Establishing a standing system for medical, psychological and social
rehabilitation of residents in the town of Beslan using the latest DiViSy
telemedicine technologies. The system will not only provide for high
efficiency of rehabilitation processes, but will become a framework for
establishing similar systems in Moscow and other regions of Russia in case
emergency situations come up.
Coordinators of project telemedicine
consultation Beslan-Moscow are: DiViSy Group, Dr. V. Kazinov and
Vladikavkaz Scientific Center of Russian Academy of Sciences, Dr. A.
Kusraev.
1. Rendering
help to the doctors at the hospital in Beslan from the leading medical
experts of institutes and clinics in Moscow in conducting medical and
psychological rehabilitation of the town residents using DiViSy
telemedicine technologies.
2. Remotely
operated further training and medical consultancy rendered to doctors at
the hospital of Beslan provided by institutes, health-care centers and
clinics of Moscow.
3. Medical
and psychological rehabilitation of patients who returned to the town of
Beslan after treatment at institutes, health-care centers and clinics of
Moscow. This rehabilitation is to be conducted with the remote
participation of doctors who were directly involved in the treatment of
those wounded and suffered while staying at Moscow clinics.
4. The
project provides for working out the principles of setting up and
operation of a similar system for Moscow and other regions of Russia in
case emergency situations come up.
In view of the decision adopted by the Russian Federation Government on
establishing a medical center of federal level in Beslan, all the
solutions and technologies within this project will be reused in future
for medical and social support to the citizens of Northern Caucasus by the
specialists of the new health-care center.
1. Conducting
telemedicine consultancy sessions between doctors at the hospital of
Beslan and doctors at leading medical institutes, health-care centers
and clinics of Moscow.
2. Conducting
rehabilitation sessions for the residents of Beslan staying temporarily
on treatment at institutes, health-care centers and clinics in Moscow
during audio-visual contacts with relatives in Beslan.
3. Conducting
psychological rehabilitation sessions for the sufferers in Beslan with
the remote participation of psychologists and psychotherapists at the
institutes and health-care centers in Moscow.
4. Conducting
medical and psychological rehabilitation of schoolchildren in Beslan
through holding joint lessons between classes at schools of Beslan and
Moscow.
5. Conducting
medical and psychological rehabilitation of citizens in Beslan during
remote sessions of cultural, educational and enlightening orientation,
as well as remotely operated festivals and contests on various fields of
life.
6. Establishing
an organizational and financial scheme for deployment, arrangement and
functioning of similar projects during liquidation of after-effects of
terrorist acts and emergency situations in Russias regions.
1. In
Moscow, abundant organizational, scientific and technological experience
of introduction and use of telemedicine technologies in the part of
developing DiViSy telemedicine systems for rendering consultancy and
remote learning has been accumulated.
2. In
1999-2001, a telemedicine network was established in Moscow, based optic
lines. Its
users are over 40 medical institutions of the Health Care Department in
Moscow, Russian Academy of Medical Sciences and RF Ministry of Health
Care.
3. At
the hospital in Beslan, a telemedicine network has been set up with
DiViSy TM21 systems introduced with the participation of the Vladikavkaz
Scientific Center of Russian Academy of Sciences and DiViSy Group
Companies.
4. During
2002-2004, experts in the DiViSy Group Companies, Vladikavkaz Scientific
Center of Russian Academy of Sciences, and the Republican fund of
obligatory medical insurance held a number of events aimed at training
the health-care organizers and medical experts of the North
Ossetia-Alania Republic to using telemedicine technologies in the
clinical practice.
5. An informal Community of
enterprises and organizations of Moscow and North
Ossetia-Alania Republic was set up for the project implementation,
comprising the following parties:
From the part of the North
Ossetia-Alania Republic:
- Vladikavkaz
Scientific Center of Russian Academy of Sciences coordinator,
- Republican
fund of obligatory medical insurance,
- Hospital
in the town of Beslan,
The republican medical Academy and the republican
Hospital are also assumed to take part.
From the part of Moscow city:
- DiViSy
Group (telemedicine technology and equipment) coordinator,
- Russian Academy of Medical Sciences with the
subordinate organizations: Institute of Surgery named after A.V.
Vishnevsky, Russian Academy of Medical Sciences; Institute of
Neurosurgery named after N.N. Burdenko, Russian Academy of Medical
Sciences; Institute of Social and Forensic Psychiatry named after V.P.
Serbsky, Russian Academy of Medical Sciences;
- Gascom
OJSC satellite channel;
- Comcor
OJSC optic lines;
- Rostelecom
OJSC is also assumed to take part, as well as the following medical
institutions: Moscow Scientific Research Institute of Pediatrics and
Pediatric Surgery at RF Ministry of Health Care, Moscow Scientific
Research Institute of Pediatric Urgent Surgery and Traumatology,
Institute of Cardiovascular Surgery named after A.N.Bakulev, as well as
other medical institutions if necessary.
1. At
the hospital in Beslan town, a local telemedicine network was set up,
with DiViSy TM21 telemedicine systems installed, as well as medical and
engineering personnel having undergone respective training.
One DiViSy TM21 telemedicine system has
been installed at the Medical Academy.
Contractors: DiViSy
Group, Vladikavkaz Scientific Center of Russian Academy of Sciences,
Republican fund of obligatory medical insurance, Hospital in Beslan.
2. The
Yamal-24 satellite station and a 2 MB/s satellite communication link
have been set up.
Contractors: Gascom
OJSC, Vladicaucases Scientific Center of Russian Academy of Sciences,
Republican fund of obligatory medical insurance, DiViSy Group, Hospital
in Beslan.
3. Works
on testing the fiber-optical telemedicine network of Moscow, additional
connection of several medical institutions to the network, as well as
commutation of the telemedicine network to the satellite communication
channel have been conducted.
Contractors: DiViSy
Group, Comcor OJSC, Gascom" OJSC, Department of Information Technologies
at the Russian Academy of Sciences.
4. Works
on testing the set up global telemedicine network have been conducted by
medical institutes, health-care centers and clinics of Moscow.
Contractors: DiViSy Group,
Comcor OJSC, Gascom" OJSC, Department
of Information Technologies at the Russian Academy of Sciences.
5. Telemedicine systems
DiViSy TM21 have been installed at the Institute of Surgery named after
A.V. Vishnevsky, Russian Academy of Medical Sciences, at the Institute
of Neurosurgery named after N.N. Burdenko, at
the Institute of Social and Forensic
Psychiatry named after V.P. Serbsky, Russian Academy of Medical
Sciences, and Moscow Scientific Research Institute of Pediatric Urgent
Surgery and Traumatology, with connection to the global telemedicine
network implemented, and the required specialists having undergone
respective training.
Contractors: DiViSy Group, Vladikavkaz Scientific
Center of Russian Academy of Sciences, Department of Information
Technologies at the Russian Academy of Sciences.
1. On
24 September 2004, a telemedicine session between the Hospital in Beslan
and the Institute of Surgery named after A.V.Vishnevsky was held using
DiViSy TM21 systems. From the part of the Hospital in Beslan, the
following participants took part in the telemedicine session: Prof. V.N.
Karginov, physician-in-chief; V.Ch.Baskaev, deputy physician-in-chief;
chiefs of departments and leading doctors of the hospital; as well as
the following project participants Prof. A.G.Kusrayev, Chairman of the
Vladicaucasian Scientific Center at the Russian Academy of Sciences, and
A.V.Pliev, chief of the IT department at Republican fund of obligatory
medical insurance. From the part of Moscow city, the following persons
took part in the telemedicine session Prof. D.D.Venediktov, head of the
IT department at the Russian Academy of Medical Sciences, corresponding
member of the Academy; Prof.
O.V.Krastin, deputy director of the Institute of Surgery named after
A.V.Vishnevsky; Prof. A.V.Pokrovsky, head of department at the
Institute, academician of the Russian Academy of Medical Sciences;
V.A.Kazinov, director general of DiViSy group of companies. During the
telemedicine session, major organizational and methodological issues of
the initial stage of the project implementation were discussed.
Both parties noted to the vital
importance of permanent operation of the project and its paramount
significance for the rehabilitation of Beslan residents.
2. On
24 September 2004, upon completion of the telemedicine session, a
telemedicine consultancy was rendered to two patients staying on
treatment at the hospital in Beslan.
Consultation No.1. A woman of 30 years old, arrived
with a mine/explosive injury, splinter wound in the neck, back, right
ankle, first finger of the right hand. Rupture
of the left eardrum. Brain
shell shock, post contusion neuritis of the auditory nerve on the
right.A splinter in the neck is 3 mm from the edge of the jugular vein.
Recommendations from a vascular surgeon
are needed.
Consultation No.2. A 20-year-old woman, at 24th
week of pregnancy. Arrived
with multiple missile wounds in the lower part of both legs.
To remove the splinters, X-ray
diagnostics contra-indicated during pregnancy is needed.
What are the surgeons recommendations?
Academician A.V.Pokrovsky held both consultations.
During the discussion of situations and examination of transmitted data,
recommendations on further steps of physicians in charge were stated.
Currently, based on the results of
following the recommendations worked out in the course of telemedicine
consultation, one of the lady patients is going to be sent to the
Institute of Surgery for a surgical operation at the department of
academician A.V.Pokrovsky.
3. On
28 September 2004, a telemedicine session was held from the Institute of
Neurosurgery named after N.N.Burdenko with V.Ch.Baskaev, deputy
physician-in-chief at the hospital of Beslan. From the part of the
Institute, there were Ya.K.Gasanov, deputy director, and M.A.Shifrin,
head of medico-mathematical laboratory. During the telemedicine session,
issues of organizational and medical interaction were discussed.
Currently, at the Institute of
Neurosurgery there are 8 patients from Beslan staying on treatment.
According to the agreement reached, a telemedicine session would be held
on 30 September between deputy director of the Institute, corresponding
member of Russian Academy of Medical
Sciences, A.A.Potapov, and deputy physician-in-chief
of the hospital in Beslan, V.Ch.Baskaev, with discussions of treatment
progress for each patient.
4. During
the first telemedicine consultations, deputy physician-in-chief of the
hospital in Beslan spoke out a wish of holding otolaryngology
consultations for patients at day-and-night and outpatient hospitals who
suffered barotraumas. On 29 September
2004, such a consultation was held. From
the part of the Moscow city, the head of otolaryngology, corresponding
member of Russian Academy of Medical Sciences, professor G.Z. Piskunov,
held the consultation. He consulted three complicated patients with
barotraumas of various severities. During
the consultations, images of endoscopic data of patients with results of
graphic examinations were transmitted. From
the part of hospital of Beslan, during the consultation there took part
the head of otolaryngology department, N.I. Kulagin. Professor G.Z.
Piskunov discussed the treatment progress for each sufferer in detail
with doctor N.I.Kulagin, and in the course of consultations outlined the
design of prosthetic eardrums, commented the technology of its
installation and use. In
view of the lack of otolaryngological surgery at the hospital in Beslan,
an agreement was reached on that one of the lady patients would undergo
surgical operation in Moscow at the G.Z. Piskunov clinic. Doctor N.I.
Kulagin noted that these recommendations and methods of prosthetics and
treatment would be extended to other patients of similar wounds. From
the part of Beslan town, present were the minister of Health Care in the
Republic of North Ossetia-Alania, Prof. A.V. Reutov, head of the
Republican fund of obligatory medical insurance, Mr. T.M. Demurov, and
chairman of the National Scientific Center, Mr. A.G. Kusrayev.
5. According
to the preliminary agreement, on 30 September 2004 a telemedicine
consultation was held between the deputy director of Institute of
Neurosurgery and corresponding member of the Russian Academy of Medical
Sciences, professor A.A. Potapov, and deputy physician-in-chief of the
hospital in Beslan, V.Ch. Baskaev, with discussions of treatment
progress for each patient staying at the Institute of neurosurgery.
Professor A.A. Potapov informed V.Ch.
Baskaev in detail on the progress and treatment and condition of each
patient. An
agreement was reached on that a telemedicine session with relatives in
Beslan would be arranged for some patients.
6. At 01 October 2004 was
telemedicine consultation from Institute
of Social and Forensic Psychiatry named after V.P. Serbsky, Russian
Academy of Medical Sciences. In this
consultation toke part of director, the academician of Russian Academy
of Medical Science T.B. Dmitrieva, the deputy director, professor Z.I.
Kikelidze, and also of the assistant to the head physician of Beslan
hospital V.Ch. Baskaev. During consultation both parties have expressed
unanimous opinion on necessity of constant interaction with use of
telemedical technologies. The academician of Russian Academy of Medical
Science, professor T.B. Dmitrieva said that psychological rehabilitation
of the citizens injured of act of terrorism has noted extreme importance
of the telemedical project. Professor Kikelidze Z.I. has lead remote
instructing on a question of interaction of administration of hospital
and various religious faiths. All instructions were closely listened and
accepted to performance by doctors of Beslan hospital.
7. At 03 October 2004 was a
telemedicine consultation of adults and children suffering heart
diseases. Telemedical consultation of leading experts of Institute of
cardiovascular surgery by N.N. Bakuleva: Dr. Med. A.A. Svobodnov, and
the doctor of functional diagnostics E. Tumeneva. During one session
were consulted 6 patients, from which two children by age 2,5 months and
7 years. During consultations from Beslan hospital was ultrasonic
research of heart of patients, which in real time was transferred to
Moscow. On each patient recommendations of therapeutic or surgical
character were given. In connection with absence cardiovascular in
republic, the decision on realization of operations in Moscow is
accepted.
After these consultations, was
meeting of the patients who are taking place on treatment in institute
of neurosurgery with relatives in Beslan.
8. At 04 October 2004 telemedical
system DiViSy TM21 is established in the Moscow scientific research
institute of urgent children's surgery and traumatology (the director of
scientific research institute, professor L.M. Roshal). Professor L.M.
Roshal has stated a wish that telemedical consultations were carried out
not only with Beslan hospital, but also with children's clinical
hospital in Vladikavkaz.
9. At 07 October 2004 in
Presidium of the Russian academy of medical sciences was held
conferences on the analysis of works of the telemedical project Beslan -
Moscow. Doctors of hospital of have taken part in this conference within
the framework of telemedical consultations. All participants of this
conference note that this project is vital importance for processes
rehabilitation of Beslan citizens.
10. At 14 October 2004
telemedicine consultation between the Moscow scientific research
institute of urgent children's surgery and traumatology and clinical
hospital of Beslan has taken place. On the part of Moscow consultation
was carried out by professor Roshal L.M., on the part of Beslan the
deputy minister of public health services РСО-А Tsidaeva T.I., the head
physician of hospital have taken part in consultation Karginov V.P.
managing faculty of obstetrics and gynecology of the North-Osetiya
medical academy of Tsallagova L.V., the head physician of a maternity
hospital 1 of VladikavkazEsaulova
S.V., the head physician of a maternity hospital 2 of Vladikavkaz
of Gasieva S.M. and the regional podiatrist of Right-bank regional
clinical hospital Fedoseenko A.B. During consultation organizational
questions of rendering of the medical and humanitarian help to injured
children, questions of creation of the new medical center in Beslan, and
also practical questions of children's public health services were
considered. The parties have agreed upon the order of the further work
on carrying out of telemedicine consultations and remote training on a
direction of children's public health services.
11. On 25 October 2004, at the request of doctors of
Republic North Ossetia-Alania Republic is lead lecture on gynecology
from the Central clinical hospital of Ministry of Railways of the
Russian Federation. Lecture professor A.L. Tikhomirov, and also doctors
Central clinic of Ministry of Railways. At hospital of Beslan there were
doctors-gynecologists of various hospitals RSO-A. During lecture unique
operation on myoma embolisation of the uterus, lead under the x-ray
control has been shown. The given medical direction is actual not only
for doctors of hospital of Beslan, but also for doctors of other
hospitals of republic.
1. The telemedicine project Moscow-Beslan already in
an initial stage has proved the importance and efficiency in business of
rendering of medical aid and rehabilitation of inhabitants of Beslan. Up
to now the project is realized only with use of financial assets of
companies-participants of the project.
2. For maintenance of constant functioning the
project his constant financing, at least within two years is necessary.
3. Within the framework of the given project it is
expedient to carry out works on working off of principles of expansion
and functioning of similar projects at occurrence of extreme situations
in other regions of Russia or in other countries.
Now the first stage within the framework of which the
information and communication environment of telemedicine consultations
is created is realized, telemedicine systems DiViSy TM21 are established
and principles of functioning of the project are fulfilled.
On results of performance of the first stage of the
project, in view of the saved up experience and the formulated technical
requirements, the question on creation of the integrated system for fast
expansion of telemedicine consultations in conditions of liquidation of
consequences of acts of terrorism and extreme situations in regions of
Russia or in other countries should be considered. Such system can solve
and other practical problems of removed medical diagnostics,
rehabilitation and remote medical education. Within the framework of the
centralized financing, the question on continuation of the given project
and expansion of sphere of his use in educational, cultural and other
directions of ability to live of the city of Beslan can be solved.
For this purpose it is necessary to perform
additional works on creation of a communication network to Beslan with
connection of schools, cultural and educational establishments,
municipality and other organizations, to establish additional systems of
remote education DiViSy ED21, DiViSy LC21 and others, in the given
organizations, to develop a corresponding supply with information and
professional educational techniques.
Telemedicine Project
Beslan-Moscow based DiViSy TM21.
Telemedicine consultation of
professor Piskunov G. by otolaryngology for patients with barotraumas
using DiViSy TM21.
At the first picture
consultation in process real endoscopic diagnostic of the ear path. At
the second picture scheme of artificial limb for eardrum.
Telemedicine consultations of professor Roshal L.M.
with group of doctors and heads of children's public health services
North-Osetiya clinics and medical academy, and also medical
institutions of Vladikavkaz and Beslan.
Remote lecture of professor Tikhomirov A. by
gynecology from Moscow to Beslan using DiViSy TM21.
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