November 30 – December 3, 2010: Armenian Association of Telemedicine (AATM) conducted a pilot telemedicine project, which established and operated a fully functional telemedicine connection between a multi-profile primary health care facility in Stepanakert, the main city of Nagorno-Karabakh (an Armenian-populated territory at the eastern border of Armenia), and the central office of AATM in Yerevan, Armenia. The project, endorsed by the authorities of Nagorno-Karabakh and conducted in association with the Union of Information Technology Enterprises of Armenia (UITE) and telemedicine R&D company Symotec LLC, provided multi-specialty teleconsultations to a number of local patients with various conditions presenting a diagnostic and clinical challenge, and thus significantly optimized their management.
The telemedicine system consisted of two PC-based telemedicine stations equipped with desktop and laptop computers and simple video-conferencing devices – standard web-cameras, LCD monitors, microphones and speakers. The high-speed internet connectivity was established between the two stations providing a bandwidth of up to 2 Mbps. On the consult side the connection was managed by Armenian Datacom Company (ADC); while at the referral site the local ISP, Karabakh Telecom, provided the connectivity as an in-kind contribution to the project. The referral site was also equipped with a set of medical devices (telemedicine peripherals), which included: a 5-parameter vital sign monitor (BP, HR, SaO2, 3-lead ECG, and body temperature); a digital stethoscope with Bluetooth connectivity (3M™ Littmann®) and tele-auscultation software (Zargis Cardioscan™); ultrasound scanners with ultrasound digitizing device and sharing software (by Symotec); an ophthalmoscope (by Welch Allyn) with camera unit (AMD Telemedicine); a digital examination camera (AMD Telemedicine); and a standard 10-MP, 10-optical zoom digital still camera. For telemedicine encounter management the system utilized a dedicated server and database capabilities provided by the organizers.
The system operated throughout one working week, from November, 29 to December 3, 2010. During this five-day program direct tele-consultations were delivered to a total of 19 patients presenting to the referral site, by leading specialists in Armenia, in the following specialties: tele-cardiology, including real-time echocardiography (3 patients); tele-ophthalmology with tele-ophthalmoscopy and real-time eye ultrasound (4 patients); neck, breast and abdominal tele-ultrasound (5 patients); and tele-dermatology (7 patients). The initiative was warmly welcomed and embraced by both physicians and patients at the referral institution, who were extremely pleased and excited by the opportunity to have expert consultations with leading healthcare specialists in Armenia while at the same time remaining at their locale.
Authorities in the region are also determined to give the people of Nagorno-Karabakh a regular and fully-functional telehealth program. This pilot project is considered the first step in a long-term initiative of telehealth network establishment in Nagorno-Karabakh, which is planned to commence next year. AATM is currently preparing a working plan of deploying regular telemedicine connection between Stepanakert and Yerevan, which should be gradually expanded to incorporate other medical institutions throughout the territory. It is planned that the proposed network would include both stationary sites (one major in the main city, and a number of secondary originating sites at smaller clinics), and a mobile unit equipped with a minimum of telemedicine peripherals and satellite or wireless connectivity, which would be used to rapidly address the need for specialty expertise of the most isolated and underserved communities. AATM team is determined to do their best to bring the people of Nagorno-Karabakh modern Health ICT tools capable of revolutionizing healthcare delivery in the country.
We would like to express gratitude to our partners and collaborators, as well as to local organizers, referring physicians and consultants, internet providers, and all those who contributed to the project.
For more detailed description of the project read Full report.