APRIL 12, 2010: AATM funded by a USAID grant via Primary Health Care Reform (PHCR) project in Armenia, officially launched its first telemedicine program connecting a rural primary health care facility to the Association’s headquarters in Yerevan, for provision of specialty tele-consultations to the population of the area.
Armenian Association of Telemedicine (AATM) is implementing its pilot project, supported by a grant through the USAID-funded Primary Health Care Reform (PHCR) project, titled “Capacity Building of the Armenian Association of Telemedicine to Result in Improved Primary Health Care Services in Armenia”. The project officially commenced on March 1, 2010, after the contract was signed between the AATM and PHCR, and is planned to finish by the middle of June 2010. It consists of four major segments: capacity building and expansion of the Association; research on the role of Telemedicine and eHealth in improving quality, accessibility and cost-effectiveness of health care system in Armenia; demonstrational telemedicine model; evaluation and dissemination of the outcomes, including public awareness campaign.
Armenia has relatively developed primary health care network; however, shortage of specialist physicians in rural areas, as well as limited funding, frequently hamper maintaining appropriate quality of care at the community level. As a result, considerable numbers of patients from rural areas seek specialty consult in large tertiary centers in Yerevan, which is associated with significant direct and indirect costs, and frequently results in delays in diagnosis and initiation of treatment. Telemedicine has potential to improve functionality of the primary health care services in rural areas of the country, to tackle health care disparities between metropolitan and rural regions, and to increase cost-effectiveness of the primary care system overall.
The actual telemedicine system (the “demo model”, or prototype of the telemedicine network) consists of two PC-based stations (the “referral station” at a rural primary care facility in a village north of Yerevan serving ca 6,000 population, and the “consult station” at the AATM’s central office in downtown Yerevan), equipped with simple video-conferencing devices and commercially available medical peripherals, connected via high-speed internet (fiber-optic and ViMax) providing 5/2 Mbps of bandwidth (See the map). The medical peripherals include: 5-parameter vital sign monitor (BP, HR, SaO2, 3-lead ECG, and body temperature); digital stethoscope with Bluetooth connectivity (3M™ Littmann®) and tele-auscultation software (Zargis Cardioscan™); standard 10-MP, 10-optical zoom digital still camera; and an ultrasound device with ultrasound digitizing and sharing software (Symotec). As telemedicine encounter management software the system utilizes Microsoft SharePoint™.
Patients presenting to the referral site are examined and triaged by primary care physicians, and scheduled for tele-consults. Patients’ data, including demographics, history and physicals, lab and instrumental studies, are either recorded for subsequent review by the specialist, or transferred live when appropriate. Direct tele-consultations are available in the following specialties: cardiology, pulmonology/respiratory medicine, endocrinology, rheumatology, gastroenterology, dermatology, neurology, general surgery, urology, reproductive health, and pediatrics; tele-consultations also provide the primary care physicians with CME content in verbal, electronic or printed format.
During the period of operation of the system and upon completion systematic assessment is to be conducted, evaluating project’s feasibility and impact on primary health care. Based on results of comparable projects in other countries, it is expected that the system will allow reducing by 60-70% patients’ visits to remote specialists, allowing timely diagnosis, improving treatment outcomes, increasing patients’ satisfaction, ensuring primary care personnel’s professional growth, reducing health care costs, and contributing to overall development of target rural community.
AATM’s partners in this project are: Ministry of Health of Republic of Armenia; Primary Health Care Reform (PHCR) project; Union of Information Technology Enterprises (UITE) of Armenia (professional association of Armenian ICT industry); Armenian Medical Association (ArMA); Microsoft-Armenia; Sourcio (IT company with eHealth experience); Cornet (ISP company); GNC Alfa (leading fiber-optic provider); and Symotec (telemedicine R&D company).
For more information on the project visit its dedicated web-page.