April 28, Georgiy Lebedev will participate in M-Health Congress 2017 as a moderator of one of conference discussion panels. Ahead of the event, M-Health Congress media office discussed with him key Russian telemedicine issues and discovered current changes in this industry.
Lebedev is the head of the Information and Internet Technologies Department at I.M. Sechenov First Moscow State Medical University, chairman of the “Internet+Medicine” Committee at Internet Development Institute, and advisor to the Director at Federal Research Institute for Health Organization and Informatics of Ministry of Health of the Russian Federation.
1. What are the problems as of today, complicating the development of digital healthcare in Russia?
Actually, there are a lot of them. I will mention only the key ones:
- The absence of legislative support. We are waiting for the adoption of amendments to the Federal Law on the Fundamentals of Protection of the Public Health of the Russian Federation. Currently, two versions are made: by the Internet community (Institute of Internet Development + Internet Initiatives Development Fund + Yandex & Co.) and by the Ministry of Health of the Russian Federation. In general, projects are similar. The first one regulates healthcare using telemedicine technologies, and the second one regulates remote consultations.
- The absence of statutory documents. Without them, the introduction of amendments to the above-mentioned Federal Law will be invalid. Thus, such documents (order of Ministry of Health of the Russian Federation, Federal Compulsory Medical Insurance Fund, and regional Ministries of Health) should be adopted immediately after the acceptance of amendments.
- The absence of a definite list of services provided by telemedicine remotely. The State has to determine them.
- There is no defined doctor’s working place while providing telemedicine services. In other words, doctors require specific instructions regarding when and how they should provide services to patients.
- There is no defined mechanism of the doctor and patient identification. Thus, it is impossible to establish personal record-keeping and doctor-patient relationship.
- Poor computer competence of healthcare staff.
- The absence of interest and even distrust in information technologies on the part of health officials.
2. How available are now remote diagnostics technologies for patients, doctors and health facilities?
In this regard, a critical challenge is the delivery of health care (both remote and using traditional methods) in rural areas, meteorological stations, oil-gas fields, as well as to original people, including migrating population, and to citizens of arctic zone colonies. For instance, the Nenets Autonomous District has the only multi-faceted establishment: the public health facility called Nenets county hospital. The region does not provide high-technology and secondary care but refers citizens to other regions (Moscow, Saint Petersburg, Arkhangelsk). Citizens quite frequently use an opportunity to attend doctors (specialists) in other regions, being on holiday or due to other reasons beyond Nenets Autonomous Area. A significant part of the area population live in places that can be reached only using the only one way – by air. Besides, air medical service expenses are really huge in terms of local budget. The Department of Health, Labor and Social Security of the Nenets Autonomous District has established the order of using telemedicine, including emergency cases. But currently, only 5% of healthcare staff applies it in work.
3. Tell about the latest prospective telemedicine developments.
Telemedicine innovations include health control methods, remote home health monitoring (home in-patient clinics, Internet of healthcare things), smart hospitals, smart urban medicine, healthcare data cloud storages and so on. The implementation of remote advisory methods is now the most successful. One has already established the Federal Consultation System of the Ministry of Health of the Russian Federation, uniting the whole range of local medical centers. Each of such centers usually has its own remote consultation office.
And other above-mentioned innovative methods are still difficult to implement. Issues related with implementing remote consultations into the ambulatory sector are still unsolved as well. For instance, one cannot arrange a visit to a doctor for remote consultation in a common hospital. But this aspect is being worked out. For example, one is developing healthcare pattern recognition systems, recognition of texts, speeches and records. Such technologies are particularly developed in the “Internet+Medicine” Committee at Internet Development Institute. I.M. Sechenov First Moscow State Medical University is seriously working on this aspect, as it has the Information and Internet Technologies Department designed to solve similar issues.
4. What tools for remote health monitoring are applied now?
One uses quite a big amount of devices from various manufacturers, including the following: electrocardiogram tester, blood pressure meter, pneumonometer, portable blood tester, blood glucose monitor, personal urine analyzer, portable ultrasound investigation systems, and fitness trackers.
5. How does medicine (and telemedicine, in particular) apply artificial intelligence technologies and robotics systems?
AI systems already allow to increase significantly diagnostics accuracy and, hereafter, will make real the so-called precision medicine and personal medical products.
to the real life application, this technology is already used by the American Heart Association. It is trying to work out new heart disease treatment methods by means of IBM Watson. Boston Children’s Hospital, focusing on rare children diseases, applies IBM Watson to establish diagnosis more accurately.
Several of such projects are developed in Russia as well. Today, by joint efforts, specialists from I.M. Sechenov First Moscow State Medical University and Kulakov Research Center of Obstetrics, Gynecology and Perinatology, are working on the development of:
- intelligent clinical decision support system in terms of the assisted reproductive technology;
- cell bulk morphological analysis systems;
- medicine pattern recognition algorithms;
- preventing health monitoring technologies;
- selection systems of operative therapy of ischemic heart diseases.
Wait for continuation of the interview soon. A new publication will allow you to find out who requires telemedicine the most: healthy or unhealthy people, how the government supports health startups and how acting digital healthcare laws influence businesses. M-Health Congress 2017 will also thoroughly discuss these issues. To participate in the conference, register on the official event website.