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

Networking in Eastern Networking in Eastern Networking in Eastern Europe and Central Asia. Networking in Eastern Europe and Central Asia. p Telemedicine perspective p Telemedicine perspective

www.ceengine.eu St ll Atki Si F U i it Stella Atkins, Simon Fraser University Jacek Gajewski, CEENet

CEENet = Association of 22 NRENs

http://www.ceengine.eu

CEENet Association of 22 NRENs

P j t i l f i l Projects – mainly of regional scope:

8x EU (Porta Opt., CAREN FS, BSI, CEENGINE) 15 NATO ( Vi t l Silk HWY I f t t 15x NATO (e.g. Virtual Silk HWY, Infrastructure 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:

coordination of e-infrastructures activities 1 build more e-infrastructures in the region

j

raising awareness & technical know-how 2 train staff, prepare for dark fibre and GEANT g fostering cooperation and GEANT extension 3 , p p

• rganize NRENs into regional projects

g p 3 intensification of dissemination of e-infrastructures 4 g g p j Detect and enable users’ communities intensification of dissemination of e infrastructures 4 Detect and enable users communities

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New Areas? New Topics? New Areas? New Topics?

Global Outreach Concept for CEENet

Find management procedures and funding sources for Define new charter

(wider geographical scope new types of

funding sources for sustained operations

scope, new types of activities)

NATO Virtual Silk Highway Project

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Silk-1 2002-2006, Silk-2 2006-2010

Silk project connected NREN NOCs

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in 9 capitals;

X X X X X X X X X X

CEENet & Silk project created NRENs

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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

Black Sea Interconnection BSI Project

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Black Sea Interconnection BSI Project

In 2009 Caucasus countries changed to fiber in framework of EU-funded BSI project

Central Asian Research and

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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.

CAREN as platform for regional cooperation ( i l t l di i li t h

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(seismology, telemedicine, climate change, water resources management, GRIDs, etc.)

UZSCINET - the best developed NREN in CA

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UZSCINET the best developed NREN in CA

UZSCINET cooperates closely with telemediciners, b ild LAN I i f G l

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e.g. build LAN Institute of Gynecology

All operations are recorded;

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recordings used also for education

Telemedicine in Central Asia

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Telemedicine in Central Asia

St t d T l th l i U b ki t Started as Telepathology in Uzbekistan

Medical diagnosis in remote regions was ti diffi lt i ll f sometimes difficult, especially of cancer 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

Telemedicine in Central Asia

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Telemedicine in Central Asia

I U b ki t t l d hi t th t l In Uzbekistan, strong leadership at the central 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 b b d Free, open source, web-based Permits the online presentation and discussion of cases within user groups mostly off line but some real time within user groups—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 584 41 M Ski 12 10 9/17/2008 584 41 M Skin cancer 12 yes 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 gall-bledder 26 yes 20 9/19/2008 589 34 M Leiyo mioma of uterus 12 No 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 593 50 F Tumor in stomach 35 yes 9/20/2008 593 50 F Tumor in stomach area 35 yes 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

• pportunities

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 di ll b t d f d i l d HSO's founding collaborators and funders include 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 th di i bli h lth i d ti t d 30+ other medicine, public health, nursing, dentistry, and community health worker courses.

GlobalUni uses a model of online training, local h d t i d t l l hands-on mentoring, and peer-to-peer local or 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.

Possibilities for development of Telemedicine in Central Asia and the Telemedicine in Central Asia and the Caucasus

TM work is mostly done in university clinics and TM work is mostly done in university clinics and NRENs. Limited opportunities for EU or NATO funded pp regional projects Verbal support of Caucasian and Central Asian governments governments Japanese, Korean and Malaysian development agencies + ADB quite active in Central Asia, which gives prospects for collaborative projects gives prospects for collaborative projects

Questions? Questions?

Shopping in Uzbekistan—July 2008

Telepathology in Uzbekistan Telepathology in Uzbekistan

2007 started from Urgench to Tashkent 2008 NATO funded an infrastructure grant for t di t l th l i U b ki t extending telepathology in Uzbekistan

funded equipment (Leica microtome) , materials and computers into 10 regions co pute s to eg o s

Sept 2008: first 5 sites were operating

Namangan, Andijan, Samarkand, Bukhara and Gulistan g j (Syrdarya region).

• Feb. 2009: 5 more systems were installed

Qoqand (Ferghana region), Denau (Surkhandarya region), Catta-Curgan (Samarkand region), Chirchik (Tashkent region), Gigduvan (Bukhara region). g ) g ( g )

GlobalUni plans to support: GlobalUni plans to support:

• The World's first free master's degree – Master in Public Health (MPH)
• partnership with the American Association of Public Health Physicians Haifa University
• Presbyterian University of East Africa,
• Public Health Foundation of India
• Residencies in General Surgery and in Orthopedic Surgery,
• partnership with the Education Committee of the College of Surgeons in East, Central and Southern

Africa

• Global Surgery at the Center for Surgery and Public Health at Brigham and Women's Hospital,
• Residencies in Ob-Gyn Women's Health Pediatrics and Adolescent health
• Residencies in Ob-Gyn, Women s Health, Pediatrics, and Adolescent health,
• partnership with WHO
• International Federation of Gynecologists and Obstetricians
• Medical Women's International Association
• American College of Preventive Medicine
• A Pre-Medical Curriculum and trainings for community health workers and for health

professionals on the Prevention and Cessation of Tobacco Use,

• Partnership with the International Federation of Medical Student Associations
• Certificates in multiple topics including Hospital and Clinic-based Infection Control (in

collaboration with WHO), Exercise and Health (in partnership with the U.S. CDC, the collaboration with WHO), Exercise and Health (in partnership with the U.S. CDC, the American College of Sports Medicine, and the Fundacion Santa Fe Bogota), and in the Prevention and Treatment of Alcohol Abuse (in collaboration with the Annenberg Physician Training Program in Addiction Medicine)

Jacek Gajewski gajewski@ceenet.org Stella Atkins stella@sfu.ca