Telemedicine in the Arctic: Myth or Reality
Gadgets that are able to hold an ECG, measure pressure and transmit data to the clinic, a real-time doctor’s appointment, a hospital online sheet, an electronic prescription statement – a few years ago it seemed somewhat fantastic. Today, these services can already be obtained under the law on telemedicine.
Telemedicine is the direction of medicine, based on the use of modern communication and digital technologies for remote medical care and consultations. For example, with the help of telemedicine, you can visit an online reception or hold a consultation of doctors, as well as remotely monitor the patient’s health.
To treat people in absentia can only medical institutions and doctors who have received special permits. Hospitals for this need to register with the Federal Register of Medical Organizations (Unified State Health Information System EGISP). The software itself is also subject to registration.
Experts consider telemedicine as a promising area, especially important for areas where it is extremely difficult to reach and fly – for example, for the Arctic region. Specialists in the field of telemedicine would like to make medicine accessible to everyone, improve the quality of treatment, reduce the number of on-site visits to the doctor and save the patient’s time.
The leading experts within the framework of the discussion club of the Project Office for Arctic Development (PORA) spoke about the prospects of development and the challenges of telemedicine, and how to overcome the skepticism of people about online treatment.
Develop in the complex
The development of telemedicine in the Arctic zone of the Russian Federation has its own peculiarities. Long distances, poor development of transport infrastructure, severe climate – all this does not allow to maintain fully equipped medical centers in each locality, says expert on innovative development of PORA Sergei Mayorov.
Now we are at the starting point of e-health services, and in order to develop this direction, it is necessary to digitize the social sphere and labor relations, says Natalia Ushakova, Chairperson of the Board of Directors of the National Center for Research and Development of Health and Social Sphere, Health Support.
Already, there are several projects in Moscow and St. Petersburg related to the digitalization of social and labor relations and the introduction of telemedicine. For example, the technology of biomedicine, which allows you to monitor the psychosomatic state of workers. It can be a bracelet that is put on the hand, or a sensor built into the clothes.
These devices allow you to observe the emotional state, assess the level of anxiety and stress. On the basis of the data obtained, one can predict when the employee’s productivity will decrease, notice chronic fatigue and promptly, without waiting for any extreme situations, to recommend changing the mode of work and rest of the employee.
As for the Arctic regions, a variety of devices can be used to perform a daily screening of the “polar voltage”. (“Polar tension” is a specific form of chronic psycho-emotional stress of the body, expressed by fatigue, dyspnea, sleep disturbance, asthenia, associated with the move to extreme northern conditions of high latitudes). The data can be transferred to health facilities and formed into systems that will help to track which symptoms are typical for workers in the Far North. On the basis of all this, prevention can be carried out.
Another development for the Arctic is a kiosk that can take 18 health parameters, for example, a person can independently do ultrasound and pass the results of the examination to the doctor.
An important aspect of the introduction of telemedicine is the education of both medical professionals and patients, notes Natalia Ushakova. It is necessary for the medical community to master the information technologies, and people understand how to use them.
This issue is now decided in the First Moscow State Medical University. Sechenov. Since 2018, the university began to train specialists for telemedicine, for example, a network doctor, IT-medic, a tissue engineering specialist and a molecular dietician.
Associate Professor of the Department of Information and Internet Technologies KIIT, First Moscow State Medical University. Sechenov George Radzievsky:
“We are now training doctors in the field of information technology. There are courses for the middle level – paramedics, pharmacists and a nurse. For them, a course on information systems in professional activity is taught. Our task is to explain what is happening in medicine from the point of view of information technology and to show the devices that are used.
There is a direction of the Master’s program “Medicine of the Future”, there is already a deeper and more serious study of this direction. In addition, since September the bachelor’s degree course “information technology and technology” has begun, people will be imprisoned for information technology – programming, creating information systems, databases. “
Now, telemedicine has just come to the start, and difficulties and legislative gaps are enough, experts say.
For example, one of such aspects is a medical secret. If the state of health is monitored at work, then the question arises: “Do I want my employer to know about this,” says Natalia Belyaeva, deputy permanent representative of Karelia under the Russian President.
Important is the security of the channels, to avoid the leakage of personal information in the case of break-ins, experts say.
This problem, for example, can be solved by a highly qualified electronic signature, says adviser for digital health Oleg Savin. However, there are very few certifying centers in Russia. Now, in order to receive electronic medical services, the patient must be authorized in the ESIA system, by entering the number of SNILS, which is not difficult to take possession of.
If we are talking about hard-to-reach regions, then not everywhere in them there is the Internet, and talking about telemedicine without the Internet is impossible, continues Belyaeva.
“I was faced with a situation when the mother of a seriously ill child needed to register on the fund’s website, which was ready to help her child. Mom simply was embarrassed to say that she does not have a computer, and has no idea how to register. And this is also a big problem, “she notes.
It is especially difficult with elderly people, adds Dmitry Skirdo, an expert with the Permanent Mission of the Krasnoyarsk Territory to the Russian government. Most of them can not even use the computer.
It is important to educate children and adolescents. We need to teach children to monitor their health and use technology properly. Experts believe that without the participation of the Ministry of Education in such a situation can not do – a possible solution would be health classes within the school computer science course.
Another big problem is the lack of a domestic certified hardware base, says Oleg Savin.
“There are complexes, but these are not mobile solutions. Many developments, but here the problem with certification is too long, it can reach 35 months. And the cost of devices, when they enter small-scale production, goes off scale. As an individual device a person will not buy it, only if the medical institutions, “- he says.
One of the most important components of telemedicine is the people’s interest in receiving such services. People are often skeptical of know-how. For example, there are cases when drivers are given bracelets that monitor the health status, and they simply do not wear them. And here, first of all, the person’s responsibility for his health is important.
Despite the difficulties in the development of telemedicine, there are regions-pioneers, for whom telemedicine is not just a word, but a real life. Such a subject is Yakutia, half the territory of which is located in the Arctic zone. Huge distances, a harsh climate, cut off territories, wandering small nations – all this affects the fact that medicine is not available for everyone. And telemedicine can solve this problem.
“Telemedicine is an important area for us. The distance between settlements [in our region] can be thousands of kilometers, so medical services may not be available to everyone. There are local people – small people, who need medical care in particular, and there is no high demand among them. They solve these problems in the region through the introduction of information technologies (for example, remote consultations, cloud clinics) and sanitary aviation, which is now actively developing. Nomadic tribes are helped, including paramedics. There is an Arctic school where specialists are trained in paramedicine. “