ARMTELEMED congress will give an important stimulus to the development of telemedicine and eHealth in Armenia – Dr. Georgi Chaltikyan

- ААТМ is a non-governmental organization established in 2008 with a mission to assist to the development of telemedicine and eHealth (also known as Health ICT) in Armenia, to ensure wider use of Information and Communication Technologies in medicine and healthcare.

eHealth is a rather broad concept describing the use of all electronic and digital applications to support healthcare delivery, administration, education and research, while the main focus of telemedicine is the provision of clinical care remotely, when the patient and the physician or two or more physicians are separated by a considerable distance.

Today there are multiple telemedicine programs and networks operating all over the world. Highly specialized clinical care is typically concentrated in large metropolitan areas, while people living in remote especially rural communities often lack local specialist physicians and often need to travel long distance to see a narrow specialist. Telemedicine is capable of solving that problem.

Telemedicine and eHealth applications are also critical for the continuous medical education and professional development of physicians. Consider a general practitioner working in a remote or isolated area of Armenia who, with the help of telemedicine tools, is able to consult with a specialist working in a major city in the country or even outside Armenia to get help in treating patients and also to receive latest news and updates on patients’ management.

- What kind of remote patient-doctor interaction exists today? To what extent can it replace the traditional clinical care?

- Today, healthcare delivery becomes more and more dependent on internet and digital technologies. Here is a typical example: an ECG (electrocardiogram) can now easily be obtained using a special digital device in the comfort of patient’s home and sent to the cardiologist via internet or other telecommunication link. The doctor can see the ECG trace, for example, on his/her smartphone while being on a business trip, on board a plane, or even on vacation, and can “consult” the patient or provide advice. By the way, talking about smartphones it should be noted that today’s telemedicine is increasingly using mobile devices and wireless connections.

- What the role of telemedicine might be in surgery? Is it more of a science fiction or a matter of remote future?

- The surgery is the most conservative field of healthcare in this regard. If non-surgical care, such as medication treatment or diagnostic services (such as reading an X-ray film or a computed tomography image) can easily be provided at a distance using contemporary digital technologies, it is much more complicated with regard to a surgical procedure. Nevertheless, even in this field the first steps have already been done.

We are speaking about surgical procedures performed with the help of special surgical robots, when the surgeon, using joystick-like manipulators, controls robotic “arms” holding the surgical instruments. Such robots are widely used today in developed countries; in some countries, like the USA, robotic-assisted surgeries have largely become a standard of treatment for some conditions, such as removal of the prostate for example.

Even though the surgeon, who is operating using the robot, is in the same operation theater, yet is physically separated from the patient and controls the procedure from the manipulating console using the “joysticks”. Hence, the same can well be achieved with the surgeon seating not in the same room but a thousand miles away if the manipulating console is linked to the robot “arms” via a high-speed internet connection just like a French surgeon, professor Jacques Marescaux from the European Institute of Telesurgery (EITS) did back in 2001, when he operated from New-York on a patient located in Strasburg. However, such cases are still considered largely experimental.

- The most dramatic telemedicine experience in Armenia dates back to 1988, when in the aftermath of the disastrous earthquake American doctors consulted their Armenian colleagues through a satellite connection established by NASA (the Spacebridge project). That gave Armenian specialists unique experience. To what extent is that experience applicable today?

- Indeed, Armenia acquired a definite telemedicine experience rather early, when telemedicine technologies were in infancy even in developed countries. Unfortunately, just as it often happens, that experience came as a result of tragic circumstances. It should be noted that telemedicine today is regarded as a powerful tool especially in the settings of natural or man-made calamities.

In the years following the earthquake telemedicine in Armenia has not been developing to any serious extent due to many understandable reasons (such as social and economic breakdown, lack of financing and investments etc). In fact, one of the major prerequisites for the establishment of our association was the significant advancement of the Information and Communication Technologies field in the country in the last 10 years.

Today, it is still premature to speak of significant developments in the field of telemedicine and eHealth in Armenia. There are several programs fueled by a group of enthusiasts. Some healthcare institutions have videoconferencing equipment and external (international) partners, who episodically consult their patients. All these are, however, little more than rare examples. We do not yet have sustainable regular telemedicine and eHealth programs or services.    

- What is AATM doing to promote systemic development of telemedicine and eHealth in Armenia?

- We are trying to intensify and support the use of telemedicine and eHealth in the country. The association has already had first experience with own telemedicine programs. The first pilot project supported by USAID grant was conducted in 2010. Within the framework of the project leading specialists from Yerevan provided clinical consultations to patients presenting to a primary healthcare center in Jrashen village of Lori region (north of Armenia). The project was followed by a series of similar initiatives.

Our vision is to establish a nationwide telemedicine network connecting all hospitals, clinics and rural out-patient primary care facilities throughout Armenia, giving patients and their managing physicians фn opportunity to consult with specialists country-wide whenever needed.

Another goal is the development of an Armenian eHealth portal – a single universal electronic interface accessible to and used by both patients and healthcare professionals. I am quite sure we will witness serious progress in the above areas in the forthcoming years.

Our association is the national member of the International Society for Telemedicine and eHealth from Armenia, thus representing our country within that global structure. It is also worth mentioning that thanks to association’s vast international relations and important collaborations built worldwide, AATM today offers its member physicians as well as presenting patients an opportunity to consult with leading specialists from around the globe, primarily in Europe and North America.

- Back to the congress: who is going to participate and what will be the major topics of discussion?

- “ARMTELEMED” International Congress on Telemedicine and eHealth is going to be the first event of that format, scope and magnitude not only in Armenia but also in the region. The major goal of the meeting is to bring together in the single forum all those interested in telemedicine and eHealth from the domains of healthcare, Information and Communication Technologies as well as from the government and other regulatory bodies to boost development of the field in Armenia.

The congress will feature keynote presentations by leading international specialists with immense experience of developing telemedicine and eHealth. Many of them are truly pioneers and founders of the field worldwide, who in their own (and other) countries followed the entire pathway of telemedicine development and installation of necessary infrastructure. Due to active international policy of AATM and global partnership created, these experts consented to visit Armenia and share their invaluable experience with the congress audience. It is further expected that the congress will be attended by more than 300 delegates.

The highlights of three days of congress work will be widely disseminated among telemedicine and eHealth specialists around the world, making Armenia more recognizable in the field. That will also allow local organizations, companies and professionals involved or interested in the telemedicine domain to present themselves on the international arena. In my opinion, the event will become an important impetus to further development of telemedicine and eHealth in Armenia: it will impart new momentum to the field and facilitate inflow of investments.