Telemedicine - treatment online
Under the current conditions in the world, we have all started to do one thing - adaptation. The picture of the world has changed, so now humanity has a chance to show its greatest talent - the ability to adapt - which for 200 thousand years has repeatedly given birth to new life in another round of evolutionary history. Yes, it may sound pathetic, but would we be fighting a pandemic here now, if once there, in the distant past, our nth - generation ancestor turned out to be a fatalist and refused to adapt to the next climate change?
Most likely, we are not aware of this, but genetic memory does its job. And when the world was quarantined, the lion’s share of able-bodied people immediately went to work online. It turned out that working on the "remote" is quite real and convenient. And relatives, who were usually out of focus due to the crazy rhythm, on the contrary became a clear epicenter of life. We have adapted, "we do what we can, with what we have, where we are": work - online, study - online, leisure - online, shopping - online, treatment - is it also online? .. Yes, but no in the sense of "ask Google", and in the sense of telemedicine.
"Telemedicine" may sound rather unusual, but in fact we have been using its elements for a long time. For example, when we seek advice on medical platforms of clinics, diagnostic centers, specialized medical institutions, where your online request is answered directly by a doctor, giving in private chat, if possible, certain recommendations. We all know the convenient service of prompt receipt of laboratory results by e-mail - also relevant to telemedicine. Also, online consultations, in particular via skype, are quite common in working with patients among pediatricians, nutritionists and psychologists.
However, the possibility of consulting a doctor online when there is a risk of coronavirus infection during a visit to the clinic should not be underestimated (especially for cancer patients who have almost zero immunity due to long courses of chemotherapy). Therefore, first of all, telemedicine is a service of remote consultation with a doctor, not only in the context of patient-doctor communication, but also doctor-doctor. In order for such a consultation to take place, you need: a computer and the Internet, appropriate software, diagnostic equipment.
Telemedicine is very popular outside of Ukraine, in Europe and the United States, where visits to the clinic are very expensive. Since 2017, telemedicine support, as a new trend in health insurance, has gradually been used by Ukrainian patients in private clinics. And since 2018, the interest of the state and, above all, the availability of telemedicine for rural areas is growing, because 30% of the population of Ukraine, which is 14 million citizens, live in rural areas.
The Ministry of Health stated that the family doctor should therefore become the person who will be able to advise the patient not only in terms of their competencies, but also to provide advice to secondary care professionals, regardless of where the patient lives. There were also 5 specialties for which telemedicine consulting services would be provided. First of all, it is cardiology, as well as endocrinology (diabetes and thyroid pathology), allergology and pulmonology (bronchial asthma and chronic obstructive pulmonary disease) and dermatology (20% of Ukrainians seek medical help in this specialty). A financing mechanism was also developed: if there is no equipment (according to the table of the Ministry of Health of Ukraine) and everything needs to be bought, it costs about 68-70 thousand UAH; computers and telemedicine equipment with connection and training - about 50 thousand UAH; 40 thousand UAH provided for electrocardiographs that are part of telemedicine equipment and a doctor’s / nurse’s bag; approximately each community receives UAH 150,000. according to the calculations of needs.
Already at the beginning of 2019, the ambitious plans planned a year ago began to be successfully implemented in a pilot project in which 5 regions of Ukraine took part - Dnipropetrovsk, Kharkiv, Poltava, Rivne and Kirovohrad. These first 5 oblasts received recommendations for the introduction of telemedicine in rural areas. They were developed with the support of the Government of Canada and the World Bank. In particular, a large-scale telemedicine network was built in the Dnipropetrovsk region in record time, uniting one third of all primary care facilities in the region. Namely - 30 treatment and prevention facilities (which, incidentally, report 178 rural clinics and 1 medical and obstetric point). At present, all primary health care centers have connected the Telemedicine module from Medstar Solutions, which interacts with the central component of eHealth, in their facilities.
“Imagine the picture: a remote area, a paramedic comes to a patient with a small portable diagnostic complex and makes a cardiogram. He sends the cardiogram to the family doctor on the computer, so he doesn’t like something in this cardiogram. The family doctor with the help of the telemedicine platform sends a request for an urgent teleconsultation with the regional cardiologist. Within 10 minutes, the cardiologist formulates his conclusion and sends it back to the primary care physician. In this way, the patient can receive an operative diagnosis without spending time traveling. The urgency of telemedicine consultations for primary care physicians in Ukraine is evidenced by the latest study initiated by the World Bank. According to them, the average number of cases when primary care physicians need teleconsultation is almost 5 times a month, ie more than once a week. As for the practice, according to the Ministry of Health, only during the pilot project in 5 oblasts the total number of teleconsultations was over 3000. An example of effective functioning of telemedicine at the regional level is Odessa oblast. Although it was not announced in the pilot project, but independently adopting the successful experience of colleagues, since April 2019, more than 10 thousand consultations have been held here. The opening of the first regional telemedicine center in Ukraine in Odessa allowed to reach such volumes of the region. The center accepts applications from primary care physicians and coordinates the provision of telemedicine consultations by specialized physicians. The center has recently started working with emergency departments and coordinating telemedicine emergency consultations. Of course, the creation of a TV network of this scale (including more than 90 medical institutions in the region) is impossible without the support of local authorities. She financed the creation of a regional medical center. And the chief doctors have already developed a system of motivations for doctors who provide telemedicine consultations. ", - says Andriy Zayats , co-founder of the IT4Medicine group of companies.
Telemedicine services may also be available, such as:
1) using a mobile phone or other device to download information about food, medication, dosage and blood glucose levels for examination by a nurse who responds electronically;
2) watch a video about the calculation of carbohydrates and download the application for this on the phone;
3) receiving reminders by e-mail, using text messages, when you need flu prevention, examination or other preventive care.
So, telemedicine is not a distant future, it is an adaptive present, in which the speed of diagnosis increases many times, distance ceases to be an obstacle, and the help of a doctor becomes an active network of professionals. And, for example, the National Cancer Institute has already switched to online rails, launching free online consultations of leading specialists for all citizens of Ukraine on its own website.
Author Kateryna Stebelska
Read also: Medical masks: how to choose and whether it will help protect against the virus
Most likely, we are not aware of this, but genetic memory does its job. And when the world was quarantined, the lion’s share of able-bodied people immediately went to work online. It turned out that working on the "remote" is quite real and convenient. And relatives, who were usually out of focus due to the crazy rhythm, on the contrary became a clear epicenter of life. We have adapted, "we do what we can, with what we have, where we are": work - online, study - online, leisure - online, shopping - online, treatment - is it also online? .. Yes, but no in the sense of "ask Google", and in the sense of telemedicine.
"Telemedicine" may sound rather unusual, but in fact we have been using its elements for a long time. For example, when we seek advice on medical platforms of clinics, diagnostic centers, specialized medical institutions, where your online request is answered directly by a doctor, giving in private chat, if possible, certain recommendations. We all know the convenient service of prompt receipt of laboratory results by e-mail - also relevant to telemedicine. Also, online consultations, in particular via skype, are quite common in working with patients among pediatricians, nutritionists and psychologists.
However, the possibility of consulting a doctor online when there is a risk of coronavirus infection during a visit to the clinic should not be underestimated (especially for cancer patients who have almost zero immunity due to long courses of chemotherapy). Therefore, first of all, telemedicine is a service of remote consultation with a doctor, not only in the context of patient-doctor communication, but also doctor-doctor. In order for such a consultation to take place, you need: a computer and the Internet, appropriate software, diagnostic equipment.
Telemedicine is very popular outside of Ukraine, in Europe and the United States, where visits to the clinic are very expensive. Since 2017, telemedicine support, as a new trend in health insurance, has gradually been used by Ukrainian patients in private clinics. And since 2018, the interest of the state and, above all, the availability of telemedicine for rural areas is growing, because 30% of the population of Ukraine, which is 14 million citizens, live in rural areas.
The Ministry of Health stated that the family doctor should therefore become the person who will be able to advise the patient not only in terms of their competencies, but also to provide advice to secondary care professionals, regardless of where the patient lives. There were also 5 specialties for which telemedicine consulting services would be provided. First of all, it is cardiology, as well as endocrinology (diabetes and thyroid pathology), allergology and pulmonology (bronchial asthma and chronic obstructive pulmonary disease) and dermatology (20% of Ukrainians seek medical help in this specialty). A financing mechanism was also developed: if there is no equipment (according to the table of the Ministry of Health of Ukraine) and everything needs to be bought, it costs about 68-70 thousand UAH; computers and telemedicine equipment with connection and training - about 50 thousand UAH; 40 thousand UAH provided for electrocardiographs that are part of telemedicine equipment and a doctor’s / nurse’s bag; approximately each community receives UAH 150,000. according to the calculations of needs. Already at the beginning of 2019, the ambitious plans planned a year ago began to be successfully implemented in a pilot project in which 5 regions of Ukraine took part - Dnipropetrovsk, Kharkiv, Poltava, Rivne and Kirovohrad. These first 5 oblasts received recommendations for the introduction of telemedicine in rural areas. They were developed with the support of the Government of Canada and the World Bank. In particular, a large-scale telemedicine network was built in the Dnipropetrovsk region in record time, uniting one third of all primary care facilities in the region. Namely - 30 treatment and prevention facilities (which, incidentally, report 178 rural clinics and 1 medical and obstetric point). At present, all primary health care centers have connected the Telemedicine module from Medstar Solutions, which interacts with the central component of eHealth, in their facilities.
“Imagine the picture: a remote area, a paramedic comes to a patient with a small portable diagnostic complex and makes a cardiogram. He sends the cardiogram to the family doctor on the computer, so he doesn’t like something in this cardiogram. The family doctor with the help of the telemedicine platform sends a request for an urgent teleconsultation with the regional cardiologist. Within 10 minutes, the cardiologist formulates his conclusion and sends it back to the primary care physician. In this way, the patient can receive an operative diagnosis without spending time traveling. The urgency of telemedicine consultations for primary care physicians in Ukraine is evidenced by the latest study initiated by the World Bank. According to them, the average number of cases when primary care physicians need teleconsultation is almost 5 times a month, ie more than once a week. As for the practice, according to the Ministry of Health, only during the pilot project in 5 oblasts the total number of teleconsultations was over 3000. An example of effective functioning of telemedicine at the regional level is Odessa oblast. Although it was not announced in the pilot project, but independently adopting the successful experience of colleagues, since April 2019, more than 10 thousand consultations have been held here. The opening of the first regional telemedicine center in Ukraine in Odessa allowed to reach such volumes of the region. The center accepts applications from primary care physicians and coordinates the provision of telemedicine consultations by specialized physicians. The center has recently started working with emergency departments and coordinating telemedicine emergency consultations. Of course, the creation of a TV network of this scale (including more than 90 medical institutions in the region) is impossible without the support of local authorities. She financed the creation of a regional medical center. And the chief doctors have already developed a system of motivations for doctors who provide telemedicine consultations. ", - says Andriy Zayats , co-founder of the IT4Medicine group of companies.
Telemedicine services may also be available, such as:
1) using a mobile phone or other device to download information about food, medication, dosage and blood glucose levels for examination by a nurse who responds electronically;
2) watch a video about the calculation of carbohydrates and download the application for this on the phone;
3) receiving reminders by e-mail, using text messages, when you need flu prevention, examination or other preventive care.
So, telemedicine is not a distant future, it is an adaptive present, in which the speed of diagnosis increases many times, distance ceases to be an obstacle, and the help of a doctor becomes an active network of professionals. And, for example, the National Cancer Institute has already switched to online rails, launching free online consultations of leading specialists for all citizens of Ukraine on its own website.
Author Kateryna Stebelska
Read also: Medical masks: how to choose and whether it will help protect against the virus