Networking in Eastern Networking in Eastern Networking in Eastern - PowerPoint PPT Presentation

Networking in Eastern Networking in Eastern Networking in Eastern Networking in Eastern Europe and Central Asia. Europe and Central Asia. p p Telemedicine perspective Telemedicine perspective www.ceengine.eu St ll Atki Stella Atkins, Simon Fraser University Si F U i it Jacek Gajewski, CEENet

http://www.ceengine.eu CEENet = Association of 22 NRENs CEENet Association of 22 NRENs P Projects – mainly of regional scope: j t i l f i l � 8x EU (Porta Opt., CAREN FS, BSI, CEENGINE) � 15x NATO (e.g. Virtual Silk HWY, Infrastructure 15 NATO ( Vi t l Silk HWY I f t t for Education&Research, CERTs, telemedicine) � Cisco OSI UNDP (Cisco Academy NREN supp ) � Cisco, OSI, UNDP (Cisco Academy, NREN supp.) � ITU (African NRENs) Educational/Scientific Workshops Educational/Scientific Workshops � Technology (yearly) � Management/Policy (yearly) Management/Policy (yearly) � Distance Education

http://www.ceengine.eu CEENGINE – FP7 3-years project CEENGINE FP7 3 years project � CEENGINE Objectives: j coordination of e-infrastructures activities build more e-infrastructures in the region 1 raising awareness & technical know-how g 2 train staff, prepare for dark fibre and GEANT , p p fostering cooperation and GEANT extension organize NRENs into regional projects g g p g p j 3 3 intensification of dissemination of e infrastructures intensification of dissemination of e-infrastructures 4 4 Detect and enable users’ communities Detect and enable users communities

http://www.ceengine.eu New Areas? New Topics? New Areas? New Topics? Global Outreach Concept for CEENet Find management Define new charter procedures and (wider geographical funding sources for funding sources for scope new types of scope, new types of activities) sustained operations

http://www.ceengine.eu NATO Virtual Silk Highway Project Silk-1 2002-2006, Silk-2 2006-2010

http://www.ceengine.eu Silk project connected NREN NOCs in 9 capitals; X X X X X X X X X X

http://www.ceengine.eu CEENet & Silk project created NRENs CEENet & Silk project created NRENs � In 2002 CEENet created “NREN Creation Handbook” and organized “NREN Creation (flying) workshop” � Silk requested one NREN per country y � Following NRENs (usually in form of Association) have been created: Kabul Association) have been created: Kabul University Network, ARENA and AS-NET, AZRENA and AzEduNet, GRENA, AZRENA and AzEduNet, GRENA, KAZRENA and KazGrid, TARENA, TURENA, UZSCINET UZSCINET

http://www.ceengine.eu Black Sea Interconnection BSI Project Black Sea Interconnection BSI Project � In 2009 Caucasus countries changed to fiber in framework of EU-funded BSI project �

http://www.ceengine.eu Central Asian Research and Education Network (CAREN) � In 2010 KG, TJ and TM were linked to GEANT PoP in China in framework of EU- funded CAREN Project. KZ and UZ are likely to join soon.

http://www.ceengine.eu CAREN as platform for regional cooperation ( (seismology, telemedicine, climate change, i l t l di i li t h water resources management, GRIDs, etc.)

http://www.ceengine.eu UZSCINET - the best developed NREN in CA UZSCINET the best developed NREN in CA

http://www.ceengine.eu UZSCINET cooperates closely with telemediciners, e.g. build LAN Institute of Gynecology b ild LAN I i f G l

http://www.ceengine.eu All operations are recorded; recordings used also for education

http://www.ceengine.eu Telemedicine in Central Asia Telemedicine in Central Asia St Started as Telepathology in Uzbekistan t d T l th l i U b ki t � Medical diagnosis in remote regions was sometimes difficult, especially of cancer ti diffi lt i ll f � Telepathology: transmit digital image of tissue slide over the internet to experts in another site slide over the internet, to experts in another site for diagnosis

http://www.ceengine.eu Telemedicine in Central Asia Telemedicine in Central Asia I In Uzbekistan, strong leadership at the central U b ki t t l d hi t th t l Pathology unit in Tashkent provides experts for remote diagnosis for remote diagnosis

Telepathology in Uzbekistan Telepathology in Uzbekistan � Expert in Tashkent making diagnosis

Telepathology in Uzbekistan Telepathology in Uzbekistan � Regional pathology centre, Qoqand

Telepathology in Uzbekistan Telepathology in Uzbekistan � Computer software used: iPath (Internet Pathology Suite) � Developed in 2001 at the University of Basel, Switzerland � Displays and archives digital pathology images from point-to-point (initially for hospitals in Switzerland). � F � Free, open source, web-based b b d � Permits the online presentation and discussion of cases within user groups within user groups—mostly off-line, but some real-time. mostly off line but some real time

Telepathology in Uzbekistan Telepathology in Uzbekistan � Each site diagnoses about 100 tissue biopsy cases/month, plus 1-2 autopsies. � about 1/3 of the patients had difficult diagnoses. g

Telepathology in Uzbekistan Telepathology in Uzbekistan Funding allows: � consultations to be carried out for diagnostic g biopsies and potentially autopsies in real time, � to provide remote training of young experts and students, and students, � to carry out medical newsgroups

Typical evaluation sheet Clinic Urgench Date 16 Sept - 16 Oct 2008 telepathology cases Date Patient ID Age Sex Suspected problem Slides Digitised? No. of slides digitised 9/16/2008 582 45 M Tumor of intestine 39 yes 29 9/16/2008 583 55 F Cholesticitis 8 No 9/17/2008 9/17/2008 584 584 41 41 M M Ski Skin cancer 12 12 yes 10 10 9/17/2008 585 74 M Appendicitis 4 No 9/17/2008 586 58 F Cholesticitis 8 No 9/17/2008 587 35 M Appendicitis 4 No 9/18/2008 588 38 F Adeno carcinoma of 26 yes gall-bledder 20 9/19/2008 589 34 M Leiyo mioma of 12 No uterus 9/19/2008 590 43 M Stomack Ulcer 9 No 9/19/2008 591 26 M Appendicitis 4 No 9/20/2008 592 54 F Tumor in colli uterus 12 yes 10 9/20/2008 9/20/2008 593 593 50 50 F F Tumor in stomach Tumor in stomach 35 35 yes yes area 28

Telepathology in Uzbekistan: Benefits Telepathology in Uzbekistan: Benefits � Telepathology in all the 12 regions in Uzbekistan has improved the diagnosis of about 300-400 cases per month. � With the installation of telepathology at gy regional sites, the staff are able to learn and improve their own diagnoses, based on feedback from the Tashkent centre and also from other sites.

Telepathology in Uzbekistan: Benefits Telepathology in Uzbekistan: Benefits � Another good result is that through using the g g g telepathology system, the pathologists at the regional pathology sites are able to become g gy more computer literate—many of them had never previously used or had access to a computer.

Extension of Telepathology in Central Asia Extension of Telepathology in Central Asia � Oct. 2010 – NATO funded a workshop on telepathology in Tashkent � Trained 40 pathologists from 6 CA countries � How to set up a telemedicine centre p � How to use iPath software � How to use Distance Education materials for teaching/learning medicine � How to perform proper autopsy techniques

Conclusion Conclusion � Telepathology can really make a difference in improved diagnoses improved diagnoses. � Using computers in medicine through telehealth and telemedicine projects can be very successful and telemedicine projects can be very successful in many ways: � Improving medical knowledge � Improving medical knowledge � Improving computer literacy � improving public health improving public health

Future Plans for Telemedicine in Central Asia and the Caucasus � Need infrastructure to develop Telemedicine � Need infrastructure to develop Telemedicine opportunities � Develop distance learning modules for continuing p g g medical education (CME) courses � CME courses are available on the world's first free university at GlobalUni www GlobalUni info university at GlobalUni www.GlobalUni.info � built on the foundation of Health Sciences Online www.hso.info � HSO delivers authoritative comprehensive free and � HSO delivers authoritative, comprehensive, free, and ad-free health sciences knowledge (with over 50,000 hand-selected resources, and 8,000 hits per day). � HSO' f � HSO's founding collaborators and funders include di ll b t d f d i l d CDC, NATO, World Bank, WHO, and the World Medical Association.

Future Plans for Telemedicine in Central Asia and the Caucasus � GlobalUni Programs include: � GlobalUni Programs include: � multiple medical residency training programs, with students remaining in their home environments � 30+ other medicine, public health, nursing, dentistry, and 30 th di i bli h lth i d ti t d community health worker courses. � GlobalUni uses a model of online training, local hands-on mentoring, and peer-to-peer local or h d t i d t l l distance feedback. � GlobalUni is piloting these trainings in schools of G oba U s p o g ese a gs sc oo s o dentistry, medicine, nursing, pharmacy, physical therapy, public health, and speech-language pathology pathology � GlobalUni is in the Caribbean, China, Colombia, India, Kenya, Nepal, South Africa, and Zambia.