Presentation at the National Capitalization conference of the Swiss-Ukrainian Mother and Child Health Programme (Kyiv, Ukraine, April 23, 2015) http://motherandchild.org.ua/eng/event/768

1. Telemedicine and electronic inventory:
experience of the regions
Oksana Maniukh
Head of the Regional Methodological and Organisational
Center for telemedical consultations of the Ivano-
Frankivsk regional children’s hospital.
Kyiv, 23rd of April, 2015

2. ICT tools implemented by the Swiss-Ukrainian
Project
• Telemedical platform iPath
Start - 2003
• OpenMEDIS software for medical equipment inventory
Start - 2010

3. Terminology definitions
TELEMEDICINE is a set of organisational, financial and technical
measures ensuring operation of a consultative and diagnostic health
care system which allow a patient or a doctor seeing a patient to
receive a remote consultation from another specialist using high-tech
medical equipment and modern ICT technologies.
Telemedical station:
 Computer
 Internet
 Possibility to use digital diagnostic images (photocamera,
scanner, diagnostic equipment)
 Specialist responsible for organisation of the telemedical
services in the clinic

4. The goal of the
telemedicine is
to ensure access to the
most actual information and
possibilities for experience
and expertise exchange
using modern ICT
technologies
to improve
professional
knowledge and
clinical practice
Effective implementation of the telemedicine in Ukrainian health care
system
Development and testing of a model of telemedical technologies’
effective application in the daily operation of Ukrainian health care
institutions.
Support and further development of the telemedical component of the
Project.
Development and implementation of the i-Рath protocol in the Project‘s
pilot facilities .
The goal of the TELEMEDICINE
project

5. Telemedical platform iPath
http://ipath.ukma.kiev.ua
• iPath was an open professional telemedical platform “ for medical
information maintainance and transfer” supported by a group of experts
from the Basel Universtty, Switzerland
Since 2006 its’ server was located in Donetsk.
• iPath provided opportunities for exchange of textual, visual, audio and
other information, as well presenting and editing of clinical cases for
simultaneous consultations.
• Telemedical platform iPath was one of the first programes to teach
Ukrainian specialists the principles of working in the telemedical
environment, was useful for specialists’ skill upgrading in various fields,
allowed the doctors and patients to feel the advantages of telemedical
consultations .

6. Main achievements in the area of telemedicine
• Regulation: telemedicine
protocols were developed
• The MoH Order as of
26.03.2010 № 261 “On
telemedicine introduction in
health care facilities”
and local governments’
orders on telemedicine
development were issued
• Telemedicine rooms were
created in all regional health
care institutions.
• Over 1000 users and 10 specialised
groups in Ukraine were registered in
the iPath platform and used it for
consultations.
• In 2007-2014 consultations were
provided in 1200 cases of mothers
and newborns’ deseases
• Since 2014 telemedical consultations
are provided via the website of the
MoH State Clinical Scientific and
Practical Center www.esemi.org.ua

7. Telemedicine allows to transfer photos, case records,
X-ray photographies, US examination fragments,
magnetic resonance images

8. One of the cases presented at the telemedicine
portal www.esemi.org.ua
A child was consulted via the telemedicine
platform by professor V.P. Prytula and a
surgeon of the reconstructive and plastic
microsurgery unit of Ochmatdit national
specialised childrens’ hospital and received
surgery as scheduled.
The state after the surgery
Аденома язика

9. Telemedicine in Crimea
Conditions for conducting
telemedical consultations were
created in all Crimean districts.
All important events in the
Perinatal Center (conferences,
discussions of difficult cases)
are broadcasted online to all
districts.
Round-the-clock online
consultations for local
specialists.

10. Telemedicine in Volyn region
• A telemedical network including16 district
facilities and 2 regional clinics is created in
Volyn region.
• Health care facilities are equipped with
computers and have internet access.
• Health care workers improved their
computer skills.
• Health care personnel is trained in using
the telemedical platform.
• A regional consultative working group is
created.
• Outcome: Doctors have opportunities to
exchange experience and consultations
with their colleagues at different levels
which allows to improve health care quality

11. Telemedicine in Ivano-Frankivsk
region
Over 200 doctors are registered at iPath
In 2011-2014 124 real-time telemedical
consultations were conducted involving 56 clinical
specialists.
40 videoconferences involving 214 doctors were
conducted.
On 24.09.13 an official opening
of the telemedicine unit for real-
time video-consultations for
children with cardio-vascular
anomalies was held.
A meeting with the regional
facilities’ chief doctors on
expanding possibilities of
telemedicine consultations was
held.

12. Near and far perspectives
Video: searching in the
telemedical portal
www.esemi.org.ua and
registration information and
some presented cases in the
Help section
One telemedical platform – many
opportunities: consultations,
diagnostics, learning, case
monitoring, video-conferences etc.
Create efficient consultant teams,
involve more doctors in telemedical
consulting and not to leave a single
case without an answer, so much
awaited by both a doctor and a patient.

13. Why it makes sense to introduce
telemedicine throughout Ukraine?
Advantages 5 in 1
Elimination of geographical borders in
health care
Reduce total expenses
Reduce time of service provision
Increasing access to tertiary medical
assistance
Simple and convenient

14. openMEDIS
special software for electronic medical
equipment inventory
• A simple, flexible and standardized tool for collecting,
processing and analyzing information on health care
technical infrastructure.
• Can be used for medical equipment data generation and
management decisions either in a single institution or in
a health care system as a whole.

15. openMEDIS
Features:
• The classification is based on the international standard
nomenclature of medical equipment UMDNS;
• The program provides easy access to entered data and
possibility to generate required reports.
• The program supports different languages: Ukrainian, English,
French, Romanian etc. with the possibility of adding translation
into other languages.
• During the previous stage of the Project the program was
implemented in 22 district and regional partner health care
facilities , over 8000 equipment units were entered in the data
base.
• Currently the program is being implemented in over 50
institutions in 4 partner regions.

16. openMEDIS
special software for medical equipment inventory
• The program provides key
information on equipment stock
in the form of tables, graphs and
diagrams, very convenient for
managers because allows to
analyze quickly all available
data in order to take a weighted
managerial decision.
• The demo version is available
here http://openmedis.scih.ch.
Login and password – demo.

17. Estimation by health care managers’
• The openMEDIS software was highly
evaluated by health care managers for
quick access to required information and
the possibility not only to collect
information about equipment but also to
process and analyse it, an important
feature for managers.

18. Main objectives of the openMEDIS
implementation
• Ensure constant access to actual data about the
medical equipment and allow data processing and
analysing for taking relevant managerial decisions;
• Control and streamline expenses on acquisition and
maintenance of the medical equipment;
• Provide opportunities for creating a network on the
basis of a health care institution, a region or at the
national level allowing timely access to information
about equipment in any clinic or in the region as a
whole and promoting transparency of the managerial
decisions.

19. It is beneficial! Structure –openMedis modes of
operation
1. Operation in an on-line mode (in Internet):
– An administrator installs openMEDIS on an internet server.
2. LAN operation :
– openMEDIS is installed on a LAN server (intranet) and all
facility’s users work with this database.
3. Operation on a local computer :
– If computers are not connected to the Internet, the openMEDIS
software and the web-service can be installed on a local
computer.

20. Do you know…
• The total amount of medical equipment in your facility?
• Amount of maintenance costs?
• Equipment age?
• Part of equipment that …
– is not used?
– requires repairing?
• Number of models and types of equipment used in your
facility?

21. The program generates an answer in a
couple of minutes

22. The program reminds about the guarantee period
and complaints about equipment

23. The program allows to select required
information via filters

24. Staff training and monitoring visits to health care
institutions in Ivano-Frankivsk region
• The trainers were trained within the framework of Swiss-Ukrainian Programme,
so that they provided training to health care workers in the region afterwards.
• Trainings were provided for 38 specialists in the region, followed by monitoring
visits to 9 facilities for providing practical help on the site several months
afterwards.
• Equipment was procured for 9 facilities (computers, printers, scanners, etc.) for
103 980,8 UAH
• An Order of the Main Health Care Department of the Regional State
Administration No 391 as of 18.10.2012 “On inventory-taking of medical
equipment of the regional health care institutions on the basis of the Openmedis
software”

25. Volyn
Tlumach
Kosiv
Galych

26. openMEDIS in the regions
• The software is implemented in all facilities of the regions.
• Precision engineers, accountants and programming engineers
have been trained on how to use the program.
• The medical equipment inventory was conducted according to
the international nomenclature UMDNS*
• Diversified medical equipment data bases have been created
in the regions (3800 units – in Vinnytsia region, 4500 units – in
Volyn region, over 7180 units – in Ivano-Frankivsk region)
• Equipment completeness is analysed as per equipment
requirements.
• Outcome: The tool helps to take correct managerial decisions
on the medical equipment’s rational distribution and use.

27. ICT tools implemented by the Programme
• Developed with support of the international experts from the
Swiss TPH and adapted to Ukrainian conditions by Ukrainian
experts,
• Created as open code software, flexible and open to any
modifications,
• Free of charge,
• Based on web-technologies allowing to work independently
from the user’s operational system,
• Minimum infrastructure requirements (computer, internet
access),
• Simple in use.

28. Requirements for implementing a teleplatform or
openMEDIS software in a clinic:
Сreate working stations for working with the tool (equipped
with computer with Internet access);
Train the personnel in using computers and the proposed tools
It makes sense to keep in mind that:
• For working with the teleplatform: there should be at least one
working place in each unit, where doctors can work with
telemedicine and have free access to it round the clock;
• It is important to keep doctors’ motivation in working with the
teleplatform (the clinic head and unit heads should look for ways
to encourage the personnel to do so)

29. In order to introduce the openMEDIS
software in a facility it is also necessary:
• To assign a specialist (1 or 2 persons)
responsible for entering information about
the facility’s equipment;
• To provide a working station;
• To timely enter and update data on medical
equipment (quarterly).

30. We would like to thank all Swiss and
Ukrainian experts who developed and
implemented the Openmedis software, all
who introduced and supported the
TELEMEDICINE in Ukraine, all who
worked in the Swiss-Ukrainian
Project for 17 years!!!

31. Today is just another day of the many
days ahead of us. But maybe all
coming days in Ukrainian medicine
depend on what we will do with you
today!