iPath Telemedicine Platform and Experience                                                        Ukrainian-Swiss Mother a...
Ukrainian-Swiss Mother and Child Health Programme                                                      Ukrainian-Swiss Mot...
ICT Tools implemented in Ukraine     by the MCH Programme:         iPath:                                                U...
All these tools are: Open source software, no license fees required Web-based tools (Apache/PHP/MySQL)                  ...
iPath Telemedicine Platform Developed at the University of Basel Designed for asynchronous telemedicine, not            ...
iPath Telemedicine Platform Simple and user-friendly web interface, multilingual;                                        ...
iPath:                  implementation in Ukraine Started in 2003 as part of the Ukraine-Swiss perinatal  health project ...
iPath Ukraine   (telemed-ipath.org.ua)                                           Ukrainian-Swiss Mother and Child Health P...
iPath: Client’s side                               iPath training                               in Crimea                 ...
Template for case presentation and            discussion               • Textual description               • Gallery of im...
Standard forms for case description:Newborn’s case form, Ob/Gyn case form, etc.                                           ...
Digest of a clinical case discussionhttp://motherandchild.org.ua/eng/resource/121                                         ...
Implementation of iPath requires…                     • Orders and regulations Software                     • Positive at...
Steps for implementation Introduction:  work with health care administrators, chief                                      ...
Steps for implementation Technical basis:  equip workplaces with computers, Internet                                     ...
Problems and challenges          (incl. a survey of ~260 doctors from 27 med                       institutions in 2009) ...
Problems and challenges It’s very discouraging to receive no response at  all to your case                               ...
Improve the efficiency Try to expand the circle of experts ToT workshops, development of training                       ...
iPath: Experience of                       implementation iPath is viable and effective in low resource  settings        ...
Web resources Swiss TPH eHealth Toolbox  http://www.swisstph.ch/services/ehealth/ehealth-                                ...
http://mch.org.ua                                                                                 Contacts                ...
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iPath Telemedicine Platform and Experience of Its Implementation in Ukraine

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iPath Telemedicine Platform and Experience of Its Implementation in Ukraine

  1. 1. iPath Telemedicine Platform and Experience Ukrainian-Swiss Mother and Child Health Programme of Its Implementation in Ukraine: Concepts, Strengths, and Challenges Grigory NAUMOVETS ICT Coordinator Programme Implementation Office Kiev, Ukraine Regional Workshop “Health Technology Management” Chişinău, Moldova October 25-26, 2012
  2. 2. Ukrainian-Swiss Mother and Child Health Programme Ukrainian-Swiss Mother and Child Health Programme Implemented in four regions of Ukraine: Vinnytsia, Volyn, Ivano-Frankivsk, Crimea 2
  3. 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. 4. All these tools are: Open source software, no license fees required Web-based tools (Apache/PHP/MySQL) Ukrainian-Swiss Mother and Child Health Programme accessible via web interface Work for any operating system Simple, user-friendly, multilingual 4
  5. 5. iPath Telemedicine Platform Developed at the University of Basel Designed for asynchronous telemedicine, not Ukrainian-Swiss Mother and Child Health Programme for urgent consultations in real time Does not require simultaneous availability of all parties for real-time communication A hybrid web- and e-mail-based system (cases and comments can be posted via web interface or by email) Functionally - between a content management system (CMS) and a groupware tool. 5
  6. 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 for standardized acquisition of clinical data; Automated e-mail alerts; Easily accessible and growing with demand; Low hardware requirements and compatibility with most operating systems and web browsers; 6
  7. 7. iPath: implementation in Ukraine Started in 2003 as part of the Ukraine-Swiss perinatal health project Ukrainian-Swiss Mother and Child Health Programme Pilot institutions: Ivano-Frankivsk Oblast Children Hospital and Institute of Pediatrics, Obstetrics and Gynecology (Kyiv) Since 2009, the Ukrainian iPath platform has been running on a server in Donetsk hosted and maintained by Association for Ukrainian Telemedicine and eHealth Development Used by more than 80 partner institutions in 4 regions – and by many other users in Ukraine and abroad 7
  8. 8. iPath Ukraine (telemed-ipath.org.ua) Ukrainian-Swiss Mother and Child Health Programme Ukrainian iPath server in Donetsk: > 1,000 users, > 10 groups, > 1,000 cases posted 8
  9. 9. iPath: Client’s side iPath training in Crimea Ukrainian-Swiss Mother and Child Health ProgrammeiPath workplace at thePerinatal Center inIvano-Frankivsk 9
  10. 10. Template for case presentation and discussion • Textual description • Gallery of images and Ukrainian-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-mail 10
  11. 11. Standard forms for case description:Newborn’s case form, Ob/Gyn case form, etc. Ukrainian-Swiss Mother and Child Health Programme 11
  12. 12. Digest of a clinical case discussionhttp://motherandchild.org.ua/eng/resource/121 Ukrainian-Swiss Mother and Child Health Programme 12
  13. 13. Implementation of iPath requires… • Orders and regulations Software • Positive attitude of bosses Ukrainian-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 sources 13
  14. 14. Steps for implementation Introduction: work with health care administrators, chief Ukrainian-Swiss Mother and Child Health Programme physicians, and doctors to win their positive attitude; Admin support: issuing appropriate orders and other documents supporting the project, appoint responsible persons, provide proper conditions for training and work 14
  15. 15. Steps for implementation Technical basis: equip workplaces with computers, Internet Ukrainian-Swiss Mother and Child Health Programme access, digital cameras, scanners, diagnostic instruments, etc.; staff training Regulations: for each medical institution, prepare protocols that regulate the use of telemedicine (who can use it, when, how, and for what purposes) 15
  16. 16. Problems and challenges (incl. a survey of ~260 doctors from 27 med institutions in 2009) Fear to demonstrate incompetence (esp. by Ukrainian-Swiss Mother and Child Health Programme doctors from rayon hospitals) Need to have more experts actively participating in discussions Language barrier: limiting community to a smaller circle Few references to evidence-based sources, lack of skills for searching, analyzing, and assessing medical information (further aggravated by the language barrier) 16
  17. 17. Problems and challenges It’s very discouraging to receive no response at all to your case Ukrainian-Swiss Mother and Child Health Programme By design, iPath is an asynchronous telemedicine tool – but in many cases it’s very important to get response fast enough On the other hand, it can be used for post factum analysis of cases – tool for distance education. 17
  18. 18. Improve the efficiency Try to expand the circle of experts ToT workshops, development of training Ukrainian-Swiss Mother and Child Health Programme modules both for trainers and students Monitor cases and responses, push experts, try to make sure that all questions are answered Trainings on evidence-based medicine and medical info searching techniques 18
  19. 19. iPath: Experience of implementation iPath is viable and effective in low resource settings Ukrainian-Swiss Mother and Child Health Programme Human issues may be more limiting than technical issues Implementation should follow a properly planned procedure, and requires administrative support Persistent efforts needed to improve and maintain the efficiency 19
  20. 20. Web resources Swiss TPH eHealth Toolbox http://www.swisstph.ch/services/ehealth/ehealth- Ukrainian-Swiss Mother and Child Health Programme toolbox.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 Health Programme http://motherandchild.org.ua 20
  21. 21. http://mch.org.ua Contacts e-mail: GN@mch.org.ua Ukrainian-Swiss Mother and Child Health Programme21
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