The Baltic Information Network

Baltic International Telemedicine NET work- BIT NET and

Future Vision

A. Veinbergs MD, U. Jaspers

Paul Stradins University Hospital

Riga, Latvia

07/04/23 Brussels "e-Health" 2

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


• The project includes 4 countries, 14 towns, 23 hospitals, 7 industrial partners and 4 clinical entities:– Clinical Neurophysiology– Diagnostic Radiology– Radiophysics / Oncology– Videoconferences


BIT NETBIT NET

EST

LV

NeurophysiologyTumour treatmentRadiologyVideoconference

LT


Pauls Stradins UHChildren`s UH

Liepaja CHLiepaja OH

Daugavpils CH

Ventspils SH

Telemedicine in Latvia


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


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


Neurophysiology

• Keypoint equipment installation was instrumental in the organization of a peripheral nerve investigation laboratory possible to organize in Paul Stradins UH


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


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


AGFA archive WEB 1000


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


Teleoncology

P.STRADINS UH

3D DOSE PLANNING SYSTEM HELAX

LIEPAJA ONCOLOGY HOSPITAL

DAUGAVPILS ONCOLOGY HOSPITAL

UPPSALA UH


Irradiation Theraphy

Lin.Acceler

HELAX 3D

MagicView 1000

Somatom AR.SP


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


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


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


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


International Teleconsultations

• UPPSALA, SWEDEN

• MOSCOW, RUSSIA– BAKOULEV SCIENTIFIC CENTER– BURDENKO INSTITUTE OF

NEUROSURGERY

• TORONTO, CANADA


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


Development of the Unified Telemedicine Information

System in Latvia

2004-2008


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

http://www.rigamap.lv/index.phtml?lang=e&l=3&fl=2&fx=250&fy=277



Existing system

Riga

Ventspils

Liepaja

Daugavpils

Dobele

Cēsis

Future partners:

Dobele

Jelgava

Jekabpils

Valmiera

Cesis

Rezekne



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

•…



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

•…


• 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;



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…


• Team

• usless trip, treatment in regional hospital

•…

Patient transport to Regional Hospital

•…

Accident


• Team

• Insufficient information

•…

P.Stradiņa University Hospital

• top high medical staff

• top level medical tehnology

•…

Thank You for Attention!

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