the baltic information network
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Baltic International Telemedicine NET work- BIT NET and
Future Vision
A. Veinbergs MD, U. Jaspers
Paul Stradins University Hospital
Riga, Latvia
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Purpose of project
• The main objective for the BIT NET project was to produce a reference for telemedical networks between the Uppsala University Hospital and the hospitals within the Baltic countries
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• The project includes 4 countries, 14 towns, 23 hospitals, 7 industrial partners and 4 clinical entities:– Clinical Neurophysiology– Diagnostic Radiology– Radiophysics / Oncology– Videoconferences
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BIT NETBIT NET
EST
LV
NeurophysiologyTumour treatmentRadiologyVideoconference
LT
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Pauls Stradins UHChildren`s UH
Liepaja CHLiepaja OH
Daugavpils CH
Ventspils SH
Telemedicine in Latvia
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Impact on Latvian Health Care
• BIT NET project implementation in Latvia improved healthcare in different fields of medicine
• Today we have a network between P. Stradins University Hospital and several large hospitals in the cities of Ventspils, Daugavpils and Liepaja
• Modern telecommunication have great potential for improving quality of medical care by making specialist knowledge and judgement available for patients far away from highly specialized medical centers
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Clinical Neurophysiology
• BIT NET made possible the installation of 7 modern EMG machines, one EEG machine and video stations in Estonia, Latvia and Lithuania
• By transferring recorder signals to Uppsala, a continuous feedback has helped improve knowledge and the quality of general understanding
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Neurophysiology
• Keypoint equipment installation was instrumental in the organization of a peripheral nerve investigation laboratory possible to organize in Paul Stradins UH
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Radiology
• The aim of this project was to increase teleradiology and improve diagnostic accuracy between the hospitals in Estonia, Lithuania and Latvia as well as between these Baltic hospitals and Uppsala
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Dry Star 3000MagicView CT/MR
Somatom AR.SP Magnetom Symphony
E-cam
Elegra
I-con Pworkstation
ControlconsoleControlconsole
BITNET Stradins/Uppsala Hospitals
SIEMENS
NIXDORF
RIS-PC
WEB ServerRaid
ServerFilm-Digitizer
ISDN
Uppsala Hospital
Film-Digitizer
SIEMENS
NIXDORF
RIS-PC
WEB PC
Lin.Acceler
Daugavpils Oncology
Centre
Controlconsole
Daugavpils Central
Hospital
Film-Digitizer
SIEMENS
NIXDORF
RIS-PC
WEB PC
Lin.Acceler
Film-Digitizer
SIEMENS
NIXDORF
RIS-PC
WEB PC
Lin.Acceler
Liepaja Oncology
Centre
ControlconsoleGE Hi Speed
Liepaja Central
Hospital
ControlconsoleBalance
PICKER DFRGE Angio Advantx
Interface
Ventspils hospital
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AGFA archive WEB 1000
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Irradiation Theraphy
• Great improvement was attained in the field of irradiation therapy
• After installation of the Helax 3D dose planning system at the P. Stradins UH the oncology patients are able to administer their own medication
• Today dose planning also is practiced in Liepaja Oncology Hospital
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Teleoncology
P.STRADINS UH
3D DOSE PLANNING SYSTEM HELAX
LIEPAJA ONCOLOGY HOSPITAL
DAUGAVPILS ONCOLOGY HOSPITAL
UPPSALA UH
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Irradiation Theraphy
Lin.Acceler
HELAX 3D
MagicView 1000
Somatom AR.SP
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Video - conference
• Achieved results: 15 videoconference-rooms were installed in hospitals of the four participating countries:– Estonia - 5– Latvia - 5– Lithuania - 2– Uppsala County - 3
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Type of meeting
15,20%
48,30%
24,70%
11,20%
7,90%
10,10%
4,50%
0,00% 10,00% 20,00% 30,00% 40,00% 50,00% 60,00%
Clinical round
Education
Consultation
Administrative meetings
Demonstration
Test
Other
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Videoconference• Percutaneous Vertebroplasty –
indications, technique and complications K.Kupcs, Riga
• MR angiography and examination of the heart
N.Valaviciene, Vilnius• Fine needle aspiration biopsy and the
value of ancillary methods H.Domanski, Lund
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Teleconsultations
• Today we have regular teleconsultations between P. Stradins UH and Uppsala UH
• Teleconsultations also take place between P.Stradins UH and Ventspils, Daugavpils and Liepaja hospitals
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International Teleconsultations
• UPPSALA, SWEDEN
• MOSCOW, RUSSIA– BAKOULEV SCIENTIFIC CENTER– BURDENKO INSTITUTE OF
NEUROSURGERY
• TORONTO, CANADA
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24
38
12
8
22
10
4
20
22
0
10
20
30
40
50
60
70
INTERNATIONAL LOCAL
LOCAL 38 8 10 20 2
INTERNATIONAL 24 12 22 4 2
P.STRADINS HOSPITAL
CHILDREN'S HOSPITAL RIGA
LIEPAJA HOSPITAL
VENTSPILS HOSPITAL
DAUGAVPILS HOSPITAL
Teleconsultations per 2002 year
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Development of the Unified Telemedicine Information
System in Latvia
2004-2008
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Telemedicine in Latvia /Riga/
Existing system
P. Stradins University Hospital
Children`s University Hospital
Future partners
Riga 1. Hospital
Traumatology & Ortopedics Hospital
Psychiatry Hospital
Riga 7. Hospital
Latvian Oncology Center
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Telemedicine in Latvia
Existing system
Riga
Ventspils
Liepaja
Daugavpils
Dobele
Cēsis
Future partners:
Dobele
Jelgava
Jekabpils
Valmiera
Cesis
Rezekne
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Telemedicine in Latvia
International consultations
•Direct access to physician
• Safety travelling arround the Latvia
•…
International consultations
• “2nd opinion”
• Improvement of diagnostics
•…
Insurance companies
• Data
• Billing
•…
Health Compulsary Insurance State Agency HCISA
Branches…
Family physician
• Access to images
•Access to medical information
• Discharge chart
• Diagnosis
•…
Citizen and imigration departament
• data of citizens
• data of foreigners
Teleconference
• Latvia
• International partners
•…
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Telemedicine in Latvia
P.Stradins University Hospital
• High level medical staff
• Top level medical tehnology
•…
Regional hospital
• Examinations
• Difficult case
•… Patient transport to Regional Hospital …
Disaster Center of Medicine
• Team
• Insufficient information
•…
Disaster Center of Medicine
• Team
• Unnecessary trip, treatment at Regional Hospital
•…
Existing system No high level medical specialist assistance in regional hospitals
Complicated cases are diagnosed by less specialized physicians
Disaster Center of Medicine personnel need to be dispatched to region
Transportation of patient to specialized hospitals necessary
INEFFECTIVE USE OF RESOURCES
Accident;
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Telemedicine in Latvia
Regional Hospital
• examination
• diagnosis via telemedicine
•…
TELEMEDICiNE CO
NSULTATION
Future: Right diagnosis via telemedicine
Saving of time as critical factor for live
Saving of moeny for specialist team trip
Medical secvice improvement in whole country
Usage of modern technologies open the door to new oportunities…
Disaster Center of Medicine
• Team
• usless trip, treatment in regional hospital
•…
Patient transport to Regional Hospital
•…
Accident
Disaster Center of Medicine
• Team
• Insufficient information
•…
P.Stradiņa University Hospital
• top high medical staff
• top level medical tehnology
•…
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Thank You for Attention!