Telemedicine Center Research Articles

An Intelligent Framework for Performance Optimization of Telemedicine Center with Trust incorporating decision-making styles

An Intelligent Framework for Performance Optimization of Telemedicine Center with Trust incorporating decision-making styles

Engineering Features From Advanced Medical Technology Initiative Submissions to Enable Predictive Modeling for Proposal Success.

The U.S. Army Telemedicine and Advanced Technology Research Center Advanced Medical Technology Initiative (AMTI) demonstrate key emerging technologies related to military medicine. AMTI invites researchers to submit proposals for short-term funding opportunities that support this goal. AMTI proposal selection is guided by a time-intensive peer review process, where proposals are rated on innovation, military relevance, metrics for success, and return on investment. Utilizing machine learning (ML) could assist in proposal evaluations by learning relationships between proposal performance and proposal features. This research explores the viability of artificial intelligence/ML for predicting proposal ratings given content-based proposal features. Although not meant to replace experts, a model-based approach to evaluating proposal quality could work alongside experts to provide a fast, minimally biased estimate of proposal performance. This article presents initial stages of a project aiming to use ML to prioritize research proposals. The initial steps included a literature review to identify potential features. Then, these features were extracted from a dataset consisting of past proposals submissions. The dataset includes 824 proposals submitted to the AMTI program from 2010 to 2022. The analysis will inform a discussion of anticipated next steps toward developing a ML model. The following features were created for future modeling: requested funds; word count by section; readability by section; citations and partners identified; and term frequency-inverse document frequency word vectors. This initial process identified the top ranked words (data, health, injury, device, treatment, technology, etc.) among the abstract, problem to be solved, military relevance, and metrics/outcomes text proposal fields. The analysis also evaluated the text fields for readability using the Flesch readability scale. Most proposals text fields were categorized as "college graduate," indicating a challenging readability level. Finally, citations and partners were reviewed as an indicator of proposal successfulness. This research was the first stage of a larger project to explore the use of ML to predict proposal ratings for the purpose of providing automated support to proposal reviewers and to reveal the preferences and values of AMTI proposal reviewers and other decision-makers. The result of this work will provide practical insights regarding the review process for the AMTI program. This will facilitate reduction in bias for AMTI innovators and a streamlined and subjective process for AMTI administrators, which benefits the military health system overall.

EFFECTIVENESS OF TELEMEDICINE HEALTHCARE SERVICES IN RURAL AREAS OF BANGLADESH: A STUDY ON SELECTED VILLAGES

Background: Bangladesh's healthcare system faces challenges in providing equitable access and quality healthcare to rural and remote communities compared to urban areas. To address these issues, the country has incorporated telemedicine into its healthcare system. Aims: This study aimed to assess the effectiveness of telemedicine services in rural Bangladesh. Methods: The study employed a mixed-method approach, including survey questionnaires and in-depth interviews. 100 participants were selected for the questionnaire survey for quantitative data, and 20 in-depth interviews were conducted to collect qualitative data. Results: The findings indicate that telemedicine has garnered a positive reception among rural residents. An overwhelming 86% regarded telemedicine as a cost-effective healthcare option. 44% reported accessing telemedicine services within 10 minutes, demonstrating their accessibility. Furthermore, a majority (54%) expressed satisfaction with telemedicine services. However, dissatisfaction was noted concerning the physical environment of the telemedicine centers. Conclusion: Overall, telemedicine in Bangladesh has proven effective in cost savings and time efficiency and has gained significant acceptance among rural residents. To further improve healthcare accessibility, expanding telemedicine centers to reach every remote union in Bangladesh is imperative. Additionally, raising awareness, providing ICT and telemedicine education, and ensuring affordable and reliable internet connectivity will maximize the potential of telemedicine services, ultimately benefiting underprivileged rural populations. Keywords: healthcare, rural Bangladesh, telehealth, telemedicine

Multidrug stewardship and adherence to guidelines in >200,000 direct-to-consumer Telemedicine encounters.

The quality of care and safety for Telemedicine-discharged patients with suspected respiratory infections are closely related to low rates of prescriptions of unjustified and high-risk medications. This retrospective study aimed to assess adherence to the current COVID-19 guidelines in direct-to-consumer telemedicine encounters at a large center using multidrug stewardship protocols. A quarterly electronic survey utilizing medical records of individual physician care assessed various quality indicators. Physicians received ongoing adaptive feedback based on personal metrics, with Telemedicine Center recommendations derived from the 2020 Infectious Diseases Society of America guidelines. The study included all consecutive adults with new respiratory symptoms in the last 14 days who sought spontaneous Telemedicine consultations between March 2020 and August 2021. This study analyzed patients with suspected or confirmed COVID-19 and other airway infections. Of the 221,128 evaluated patients, 42,042 (19%) had confirmed COVID-19; 104,021 (47%) were suspected to have COVID-19; and, 75,065 (33%) had other diagnoses. Patients with suspected or confirmed COVID-19 had a mean (+DP) age of 35±12 years. A total of 125,107 (85.65%) patients were managed at home, 2,552 (1.74%) were referred for non-urgent in-office reassessment, and 17,185 (11.7%) were referred to the emergency department for whom there was no further treatment recommendation. The antibiotic rate in confirmed or suspected COVID-19 cases was 0.46%/0.65% and that for non-evidence-based prescriptions was 0.01%/0.005%. Guideline training and Telemedicine consultation feedback may lead to lower antibiotic and antimicrobial prescriptions in suspected and confirmed COVID-19 cases. Multidrug stewardship protocols may improve guideline adherence and reinforce the quality of care and safety in Telemedicine encounters.

A Compression and Encryption Based Heart Disease Diagnosis with Deep Learning through ECG Signals

Electrocardiogram (ECG) monitoring models are commonly employed for diagnosing heart diseases. Since ECG signals are normally acquired for a longer time duration with high resolution, there is a need to compress the ECG signals for transmission and storage. So, a novel compression technique is essential in transmitting the signals to the telemedicine center to monitor and analyses the data. In addition, the protection of ECG signals poses a challenging issue, which encryption techniques can resolve. The existing Encryption-Then-Compression (ETC) models for multimedia data fail to properly maintain the trade- off between compression performance and signal quality. In this view, this study presents a new ETC with a diagnosis model for ECG data, called the ETC-ECG model. The proposed model involves four major processes, namely, pre-processing, encryption, compression, and classification. Once the ECG data of the patient are gathered, Discrete Wavelet Transform (DWT) with a Thresholding mechanism is used for noise removal. In addition, the chaotic map-based encryption technique is applied to encrypt the data. Moreover, the Burrows-Wheeler Transform (BWT) approach is employed for the compression of the encrypted data. Finally, a Deep Neural Network (DNN) is applied to the decrypted data to diagnose heart disease. The detailed experimental analysis takes place to ensure the effective performance of the presented model to assure data security, compression, and classification performance for ECG data

Transformational Healthcare Leadership in Improving Tele-Health System and Safety Performance Sustainability in University Teaching Hospitals

In developed countries, telehealth system applications are available in hospitals, hospital-based telemedicine centers, and rehabilitation centers. However, in contrast to developing countries, the telehealth system has not been implemented properly. Countries that implement telehealth systems experience different benefits, especially in developed countries. In developing countries, implementation remains challenging due to the requirement for literacy about the telehealth system itself in addition to using smartphone and tablet cellular technology for access. This research is motivated by concerns about the role of transformational leadership in providing a telehealth system to ensure the safety of medical personnel. The study adopts a quantitative approach with primary data collected at three major Indonesian university teaching hospitals—Gajah Mada Hospital, Diponegoro National Hospital, and Sebelas Maret Hospital—with medical personnel and administrative staff as the observation units. Hypothesis testing is conducted using Smart PLS 3.0. The study’s results reveal that traditional health services remain problematic despite efforts to make long-term changes. This study aligns with previous research, emphasizing that strategic flexibility serves as a proactive and reactive strategy for effecting long-term changes in key aspects of a company fostering innovation processes that contribute to sustainable business growth. Received: 21 November 2023 / Accepted: 12 March 2024 / Published: 5 May 2024

Provider's satisfaction with telemedicine services for tribals of Western Rajasthan: A qualitative analysis.

There are significant barriers to healthcare access in tribal areas, even though for every 834 people, there is one public physician (registered allopathic and AYUSH doctors). More than 86% of hospital visits occur in rural areas. Furthermore, the bulk of them travel long distances to reach hospitals. A telemedicine center was established in the aspirational tribal district of Sirohi, Rajasthan, to provide accessible quality health care. To understand providers' attitudes and satisfaction with telemedicine services for tribal populations. This cross-sectional, mixed-method study enrolled consultants from various clinical departments of AIIMS Jodhpur (n = 23) who provide teleconsultations to the tribal population. The mean score of the satisfactory index was 54.7 ± 22.04. The higher score is 87.4 regarding the ability to use the technology platform during teleconsultation. The lower score was 34.7 for video quality during teleconsultation at STHR. 91.3% found this a beneficial model for the tribal population. Consultants providing teleconsultations expressed that this model is a boon for tribal patients as a screening tool and will save time and money for improved accessibility. Positive indications of teleconsultation with a provider's utility, acceptability, and satisfaction. Most marginalized people can efficiently access all levels of (primary, secondary, or tertiary) health care from experts through telemedicine, which will broaden outreach in hard-to-reach or inaccessible tribal or rural areas.

An Analysis of Corporate Social Responsibility Practices and Their Impact on Local Communities in the Case of Samsung Electronics in India

This paper delves into Samsung Electronics’ corporate social responsibility (CSR) initiatives in India and assesses their impact on local communities. It examines a range of programs aimed at social and economic development, from educational enhancements to healthcare access and environmental sustainability. The study seeks to provide a nuanced understanding of how these initiatives are planned, executed, and received by the communities they intend to serve. The analysis includes an exploration of Samsung’s Smart Class Program, which has transformed educational experiences by integrating digital technologies into classrooms in underserved areas. This initiative’s effect on student engagement and learning outcomes is evaluated to gauge its contribution to educational advancement. The paper also investigates Samsung’s healthcare projects, such as the deployment of mobile healthcare units and telemedicine centers, which have been instrumental in bringing medical services to remote and marginalized communities. Additionally, the research addresses the challenges Samsung faces in implementing its CSR initiatives, including issues of scalability and sustainability. It discusses the strategies the company has employed to overcome these hurdles and the lessons learned from these experiences. The paper emphasizes the importance of collaboration between corporations, government entities, and NGOs in enhancing the effectiveness of CSR activities. The paper provides a comprehensive overview of Samsung Electronics’ CSR practices in India and their significant contributions to community welfare and sustainable development. It highlights the potential of corporate social responsibility as a powerful tool for driving positive social change and underscores the need for ongoing commitment and innovation in CSR strategies to meet the evolving needs of local communities.

Adherence to Emergency Department Referral Criteria in a Direct-to-Consumer Telemedicine Center.

Background: The safety of direct-to-consumer telemedicine (TM) is closely related to red flag detection and correct referrals. The adherence to referral criteria from current guidelines is not well quantified. Objective: To analyze the emergency department (ED) referral rate and adherence to referral guidelines in TM encounters of acutely ill patients calling a center that adopts stewardship protocols. Methods: This is a retrospective observational unicentric study, between March 2020 and March 2022, with patients who spontaneously sought direct-to-consumer urgent virtual medical assistance. A video-based teleconsultation was provided immediately after connection. Physicians managed situations according to their clinical judgment. Current guidelines, containing specific guidance for referral if red flags were identified, were available for consultation. Physicians' semiannual performance feedback was carried out. We analyzed the patterns for referral to immediate face-to-face medical evaluation and the agreement degree with the institutional guidelines. Results: A total of 232,197 patients were available, and 14,051 (6.05%) patients were referred to ED. A total of 8,829 (68.4%) referrals were based in specific guidelines according to the International Classification of Diseases hypothesis, and 8,708 (98.6%) were justified according to guidelines. Diarrhea had the highest guidelines' adherence to referral (97.6%), followed by COVID-19 (90%), headache (84.2%), and conjunctivitis (78.8%). Policies did not support 5,222 (31.6%) referrals, though 5,100 (97.6%) of these were justified according to the doctor's clinical judgment. Conclusion: TM doctors' assessment of acutely ill patients has high rates of adherence to guidelines regarding referral. Stewardship protocol adoption provides high rates of red flag description, even in the referral of nonpolicy diseases.

Clinicodemographic Profile and Clinical Outcome of Children Presenting to Telemedicine Center at Institute of National Importance of India: A Prospective Observational Study.

There is a global shortage of healthcare professionals, especially in developing countries, leading to disparities in access to healthcare, worsened by the pandemic. Telemedicine is emerging as a solution, with growing adoption worldwide due to advancements in technology and increased awareness. Research Problem. The establishment of telemedicine depends on resources, infrastructure, and knowledge about healthcare needs. Further studies are needed to monitor and address evolving issues in telemedicine. The Overall Purpose of the Study. Rural health disparities stem from multiple factors, like limited healthcare access, workforce shortages, lifestyle choices, and lower socioeconomic status, leading to higher mortality and chronic diseases. Addressing these challenges is vital for rural community well-being. Telemedicine centers present a promising solution, bridging gaps, and improving healthcare outcomes for underserved remote populations. Methodology. Objective: This study assessed the clinicodemographic profile and clinical outcome of children presenting to the telemedicine center at the Institute of National Importance in India. Design: Prospective observational study. Setting: A single-center tertiary care level. Participants: This study included 79 children aged up to 18 years. Major Findings and Summary of Interpretations. In our study, 79 children using telemedicine found a near-equal gender distribution. 8.9% needed emergency care, with common complaints being respiratory issues, fever, abdominal pain, and vomiting. After two weeks, 83.5% showed improvement, emphasizing telemedicine's effectiveness in pediatric care. Our study underscores telemedicine's positive impact on pediatric healthcare, emphasizing its potential to enhance access, outcomes, and cost-efficiency. Wider telemedicine adoption can reduce morbidity and mortality, support preventive care, and streamline posttreatment services, alleviating pressure on specialized facilities. While our focus was pediatrics, the telemedicine model is adaptable to various age groups and conditions, but it should be seen as a valuable supplement to, not a total substitute for, in-person healthcare visits.

Bottom-Up Analysis of Telemonitoring Costs: A Case Study in Slovenian Primary Care.

Telemonitoring improves clinical outcomes in patients with arterial hypertension (AH) and type 2 diabetes (T2D), however, cost structure analyses are lacking. This study seeks to explore the cost structure of telemonitoring for the elderly with AH and T2D in primary care and identify factors influencing costs for potential future expansions. Infrastructure, operational, patient participation, and out-of-pocket costs were determined using a bottom-up approach. Infrastructure costs were determined by dividing equipment and telemonitoring platform expenses by the number of participants. Operational and patient participation costs were determined by considering patient training time, data measurement/review time, and teleconsultation time. The change in out-of-pocket costs was assessed in both groups using a structured questionnaire and 12-month expenditure data. Statistical analysis employed an unpaired sample t-test, Mann-Whitney U test, and chi-square test. A total of 117 patients aged 71.4±4.7 years were included in the study. The telemonitoring intervention incurred an annual infrastructure costs of €489.4 and operational costs of €97.3 (95% CI 85.7-109.0) per patient. Patient annual participation costs were €215.6 (95% CI 190.9-241.1). Average annual out-of-pocket costs for both groups were €345 (95% CI 221-469). After 12 months the telemonitoring group reported significantly lower out-of-pocket costs (€132 vs. €545, p<0.001), driven by reduced spending on food, dietary supplements, medical equipment, and specialist check-ups compared to the standard care group. To optimise the cost structure of telemonitoring, strategies like shortening the telemonitoring period, developing a national telemonitoring platform, using patient devices, integrating artificial intelligence into platforms, and involving nurse practitioners as telemedicine centre coordinators should be explored.

Effect of Educational Intervention on Awareness and Attitude regarding Voluntary Blood Donation among Rural People: A Quasi- Experimental Study

Donation of blood has always been considered as Humanitarian act. Despite the increasing demands for blood and its products, many people have little interest in donating blood. We undertook this study to assess the level of knowledge &amp; attitude and to assess the effect of awareness talk regarding voluntary blood donation among rural people. Information from attendants of the patients visiting the Telemedicine Centre was collected using the Predesigned Pretested Semi open ended Interview Schedule. Out of 108 study subjects, 83 (76.8%) of study subjects didn’t knew their blood group. 52 (48.1%) said women cannot donate blood while they are pregnant or lactating. After the awareness talk, 78 (72.2%) were motivated for voluntary blood donation. There should be more awareness activities to promote voluntary blood donation in public.

Assessment of suicidal ideation via telemedicine: a case report and management suggestions

BackgroundNowadays, we find ourselves in very unexpected and challenging circumstances facing the COVID-19 pandemic. The impact of the new coronavirus pandemic probably affected everyone’s mental health, and people with pre-existing mental disorders may have an aggravated disease condition, leading to a suicide attempt. Pandemic also increased the use of direct-to-consumer telemedicine (TM) exponentially, and consequently, it was expected that cases of attempted suicide could be evaluated remotely. Some TM centers have adapted safety protocols from psychiatric guidelines for managing these patients. However, there is a lack of evidence of the effectiveness of follow-up by TM for patients at high risk for suicide, and there is no consensus on what action should be taken vis-à-vis the patient who requests immediate help remotely.Case presentationHere, we reported a case of a TM evaluation of a patient’s suicidal ideation in a direct-to-consumer telemedicine emergency center, describing the conduct taken in the face of this situation. We also discuss the importance of planning the emergency telemedicine center for situations of risk of suicide.ConclusionsTelemedicine centers should be prepared for direct consumer assessment of suicidal ideation. Current management suggestions include recognizing the risk profile through institutional training and software skills and immediate referral for face-to-face assessment, encouraging continuous monitoring until the admission and active recruitment of family members or closest friends.

Remote management of worsening heart failure to avoid hospitalization in a real-world setting.

From a patient and health system perspective, managing worsening heart failure (WHF) as an outpatient has become a priority. Remote management allows early detection of WHF, enabling timely intervention with the aim of preventing hospitalization. The objective of the study was to evaluate the feasibility and safety of remotely managing WHF events using a multiparametric platform. All patients enrolled in the heart failure remote management programme of the Bordeaux University Hospital Telemedicine Center between 1 January and 31 December 2021 were included in the study. Follow-up data were collected until 1 March 2022. Inclusion criteria were chronic heart failure (HF) with New York Heart Association ≥II symptoms and an elevated B-type natriuretic peptide (BNP>100pg/mL or N-terminal-pro-BNP>1000pg/mL). Patient assessments were performed remotely and included measurements of body weight, blood pressure, heart rate, symptoms, biochemical parameters, and data from cardiac implantable electronic devices when available. In total, 161 patients (71±11years old, 79% male) were followed for a mean of 291±66days with a mean adherence to the remote monitoring system of 80±20%. Over this period, 52 (32.3%) patients had 105 WHF events, of which 66 (63%) were successfully managed remotely, the remaining requiring hospitalization. Freedom from WHF events and hospitalization at 300days were 66% and 85%, respectively (P<0.001 for the difference). Increased level of BNP was associated with an increased risk of WHF event [hazard ratio (HR) per unit increase in BNP: 1.001; 95% confidence interval (CI) 1-1.002; P=0.001] and hospitalization (HR 1.002; 95% CI 1.002-1.003; P=0.002). A decrease in the level of glomerular filtration rate was associated with an increased risk of hospitalization (HR per unit decrease in estimated glomerular filtration rate: 0.946; 95% CI 0.906-0.989; P=0.014). WHF event recurrence and (re)hospitalization rates at 1-month were similar among patients managed remotely (18% and 12%, respectively) and those requiring hospitalization (21% and 10%, respectively). Iatrogenic complications occurred more often during hospitalization than remote management (26% vs. 3%, P<0.001). Our study suggests that remote management of WHF events based on a multiparametric approach led by a telemedical centre is feasible and safe. Adopting such a strategy for patients with chronic HF could reduce HF-related hospitalizations with expected benefits for patients, care providers, and health care systems.

Optimizing teleconsultation scheduling to make healthcare greener

Some international organizations have called for greener healthcare in the post-pandemic era. Telemedicine has made an important contribution to achieving the goal of green healthcare by reducing the travel distance of patients. From the perspective of operation management, we put forward the teleconsultation room scheduling problem to get a better scheduling scheme to make telemedicine more low-carbon and green. First, we propose a deterministic teleconsultation room allocation scheduling model and a stochastic teleconsultation room allocation scheduling model. Then, we utilize some transformation techniques to simplify the models and solve them through numerical experiments. Next, we put the obtained scheduling schemes into the actual situation and compare them with the staff scheduling scheme. The results show that the stochastic programming model performs the best. In addition, the instability of the teleconsultation service duration has a great impact on the scheduling scheme. The telemedicine center should encourage experts from higher-level hospitals to provide more stable service time.

Implementation, service effectiveness and satisfaction with teleconsultation services in China during the COVID-19 pandemic: from the Perspective of Primary Health Care Professionals

ObjectiveThis study aims to evaluate satisfaction and service effectiveness of primary hospital physicians participating in the National Telemedicine Center of China during the COVID-19 period, and to identify potential improvement suggestions. MethodsAn online questionnaire was developed to assess the impact and satisfaction of teleconsultation services. A teleconsultation manager from each of the 98 hospitals randomly invited the medical staff involved in teleconsultation to complete the online questionnaire. ResultsA total of 379 health care professionals responded to the online questionnaire, with a mean age of 36.74 years. Out of these respondents, 95.5% had a positive attitude towards teleconsultation during the epidemic. Only 6.6% believed that teleconsultation systems were not useful in preventing and controlling the COVID-19 pandemic. Those respondents who were very satisfied with teleconsultation participated in it 1.81 times per week averagely. Factors related to satisfaction included weekly participation frequency（P=.003）, patient data quality(P=.023), equipment operation proficiency（P=.006）, audio and video clarity and smoothness（P=.004, P=.020）, environmental satisfaction（P=.032）, and incentive measures of title promotion（P=.003）. The main challenges in teleconsultation were the lack of understanding of medical staff and the public, insufficiently advanced software and hardware equipment, and the lack of optimization of service processes. ConclusionsPrimary hospital doctors demonstrate high satisfaction levels, suggesting that teleconsultation could be an effective tool for patients seeking medical care in areas under lockdown during the COVID-19 pandemic. The primary barriers to teleconsultation include lack of public understanding and unadvanced equipment. These findings should inform future efforts to establish regional telemedicine programs in the post-COVID-19 era.

Clustering Research Proposal Submissions to Understand the Unmet Needs ofMilitary Clinicians.

The Advanced Medical Technology Initiative (AMTI) program solicits research proposals for technology demonstrations and performance improvement projects in the domain of military medicine. Advanced Medical Technology Initiative is managed by the U.S. Army Telemedicine and Advanced Technology Research Center (TATRC). Advanced Medical Technology Initiative proposals span a wide range of topics, for example, treatment of musculoskeletal injury, application of virtual health technology, and demonstration of medical robots. The variety and distribution of central topics in these proposals (problems to be solved and technological solutions proposed) are not well characterized. Characterizing this content over time could highlight over- and under-served problem domains, inspire new technological applications, and inform future research solicitation efforts. This research sought to analyze and categorize historic AMTI proposals from 2010 to 2022 (n = 825). The analysis focused specifically on the "Problem to Be Solved" and "Technology to Demonstrated" sections of the proposals, whose categorizations are referred to as "Problem-Sets" and Solution-Sets" (PS and SS), respectively. A semi-supervised document clustering process was applied independently to the two sections. The process consisted of three stages: (1) Manual Document Annotation-a sample of proposals were manually labeled along each thematic axis; (2) Clustering-semi-supervised clustering, informed by the manually annotated sample, was applied to the proposals to produce document clusters; (3) Evaluation and Selection-quantitative and qualitative means were used to evaluate and select an optimal cluster solution. The results of the clustering were then summarized and presented descriptively. The results of the clustering process identified 24 unique PS and 20 unique SS. The most prevalent PS were Musculoskeletal Injury (12%), Traumatic Injury (11%), and Healthcare Systems Optimization (11%). The most prevalent SS were Sensing and Imaging Technology (27%), Virtual Health (23%), and Physical and Virtual Simulation (11.5%). The most common problem-solution pair was Healthcare Systems Optimization-Virtual Health, followed by Musculoskeletal Injury-Sensing and Imaging Technology. The analysis revealed that problem-solution-set co-occurrences were well distributed throughout the domain space, demonstrating the variety of research conducted in this research domain. A semi-supervised document clustering approach was applied to a repository of proposals to partially automate the process of document annotation. By applying this process, we successfully extracted thematic content from the proposals related to problems to be addressed and proposed technological solutions. This analysis provides a snapshot of the research supply in the domain of military medicine over the last 12 years. Future work should seek to replicate and improve the document clustering process used. Future efforts should also be made to compare these results to actual published work in the domain of military medicine, revealing differences in demand for research as determined by funding and publishing decision-makers and supply by researchers.

Optimization of teleconsultation appointment scheduling in National Telemedicine Center of China

Teleconsultation service plays an important role in the Chinese healthcare service provision especially during the period of the COVID-19 pandemic. We propose a two-stage distributionally robust optimization model in teleconsultation appointment scheduling to minimize the total cost considering doctors’ and an inpatient’s waiting for appointments in a neurology department. This approach suits well with unique type of patients, expert doctor’s mobility and primary doctors’ time-anxiety of teleconsultation in the National Telemedicine Center of China. Given the ambiguity set based on the estimated mean and covariance matrix of the distribution, an approximate semidefinite programming model is reformulated, which can be solved by a standard solver due to special structures of constraints. In this paper, we have compared the performance of the strategy with and without considering primary doctors’ time-anxiety. We have used real-world data to conduct numerical experiments to determine the sensitivity of the results with respect to the changes in the parameters such as ambiguity set parameters, the risk level of overtime and waiting cost. Finally, managerial recommendations are provided for decision-makers to achieve better performance in the case of teleconsultation systems.

Опыт преподавания телемедицины в системе высшего профессионального образования.

In healthcare, a new digital branch of medicine has emerged – telemedicine, which is especially relevant for primary healthcare. To ensure the quality functioning of telemedicine centers, it is important to provide timely and high-quality training of medical personnel in the relevant field of knowledge. The solution of this problem is entrusted to the leading medical universities of the country. The article is devoted to the generalization of the experience of teaching telemedicine technologies at the Department of Family Medicine with the course of telemedicine technologies of the Samara State Medical University at the levels of specialist, residency, advanced training of doctors and primary retraining of doctors in the specialty "General Medical Practice (Family Medicine)" and «Therapy». A successful combination of presenting theoretical material and developing practical skills for conducting telemedicine consultations in practical classes in the form of training simulation telemedicine consultations in real conditions of outpatient practices, including using the capabilities of the Center for Remote Medicine Clinics of the Samara State Medical University, made it possible to train more than 300 specialists who have the skills to conduct telemedicine consultations, who use telemedicine consultations in real medical practice in medical institutions of the Samara region.

Aspects of Development of Telemedicine Technologies in Moscow

Aim. This study describes the development features of telemedicine technologies in Moscow. For this purpose, authors analyzed publications, regulatory acts, and experience of the Telemedicine Center of Center of Medical Prevention of Moscow Healthcare Department, including its work during the COVID-19 pandemic.&#x0D; Results. With the onset of the COVID-19 pandemic, Telemedicine Service for Patients with Coronavirus Infection (the Telemedicine Center of Moscow Healthcare Department) began operating in Moscow. The service provides telemedicine doctor-patient consultations in the following areas: management of patients with coronavirus infection, participants in a clinical trial of Gam-COVID-Vak vaccine, and visitors of Moscow Health pavilions. Doctors and patients communicate via the Telemedicine Information System that is accessible either through a mobile app or a browser. To access patient medical records, doctors use the Unified Medical Information and Analytical System of Moscow. To develop the specialized skills necessary to provide remote medical consultations to Moscow residents, a doctor of the Telemedicine Center receives further training, including workplace internships.