Improving Health Care in the Balkans

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Improving Health Care in the Balkans

• Using Telemedicine, Advanced Technologies, and
  Cultural Exchange Program
• as a Platform

Rifat Latifi, MD, FACSProfessor of Surgery, The
University of Arizona, Tucson, Arizona, USA
Program Director Telemedicine Program of
KosovaPresident, International Virtual e-Hospital
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Funded

• The Bureau of Education and Cultural Exchange
  of the Department of State of the United States
  of America
• ECA/PE/C/EUR-06-61
• September 6-06-August 31, 08

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Telemedicine Program in Kosova

• IVEH created 1st phase of TM program
• Telemedicine Program of Kosova (TPK) began in
  2002

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Telemedicine Program of Kosova

• Consultations
• Medical electronic library
• Medical education and informatics
• Telemedicine training center

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Objective of Current Project(1)

• Improve health care delivery in the Balkans
• Establish multi-institutional, multi-state, and
  multi country telehealth program
• Create virtual international medical education
  network

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Objective of Current Project(2)

• Create partnerships and new international
  collaboration
• Develop education and cultural exchange programs
  between the USA and the Balkans
• Provide access to distance education
  opportunities in the region

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Selected Sites

• Kosova
• Macedonia
• Montenegro
• Albania

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Goals

• Create and extend existing TM program in regional
  hospitals of Kosova
• Create a new human capacity that will lead
  telemedicine and telehealth in the Balkans
• Educate new leadership in trauma and critical
  care regionally
• Integrate technology into current clinical
  practices

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Training

• In Telemedicine, e-health and electronic
  libraries practices
• Trauma and Surgical Critical Care

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Key Leadership

• Physicians
• Nurses
• Administrators
• Technical professionals

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Program Activities

• Telemedicine, e-Health and Virtual Medical
  Library Training
• Trauma Physician Leadership Training Programs
• Trauma Nursing Leadership Training Programs
• Virtual Education Program Series
• Continuing education workshops and seminars

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Telemedicine, e-Health and Virtual Medical
Library Training 28 participants

• 1 week in Anchorage, Alaska
• 2 weeks in Tucson, Arizona
• Medical and technical personnel, medical students
  and hospital administrative staff

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Telemedicine, e-Health and Virtual Medical
Library Training

• Course focus
• Implementation
• Adoption
• Training
• Transformation
• Cultural programs and other attractions

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Telemedicine, e-Health and Virtual Medical
Library Training

• Anchorage program Implemented by AFHCAN
• Public, federally funded and private sector
  healthcare systems
• TM and e-Health Professional Training

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Alaska Schedule
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Telemedicine, e-Health and Virtual Medical
Library Training

• Arizona curriculum combination of Arizona Health
  Science Library and ATP
• Exposure to classroom-level educational programs
• Hands on activities
• Visit active telemedicine and teletrauma sites
• Exit surveys

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Trauma Physician Leadership Training Programs10
Physicians

• University Medical Center in Tucson, Arizona
• 1 Month per participant
• Medical Faculty/University Clinical Center
• Regional hospitals

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Trauma Physician Leadership Training Program

• Trauma, surgical critical, and emergency medicine
• 2 participants at a time will spend a month at
  the University Medical Center
• Two weeks rotations on trauma and surgical
  critical care services
• Teamed with physicians, residents, and nurses

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Trauma Physician Leadership Training Program

• Attend rounds, conferences, seminars, grand
  rounds, operating room
• Presentations at end of each rotation
• Work of interest or project proposal
• Exit interviews
• Certificate of participation upon completion

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Trauma Nursing Leadership Training Program

• UMC in Tucson, Arizona
• 2 weeks intensive program
• 10 Nurses
• 2 groups of 5

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Trauma Nursing Leadership Training Program

• Coordinated by IVEH site coordinator
• Led by UMC nursing leadership
• Trauma and surgical critical care management
• Followed by workshops in Kosova
• Arizona/ Kosova long term relation ship and
  partnership

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Trauma Nursing Leadership Training Programs
Follow up

• Relationship building
• Develop protocols
• Monthly programs via Telemedicine Network

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Virtual Education Program Series

• Continuously for 2 years
• Virtually
• Program participants
• Country wide audience at regional hospitals

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Virtual Education Program Series

• Practical clinical lessons
• Distance learning
• Maximize use of Telemedicine Network
• Internet based, interactive
• Real time

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Virtual Education Program Series

• Live Interactive Lectures
• Video conferencing
• Internet
• Monthly scheduled lectures
• Multimedia oriented, multidisciplinary programs

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Live Interactive Lectures

• PowerPoint and other learning materials
• Web streamed lectures world wide
• Aid in interactive classroom experience

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Live Interactive Lectures

• Program and other guest speakers from other
  academic institution
• Lectures from home site
• Lectures will be evaluated
• Lectures will be available for future use

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Existing Live Interactive Lectures of ATP
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Live Interactive Lectures of ATP

• Last stats showed 8,500 credits. Each program is
  evaluated to determine the programs relevance and
  interest. 90 answer question on ability to
  attend without Telemed as they would not have
  been able to attend

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Virtual Education Program Series

• Web based store and forward lectures
• Interactive web site
• PowerPoint aided by voice and video

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Web Based Store-and-Forward Lectures

• Program participants required to view the lecture
• Electronic sign in
• Review it any time
• Available for later use

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Web Based Store-and-Forward Lectures

• Telemedicine and e-health, trauma, critical care
  and other related topics
• Review lecture within 5 working days
• Evaluate effectiveness at end of each session

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http//video.biocom.arizona.edu/video/
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Continuing Education Workshops and Seminars

• Four 2-day workshop in Kosova
• Program participants and other in-country wide
  audiences
• Every six months
• TM, medical libraries, trauma and nursing
  clinical practices

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Continuing Education Workshops and Seminars

• One 2-day workshop in Macedonia, Montenegro,
  Albania
• In sequence after 1st workshops in Kosova
• Led by specialist physicians, nurses, and other
  experts

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Continuing Education Workshops and Seminars

• Lectures, grand rounds and interactive
  collaboration will be organized
• Introduce specifics of each program
• Scope, goals and objectives will be defined

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Expanding Telemedicine Sites in Kosova 2nd Phase
of TPK

• To 6 sites all together Gjilan, Prizren,
  Gjakove, Peje, Mitrovice, Skenderaj
• Each site is a Regional Telemedicine and
  Telehealth Center (RTTHC)
• Will have electronic classroom with 10 computers
• Will be self administrative and independent
  centers
• Develop and adopt policies and procedures of
  Telemedicine Program of Kosova

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Scientific program

• Introduce international workshops and seminars
• Establish permanent virtual educational program
• Access for healthcare providers regionally

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Timeline
Year 1

• Identify participants
• Order and install equipment
• Conduct telemedicine, telehealth and trauma
  training in US
• Secure technical component
• Establish regional workshops
• Launch Virtual Programs

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Timeline
Year 2

• Continue with VEP
• Evaluate training program
• Address problem areas
• Continue training
• Plan future activities with program participants

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Expected Outcomes

• Create leadership to advance technologies
• Improve health care delivery in the Balkans
• Enrich learning environment in the region

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What we expect from you

• Leadership
• Creativity
• Collaboration amongst yourself and in the region
• Collaboration with your new partners identified
  in the USA
• Become part of telemedicine family
• Project proposals

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What should you expect from us?

• Will be with you at all times
• You can always count on us for advise and
  collaboration
• Will give you the tools that you need to succeed
  in you country
• The program does not end August 30, 2008

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Questions?
Rifat Latifi, MD Rlatifi_at_email.arizona.edu
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