Sunday, November 27, 2005

The actuality of eHealth introduction in Georgian healthcare

The actuality of eHealth for Georgia (as the realization of distance medical service) is stipulated by the following basic moments:
- Population localization in the capital
- Centralization of healthcare
- Country geo-climatic features
- High level of treatment cost expenses.
The introduction of eHealth will ensure:
- Realization of qualified and specialized medical service in regions and rural areas;
- Shortening of time between beginning of disease and starting of treatment;
- Improvement of population health indices through reliable diagnostic and correct treatment strategy;
- Application of regional specialists’ potential;
- Realization of economic efficiency.

eHealth

The fast development of info-communication technologies and the tendencies of their successful and effective application in different fields during last decades were observed. This was reflected in Millennium Goals, particularly in 18th Goal: “The common accessibility of the modern technologies, particularly of info-communication possibilities should be realized in collaboration with private sector”. The World Health Organization (WHO) is implementing the intensive introduction of information technologies application for medical-sanitation services and healthcare aims during last ten years. In particular, at December, 1997 the International Consulting Conference organized by WHO prepared the material about “telematics” (EB101/INF.DOC./9). WHA51.9 Resolution (1998) had been determined the realization of goods of medical purpose through Internet.

The term “eHealth” is widely distributed and commonly accepted at present. It implies the application of info-communication technologies for medical aims as locally so at distance. eHealth is the unique possibility of development of public health. This topic was among questions those were revealed at the World Summit of Information Society in Geneva, Switzerland at December 2003. The Secretariat of WHO worked out the strategy project of eHealth, which determines the main directions of work in this field and actions of WHO in eHealth field by itself too.

The extremely fast development of eHealth in last period was stipulated by the progress of info-communication technologies. The electron system of health can be presented by the digital products, systems and services of medical-sanitation purpose. The mentioned technologies are extremely perspective as for low- so for high-income countries. It should be noted, that info-communication technologies have already brought benefits for the range of countries, which is reflecting not only upon the systems of medical-sanitation services, but on public health, healthcare management, finances, education, scientific research and economic activity too. At 7 April 2005 at 59th World Health Assembly (A58/21) the renewed strategy of eHealth (Provisional agenda item 13.17) was approved. In accordance with it the concept and strategy of national eHealth should be worked out by member countries. It should be emphasized, that eHealth system must ensure the increasing of medical services efficacy and the accessibility of medical-sanitation services in country at general and especially in remote areas. This should be useful and suitable possibility for providers of medical-sanitation services, specialists and users through increasing of service quality and improvement of health situation. eHealth should be positively reflected upon cost of medical service through the reducing of quantity of additional investigations and their repetitions and through ensuring of economy stipulated by scale effect.

There are organizations working in healthcare field, which not only apply the advantages of info-communication technologies in member countries, but stimulate development of eHealth significantly. No obstacle barrier interrupting exchange of medical-sanitation data exists; this is the helpful possibility for realization of operational and multilateral epidemiologic control. Working out of the global approach for data processing will ensure standardization and reducing of service cost.

The increasing of technical professionalism level in countries with low-income is observed, which is the suitable possibility to gain personal expert knowledge. Although for the most part of countries the expected benefits of eHealth were not materialized till present. As a result the speed and scale of info-communication technologies’ influence upon different healthcare systems were not determined till today. For the aim to work out individual, cost-effective models and especially to determine factors ensuring realization and stability of eHealth systems implementation of the consequent analytical studies and obtaining-exchange of the knowledge should be implemented. The necessary conditions of eHealth successful integration in medical-sanitation systems foresee the long-term commitments taken by government on the background of consequential strategic plan, realization of eHealth advantages at national level and availability of the qualified human resources.

The imbalance between accessibility of info-communication technologies and their application existed among different countries and in the borders of singular country too is observed. From this point of view the questions associated with human rights, ethical and juridical rights and especially – the accessibility of the best possible healthcare should be regulated.

VHCC - The concept of CME

At April 2005 the Telemedicine Unit was created by the Georgian Telemedicine Union (Association) at the JSC "REA" Rehabilitation Center. It aims organization of remote medical consultations, distance educational courses and the Continuous Medical Educational programmes focusing upon Telemedicine, eHealth and their applications.

At November 2005 the Georgian Telemedicine Union (Association) in collaboration with the Telemedicine Unit of JSC "REA" Rehabilitation Center worked out the CME programme "eHealth - Perspectives and Possibilities", which aims the introduction of the new field of medicine, its possibilities and perspectives to audience and the description of the possibilities to increase the quality, efficacy and adequacy of medical service through implementation of eHealth and telemedicine.

This programme is addressed to the following medical specialities:
- Pathologists
- Clinical cytologists
- Oncologists
- Radiologists
- Infectionists
- Cardiologists
- Hematologists
- Dermatologists
Each course can be attended by the 30 listener.

The duration of programme "eHealth - Perspectives and Possibilities" is estimated as 2 working days (11 educational hours), it will be realized through lectures (45 min of duration each) and seminars (2x45 min of duration each).

Creation of the other CME programmes focused eHealth and telemedicine and their applications will be worked at next steps.

VHCC - The description of case consultations

At July 2005, the usage of VHCC server for consultation purposes started, which is organized by the usage of the tool Simple Machine Forum. For the purpose to organize remote consultation in the most effective and comprehensive degree each case contained as description (the resume of medical history) and illustrations (microphotographs, CT images, X-rays and etc.). Just to create the full impression regarding the case the resume of medical history includes the data regarding the patient's objective condition, complaints, working diagnosis and clinical findings.

All illustrations were captured by the digital camera at resolution 5.0 mln pixels, transferred at PC and edited by the PhotoShop, particularly the images were optimized in contrast, brightness and sharpness by Adobe PhotoShop 5.0, then compressed and saved in JPEG format files at a resolution of 500x375 pixels.

As soon as the case was uploaded at the server the notification letter was sent to experts.

Since July 2005 till 28 November, 2005 79 cases were discussed at server.