Articles from rubric: «Telemedicine»
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2020 № S5 Telemedicine technologies: prospects and limitations
In the context of rapid technological progress, the outlines of the prospects for the development of telemedicine
technologies are becoming more and more clear. At the same time, changes in the organizational, legal and economic spheres often do not keep up with technological changes. This was especially evident in the conditions of the spread of the COVID‑19 coronavirus.
The article contains an analysis of the features of telemedicine technologies application in modern conditions, prospects and obstacles that arise in this area. -
2020 № 4 Telemedicine as a tool for remote interaction with regional hospitals: 5-year experience of the National Research Center for Hematology
Significant expansion of telemedicine technologies was made possible by the adoption of the necessary legal regulation
and initiation of the national program “Healthcare”. National research centers were assigned a mission to provide advisory and methodological support to the regional hospitals.
The manuscript describes the experience of the National Research Center for Hematology in application of telemedicine technologies in order to improve the quality of specialized medical care. Progressive increase in the number of requests for telemedicine consultations was observed during the last 5 years, also due to the activities aimed at expansion of geographical coverage of telemedicine technologies and involvement of the regional doctors. In 2019 1380 requests were received from 80 regions of the Russian Federation. The largest number of requests came from the hospitals of the Central (28%) and Siberian (25%) Federal Districts. Distribution of consultations by aim, disease, regions of origin is presented in the manuscript.
Telemedicine consultations significantly contribute to the implementation of precise diagnostics and monitoring of patients with blood disorders, shortening of the time of diagnosis, timely treatment initiation, help to organize correct patient referrals, ultimately reducing the risks of treatment failure, complications and lethal outcomes. Analysis of the data accumulated in the consulting
National research center allows to assess the quality and effectiveness of medical care in the regional hospitals. -
2020 № 3 Procedure for conducting telemedicine consultations in the subjects of the Russian Federation
In the article, the authors analyze trends in the development of telemedicine in the subjects of the Russian Federation,
and also conclude that the formation of the system is carried out at different rates. Determine that one of the main stages of development is the formation of a legal framework dedicated to this area. Based on the analysis of legal acts of the subjects of the Russian Federation on the implementation of telemedicine consultations, the authors present a General algorithm for conducting telemedicine consultations, as well as reflect current problems and form proposals for their solution. -
2020 № 3 Economic aspects of providing medical care using telemedicine technologies
The aim of the research is to study the economic aspects of telemedicine technologies application, taking into account
the experience of other countries; to develop methodological approaches to evaluating the effectiveness of telemedicine technologies; to analyze the features of evaluating the effectiveness of telemedicine technologies in the conditions of COVID‑19 coronavirus spread. Methodological approaches to evaluating the effectiveness of telemedicine technologies are proposed.
The additional costs and benefits of using telemedicine technologies are analyzed in the context of the main participants: the state, medical organizations, doctors, and patients. The additional costs of introducing telemedicine technologies are estimated in terms of their belonging to the so-called “necessary costs” or investments that have different economic content . The proposals developed by the authors allow us to more correctly assess the effectiveness of investments in the provision of telemedicine services and, thus, choose the most optimal options. -
2020 № 2 Personal telemedicine. Prospects for implementation
This article is devoted to the introduction of one of the most promising areas of telemedicine – personal telemedicine. A number of definitions are given, and some aspects of implementation are briefly considered. Based on the analysis of foreign experience and the current situation in Russian healthcare, the necessary steps are considered for the implementation of this direction.
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2020 № 2 Legal problems of telemedicine technologies application in the context of fighting the spread of COVID-19 coronavirus
The purpose of the research is to analyze the legal problems of using telemedicine technologies, taking into account the experience of other countries; to assess the limitations of using telemedicine technologies in preventing the spread of COVID-19 coronavirus; to develop approaches to overcome existing restrictions in this area.
The authors consider the system of legal relations that arise between various participants in the provision of telemedicine services, focusing on international experience in this field.
On the example of the Russian Federation, the analysis of legal restrictions for the development of telemedicine technologies, which are typical for other countries, is carried out. A number of common problems of implementing telemedicine technologies are identified, as well as the specifics of legal regulation of telemedicine services in the Russian Federation.
Measures are proposed to overcome a number of legal restrictions in the use of telemedicine services related to licensing, labor legislation, etc. -
2020 № 2 Telemedicine and COVID-19: quality of patient-initiated teleconsultations in case of acute respiratory disease
There is a global increase in demand for direct-to-patient telemedicine consultations due to COVID-19 pandemic. We made a quality assessment of the patient-initiated consultations in case of acute respiratory viral infection symptoms (COVID-19). There are 20 teleconsultations of 2 simulated patients in 10 the most popular telehealth services. An incomplete history of the disease was recorded in 50.0% of cases, incomplete allergy anamnesis – in 60.0%, and epidemiology anamnesis – in 35.0%. Information on chronic illnesses (critical for COVID-19 suspected situations) is fully collected only in 50.0% of cases. Due to defects in the history taking the target diagnostic concept was achieved in 30.0% of teleconsultations, target actions were recommended in only 35.0%. Telemedicine services did not provide continuity of medical care. In 60.0% of cases, medications were prescribed, including injectable antibacterial agents, which completely contradicts not only the legislation, but also the accepted international methods and practices of distance counseling. The quality of the direct-to-patient telemedicine services remains unsatisfactory. There is no effective quality control and quality assurance systems.
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2020 № 1 The quality of primary direct-to-consumer telemedicine consultations (by results of testing telemedicine services)
The adoption of a number of special regulatory documents has significantly expanded the possibilities of using
telemedicine technologies in the Russian Federation. A significant number of services have appeared on the market, offering
direct-to-consumer and patient initiated telemedicine consultations. The explosive growth in the number of such services requires
a careful study of the telemedicine interaction quality. The research objective is to assess the quality of remote interaction of
participants in primary telemedicine consultations with simulated patients. For testing, we used descriptions of simulated patients
basing on real records of patients from the therapeutic department of the municipal clinical hospital. For objectification and
analysis of the telemedicine interaction process (collection of complaints, questioning, recommendations, etc.) a checklist has been compiled. Initially, the study included such services as “Yandex. Health”, “MMT (OnlineDoctor)”, “TelemedHelp”, “Doctor at work”,
“DoctorSmart”, “DocDoc”; then, for technical reasons, 2 services were excluded from the study. Two simulated patients were sent
to 4 services; as results, 8 primary teleconsultations were made. In all cases, incorrect, incomplete collection of anamnesis data
was recorded. Target diagnosis (in the form of diagnostic concept) was achieved in 25% of cases, and target prescriptions were
made in 50% of cases. A personal consultation and additional examinations were recommended in 75% of teleconsultations.
There was no continuity, drugs were somehow prescribed in 62.5% of cases. As results, an urgent development of methods of
internal and departmental quality control of medical care provided with the use of telemedicine technologies is required. -
2019 № 2 Process integration in e-health system based on industry 4.0: developing of the business model for the russian practice (theoretical aspect)
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2019 № 2 Teleradiology in Russian Federation: state-of-art
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2019 № 1 Project design portal teleservicing neurorehabilitation “Neyrodom”
The results of the project design of the information system for the remote rehabilitation of patients with neurological
deficit are presented. The field of research is a new direction in health care – telemedicine. The developed remote rehabilitation is the third outpatient stage of medical rehabilitation, including the necessary monitoring of rehabilitation procedures carried out at home. Software and technical implementation of interactive methods of rehabilitation, based on the author’s medical techniques. The design was implemented using modern information design and development approaches. Presents diagrams of neurorehabilitation business processes and use cases, shows the structure of the database. The article pays special attention to the design of the database and the interface part of the application. -
2018 № itm Telemedicine: whom, what and how to teach
This article is devoted to the issue of professional training for the new organizational-technological area of health care- telemedicine. The history of this area development in Russia, basic concepts and definitions is briefly considered. On the basis of our long-term experience, recommendations are given on training of specialists in various fields involved in the application of remote technologies for providing of medical care and professional education in medicine.
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2018 № 4 Expert Telemedicine Consultations in Radiology Service of Moscow
In 2017 Moscow Research and Practical Center of Medical Radiology conducted 2678 expert telemedicine consultations (i.e., TMC) following the requests from the radiology departments in Moscow municipal hospitals. A system-integrated base for distance consultations is called Unified Radiological Information Service (i.e., URIS). Expert TMCs were performed based on their modality, i.e. 52% (1386 cases) for MR imaging, 47% (1257 cases) for CT, 1% (35 cases) for X-ray imaging. The vast majority (i.e., 96.7% cases) of all applications were received from municipal outpatient clinics, providing healthcare assistance to the adult population. 3.2% of cases of expert TMC were conducted on an urgent basis. For the first time we defined the average demand for expert TMC results of radiology studies to be equal to 4,8 teleconsultations for 1,000 CTs, 17,42 – for 1 CT scanner, 8,9 – for 1,000 MRI, 26,98 – for 1 MRI scanner
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2018 № 2 «Cross-reporting» as a way for sub-speciality teleradiology
There is an original telemedicinebased approach for a subspeciality reporting of a radiology examinations at primary level facilities. This approach allows to increase quality of «neuroradiology» reporting at children. The level of discrepancies decreased from 42,0% to 20,0%.
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2017 № 3 Organizational telemedicine
Scientific bases of organizational telemedicine as a new direction of application of information and telecom- munication technologies in the system of citizens’ health protection are developed. The terminology, principles and role of telemedicine in the field of organization of public health and public health are defined. The advantages of using organizational telemedicine for improving the organization of medical care in the system of national and departmental health of the Russian Federation are shown. A new view of telemedicine as a tool for maneuvering health resources is proposed for the rapid change in the volume and level of medical care in the interests of a broad contingent of the population. The integrative role of organizational telemedicine in the integrated application of various information technologies in health care is shown
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2017 № 2 Possibility of mobile app usage as a tool to improve compliance for patients with cardiovascular disease, Federal State Budgetary Scientific Institution Research Institute for Complex Issues of Cardiovascular Diseases.
Currently, low adherence is a problem of treatment of patients with cardiovascular diseases. Developing of the modern tool to raise patient’s awareness of their disease and to improve adherence to all requirements of doctors is particularly important. The aim of our study was to investigate the readiness of patients to use mobile software and applications designed to improve adherence to treatment.
In the study were included 106 patients hospitalized in the clinic in February 2017 with various cardiovascular diseases. All patients filled out the original questionnaire, which included questions about the use of mobile phones, activity in social networks and ready to use applications and programs for patients. In this sample was revealed a high percentage of active users of mobile phones (97%). More than a half (57%) of patients expressed their willingness to use the programs and applications to improve adherence to treatment. The potential cohort of patients for using applications are persons of age 51–70 years. Among the different disease groups, the best results showed patients with arterial hypertension, acquired heart diseases and stable angina (66–70%). No significant gender differences were found. A high percentage of mobile phone usage among patients and readiness for active use of programs and applications can be used as a tool to improve adherence to treatment. -
2017 № 1 Integrated telemedicine technologies for support and care patients. Worldwide trends, the results of research about informatization, technological solutions for doctors based on service ONDO.
This article analyzes mobile and telemedicine as an example of recent researches. Next – survey results from the company ONDOC: doctors – about remote consultation and diagnosis, the heads – about mobile medicine and informatization. Next – the idea about combination of mobile and electronic health. It helps in monitoring and sup- porting the patients. Author described the opportunities of complexity: the communication «doctor-patient» and clinics in ONDOC project. In conclusion – a summary about the eHealth-industry in between stage. This stage means that it carries a new approach: a complete personalization of treatment and responsibility.
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2016 № 2 Development of a technical field of the «bio-sensory e-health systems» through the prism of a patent analysis
The article presents the results of the multi-criteria patent analysis, which describes certain features of the development of the technological field of the «bio-sensory devices for measuring physiological indexes» at its current stage. The article notes that suggested technical solutions are characterized by multidisciplinary features and by a stable in-line growth of patent activity in the past two decades. An absolute technological leader in this field is the United States, however, in the period between 2010 and 2015 a rapidly growing number of patents were granted to Chinese residents. The article demonstrates that citizens of Russian Federation exhibit a considerably lower, compared to other countries, productive activity in the area of bio-sensory devices. The Russian patent landscape in this industrial area is characterized by stagnation of patent activity in the period of 2014–2015, by an insignificant number of patent documents released overseas and by the absolute absence of triad patent communities. The conclusion is made that domestic capacities in this area are noncompetitive which should be considered when choosing scientific-technological priorities of the country.
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2016 № 2 Telemedicine prevention, rehabilitation and health management: problems and solutions
The analysis of the problems arising when introducing technologies of personal telemedicine in the practice healthcare is performed. The ways to overcome obstacles and improve the effectiveness of telemedicine technologies for the prevention and rehabilitation of cardiovascular diseases are suggested.
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2015 № 2 About the definition and classification of telemedicine services
The definition of telehealth. Describes a set of criteria for the classification of telemedicine services and proposed their classification. The rules of naming telemedicine services for inclusion in the Nomenclature of medical services.
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2015 № 2 Telemedicine systems and the protection of personal data
The article contains the information of the problem of the protection of personal data in information systems. It was carried out an analysis of the existing legal framework and possible implementation of protection of personal data. It was suggested personal version of the protection of personal data by the example of the worked out telemedicine system «Logoderm» used in dermatovenerology.