iPath Telemedicine Platform and Experience of Its Implementation in Ukraine

iPath Telemedicine Platform and Experience

Ukrainian-Swiss Mother and Child Health Programme
of Its Implementation in Ukraine:
Concepts, Strengths, and Challenges

Grigory NAUMOVETS
ICT Coordinator
Programme Implementation Office
Kiev, Ukraine

Regional Workshop “Health Technology Management”
Chişinău, Moldova
October 25-26, 2012


Implemented in four regions
of Ukraine:
Vinnytsia, Volyn,
Ivano-Frankivsk, Crimea

2

ICT Tools implemented in Ukraine
by the MCH Programme:

iPath:

a Telemedicine platform

openMEDIS:
medical equipment inventory software

Perinatal registry:
database of information related to
pregnancy and childbirths

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All these tools are:

 Open source software, no license fees required

 Web-based tools (Apache/PHP/MySQL)

accessible via web interface
 Work for any operating system

 Simple, user-friendly, multilingual

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iPath Telemedicine Platform

 Developed at the University of Basel
 Designed for asynchronous telemedicine, not

for urgent consultations in real time
 Does not require simultaneous availability of all
parties for real-time communication
 A hybrid web- and e-mail-based system
(cases and comments can be posted via web
interface or by email)
 Functionally - between a content management
system (CMS) and a groupware tool.
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iPath Telemedicine Platform

 Simple and user-friendly web interface, multilingual;

 Integration of various file formats, e.g. documents,
images, audio and video files;

 Integration of application-specific case forms for
standardized acquisition of clinical data;

 Automated e-mail alerts;

 Easily accessible and growing with demand;

 Low hardware requirements and compatibility with most
operating systems and web browsers;
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iPath:
implementation in Ukraine
 Started in 2003 as part of the Ukraine-Swiss perinatal
health project

 Pilot institutions: Ivano-Frankivsk Oblast Children
Hospital and Institute of Pediatrics, Obstetrics and
Gynecology (Kyiv)
 Since 2009, the Ukrainian iPath platform has been
running on a server in Donetsk hosted and maintained
by Association for Ukrainian Telemedicine and eHealth
Development
 Used by more than 80 partner institutions in 4 regions –
and by many other users in Ukraine and abroad
7

iPath Ukraine (telemed-ipath.org.ua)

Ukrainian iPath server in Donetsk:
> 1,000 users,
> 10 groups,
> 1,000 cases posted 8

iPath: Client’s side

iPath training
in Crimea

iPath workplace at the
Perinatal Center in
Ivano-Frankivsk 9

Template for case presentation and
discussion
• Textual description
• Gallery of images and

documents
(authors are encouraged
to fill standard forms
developed for case
description)
• Comments

Cases and comments can
be posted
•Online (via the web site)
•via e-mail 10

Standard forms for case description:
Newborn’s case form, Ob/Gyn case form, etc.

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Digest of a clinical case discussion
http://motherandchild.org.ua/eng/resource/121

12

Implementation of iPath requires…

• Orders and regulations
 Software
• Positive attitude of bosses

 Hardware • Proper conditions for training
and work
• Procedures and protocols
 Admin support
• Training
 Community
• Coordination
• Moderation
• Promotion of EBP, use of
reliable sources
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Steps for implementation

 Introduction:
work with health care administrators, chief

physicians, and doctors to win their positive
attitude;
 Admin support:
issuing appropriate orders and other documents
supporting the project, appoint responsible
persons, provide proper conditions for training
and work

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Steps for implementation

 Technical basis:
equip workplaces with computers, Internet

access, digital cameras, scanners, diagnostic
instruments, etc.; staff training
 Regulations:
for each medical institution, prepare protocols
that regulate the use of telemedicine (who can
use it, when, how, and for what purposes)

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Problems and challenges
(incl. a survey of ~260 doctors from 27 med
institutions in 2009)
 Fear to demonstrate incompetence (esp. by

doctors from rayon hospitals)
 Need to have more experts actively participating
in discussions
 Language barrier: limiting community to a
smaller circle
 Few references to evidence-based sources, lack
of skills for searching, analyzing, and assessing
medical information (further aggravated by the
language barrier)
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Problems and challenges

 It’s very discouraging to receive no response at
all to your case

 By design, iPath is an asynchronous
telemedicine tool – but in many cases it’s very
important to get response fast enough
 On the other hand, it can be used for post
factum analysis of cases – tool for distance
education.

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Improve the efficiency

 Try to expand the circle of experts
 ToT workshops, development of training

modules both for trainers and students
 Monitor cases and responses, push experts, try
to make sure that all questions are answered
 Trainings on evidence-based medicine and
medical info searching techniques

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iPath: Experience of
implementation
 iPath is viable and effective in low resource
settings

 Human issues may be more limiting than
technical issues
 Implementation should follow a properly planned
procedure, and requires administrative support
 Persistent efforts needed to improve and
maintain the efficiency

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Web resources

 Swiss TPH eHealth Toolbox
http://www.swisstph.ch/services/ehealth/ehealth-

toolbox.html
 Ukrainian iPath Telemedicine server:
http://telemed-ipath.org.ua
 iPath Moldova Telemedicine platform:
http://www.ipath-network.com/moldova/
 Ukrainian-Swiss Mother and Child Health
Programme http://motherandchild.org.ua

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http://mch.org.ua
Contacts
e-mail: GN@mch.org.ua

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iPath Telemedicine Platform and Experience of Its Implementation in Ukraine

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