Tyumen Regional Telemedicine Integration Center offers unique services that cannot be seen in any other part of the Russian Federation. It conducts telemedicine consultations of a ‘doctor-doctor-patient’ type as well as directs to remote low-channel ECG by giving patients a miniature ECG machine.
Head of Tyumen Regional Telemedicine Integration Center Alexander Potapov dwelled on these developments and explained the reasons for their appearance.
Alexander Potapov will take part in the panel discussion at M-Health Congress on March 5. Along with other experts, he will feature remote monitoring and chronic patient rehabilitation.
Home low-channel ECG
Every family is known to have a blood pressure meter. Here, in Tyumen, we strive to make a mobile ECG machine a commonplace.
We have developed a device that is called CaRe 1.0.
“Patients get the device for free”
To create this device, we had to face two major problems: compactness and price.
We tackled these challenges due to solid business contacts with one of the manufacturers and integrators of such devices. Thus, we obtain devices at average cost price of 1500 RUB. Patients get CaRe 1.0 for free.
The biggest advantage of the device lies in its certification by Federal Service for Surveillance in Healthcare. It means that medical institutes can prescribe this device to patients, unlike uncertified ones.
The prescription process of CaRe 1.0 is pretty simple. A patient comes to a functional diagnostics suite to get the service called ‘Home ECG monitoring’. A doctor instructs them on how to put electrodes and write down ECG results in the right way. A nurse registers a device in a patient medical record. A patient is informed about the frequency and conditions of the procedure. That’s it.
“Patients never say no to the device”
As soon as a patient registers device readings, they connect CaRe 1.0 to a PC via USB and send data to the doctor’s e-mail. Currently, even aged people have no difficulty in doing this since their children and grandchildren can help. Within four years, nobody has said no to a home ECG machine for the lack of data transferring skills.
A doctor obtains data and interprets it as if they were at hospital. This became feasible due to our training material called ‘Atlas of low-channel cardiography’. We created it in collaboration with our state universities: Tyumen State Medical University and Tyumen State University.
All in all, home ECG may save human life since it’s the most reliable and precise method of heart problems diagnostics. The sooner ECG results are provided, the quicker will we identify a disease and prescribe treatment.
Tyumen Regional Telemedicine Integration Center also conducts unique ‘doctor-doctor-patient’ consultations you will never find in any other area across Russia.
“It took us 30 years to achieve this aim”
It should be noted that it took us thirty years to achieve such a result. Within this period, we were developing the concept of healthcare informatization. Top figures of our region tremendously contributed to this process: Vladimir Vladimirovich Yakushev (he was Governor of Tyumen Oblast for 13 years) and Director of the Healthcare Department of Tyumen Oblast Kulikova Inna Borisovna.
“Developed infrastructure is essential”
Apart from the technical aspects such as video cameras and Internet access, we had to solve the data protection problem, organize work places, train personnel, elaborate guidelines, take into account all the limits, and allocate money. The healthcare information system has been effective in our region since 1985, so we had the developed infrastructure by this time.
A consultation is conducted via video connection. Not two, but three people take part in it – two doctors and one patient. Here is how it looks like: a patient has a face-to-face appointment with a doctor who carefully listens to their problem. Then, a doctor decides to consult another specialist via video connection.
“Telemedicine cannot be a method of making a primary diagnose”
However, there are nuances: such a consultation won’t work for the primary diagnostics, only secondary. As laid down by Federal Law No. 323-FZ, we do not have the right to make diagnoses and prescribe treatment during a primary telemedical examination. In other words, we have to open a patient medical record and make a diagnosis – this only condition enables ‘doctor-doctor-patient’ consultations.
Such consultations give a doctor an opportunity to get recommendations from an expert from another sphere. Besides, no problem occurs with patient identification since they visit a doctor face-to-face. Here is the third nuance – patients sometimes find it difficult to clearly describe a problem. A doctor will help.
Such a consultation takes about 15 minutes – a standard time of a face-to-face examination.
Unfortunately, not all Russian regions are capable of carrying out such consultations. What is more, you cannot just steal other developments and integrate them into your practice – that will not do. What we need is the well-developed infrastructure and control of top figures of the region – then, it will be a success.