convenient for

managers because allows to

analyze quickly all available

data in order to take a weighted

managerial decision.

• The demo version is available

here http://openmedis.scih.ch.

Login and password – demo.

Estimation by health care managers’

• The openMEDIS software was highly

evaluated by health care managers for

quick access to required information and

the possibility not only to collect

information about equipment but also to

process and analyse it, an important

feature for managers.

Main objectives of the openMEDIS

implementation

• Ensure constant access to actual data about the medical equipment and allow data processing and analysing for taking relevant managerial decisions;

• Control and streamline expenses on acquisition and maintenance of the medical equipment;

• Provide opportunities for creating a network on the basis of a health care institution, a region or at the national level allowing timely access to information about equipment in any clinic or in the region as a whole and promoting transparency of the managerial decisions.

It is beneficial! Structure –openMedis modes of

operation

1. Operation in an on-line mode (in Internet):

– An administrator installs openMEDIS on an internet server.

2. LAN operation :

– openMEDIS is installed on a LAN server (intranet) and all

facility’s users work with this database.

3. Operation on a local computer :

– If computers are not connected to the Internet, the openMEDIS

software and the web-service can be installed on a local

computer.

Do you know…

• The total amount of medical equipment in your facility?

• Amount of maintenance costs?

• Equipment age?

• Part of equipment that …

– is not used?

– requires repairing?

• Number of models and types of equipment used in your

facility?

The program generates an answer in a

couple of minutes

The program reminds about the guarantee period

and complaints about equipment

The program allows to select required

information via filters

Staff training and monitoring visits to health care

institutions in Ivano-Frankivsk region

• The trainers were trained within the framework of Swiss-Ukrainian Programme, so that they provided training to health care workers in the region afterwards.

• Trainings were provided for 38 specialists in the region, followed by monitoring visits to 9 facilities for providing practical help on the site several months afterwards.

• Equipment was procured for 9 facilities (computers, printers, scanners, etc.) for 103 980,8 UAH

• An Order of the Main Health Care Department of the Regional State Administration No 391 as of 18.10.2012 “On inventory-taking of medical equipment of the regional health care institutions on the basis of the Openmedissoftware”

VolynTlumach

KosivGalych

openMEDIS in the regions

• The software is implemented in all facilities of the regions.

• Precision engineers, accountants and programming engineers

have been trained on how to use the program.

• The medical equipment inventory was conducted according to

the international nomenclature UMDNS*

• Diversified medical equipment data bases have been created

in the regions (3800 units – in Vinnytsia region, 4500 units – in

Volyn region, over 7180 units – in Ivano-Frankivsk region)

• Equipment completeness is analysed as per equipment

requirements.

• Outcome: The tool helps to take correct managerial decisions

on the medical equipment’s rational distribution and use.

ICT tools implemented by the Programme

• Developed with support of the international experts from the

Swiss TPH and adapted to Ukrainian conditions by Ukrainian

experts,

• Created as open code software, flexible and open to any

modifications,

• Free of charge,

• Based on web-technologies allowing to work independently

from the user’s operational system,

• Minimum infrastructure requirements (computer, internet

access),

• Simple in use.

Requirements for implementing a teleplatform or

openMEDIS software in a clinic:

Сreate working stations for working with the tool (equipped

with computer with Internet access);

Train the personnel in using computers and the proposed tools

It makes sense to keep in mind that:

• For working with the teleplatform: there should be at least one

working place in each unit, where doctors can work with

telemedicine and have free access to it round the clock;

• It is important to keep doctors’ motivation in working with the

teleplatform (the clinic head and unit heads should look for ways

to encourage the personnel to do so)

In order to introduce the openMEDIS

software in a facility it is also necessary:

• To assign a specialist (1 or 2 persons)

responsible for entering information about

the facility’s equipment;

• To provide a working station;

• To timely enter and update data on medical

equipment (quarterly).

We would like to thank all Swiss and Ukrainian experts who developed and

implemented the Openmedis software, all who introduced and supported the

TELEMEDICINE in Ukraine, all who worked in the Swiss-Ukrainian

Project for 17 years!!!

Today is just another day of the many

days ahead of us. But maybe all

coming days in Ukrainian medicine

depend on what we will do with you

today!