Abstract

Background and context: More than 4000 cases of pediatric cancer are registered in the Russian Federation annually. A well-functioning system of the centers and departments of pediatric, hematology and oncology required to obtain good treatment results. Features of the Russian Federation require close collaboration between Dmitry Rogachev Center, NSPHO and regional medical institutions. Aim: Development and implementation of the system of direct collaboration between Dmitry Rogachev Center, NSPHO and regional medical institutions for improvement of diagnostics, treatment and rehabilitation of children with hematologic and oncological diseases on the all territory of the Russian Federation. Strategy/Tactics: Dmitry Rogachev Center was set by the Ministry of Health of the Russian Federation as the National Center in charge of pediatric hematology and oncology. Thus, the collaborative initiatives between Dmitry Roigachev Center, NSPHO and regional medical institution were prioritized. Key points of the regional strategy are 24/7 telemedicine support for regional institutions, forming of database of centers and specialists based on NSPHO catalogue of institutions, usage of unique clinical guidelines and standards for all regions of Russia based on tandem agreements and continuous medical education and scientific work. Program/Policy process: To obtain above-mentioned goals, the following steps were made. Federal Center of Telecommunication for Children with hematologic and oncological diseases was founded. A special Web-based application was constructed for the forming of the database of the institutions (the base of this work is the 9 years experience of NSPHO in accumulating of data on centers and specialists on the Russian territory). More than 50 guidelines were prepared and approved for hematologic and oncological diseases treatment in children. Tandem agreements are signing now between Dmitry Rogachev Center, NSPHO and regional medical institutions. Different educational activities are available for specialists from all Russian regions (e.g., on-site seminars, online meetings, etc.). Outcomes: Regional network consists of 86 institutions in all Russian regions (about 3900 beds). During the test period of work of FCT in 2017 more than 5000 consultations were made. Estimated number for 2018 is 6000. All these institutions and specialists (1050) are included to the monthly updated database including the contact and other information. Approved guidelines updating periodically based on the results of multicenter studies. Nowadays more than 50 institutions signed the tandem agreements. These steps allowed to control all pediatric cancer cases in country. What was learned: Only scientific-based multicentre collaboration under the leadership of the National Center and strong national society with support of the government could lead to control of cancer cases and success in treatment. This experience could be used in other countries

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