Armenian Association of Telemedicine (AATM) is implementing its pilot project, supported by a grant through the USAID-funded Primary Health Care Reform (PHCR) project, titled "Capacity Building of the Armenian Association of Telemedicine to Result in Improved Primary Health Care Services in Armenia". The project officially commenced on March 1, 2010, after the contract has been signed between the AATM and PHCR, and is planned to finish by the middle of June 2010. It consists of four major segments: capacity building and expansion of the Association; research on the role of Telemedicine and eHealth in improving quality, accessibility and cost-effectiveness of health care system in Armenia; demonstrational telemedicine model; evaluation and dissemination of the outcomes, including public awareness campaign.

Armenia has relatively developed primary health care network; however, shortage of specialist physicians in rural areas, as well as limited funding, frequently hamper maintaining appropriate quality of care at the community level. As a result, considerable number of patients from rural areas seek specialty consult in large modern centers in Yerevan, which is associated with significant direct and indirect costs, and frequently results in delays in diagnosis and initiation of treatment. Telemedicine has potential to improve functionality of the primary health care services in rural areas of the country, to tackle health care disparities between metropolitan and rural regions, and to increase cost-effectiveness of the primary care system overall.

The actual telemedicine system (the "demo model", or prototype of the telemedicine network) consists of two PC-based stations (the "referral station" at a rural primary care facility in a village north of Yerevan serving ca 6,000 population, and the "consult station" at AATM's central office in downtown Yerevan), equipped with simple video-conferencing devices and commercially available medical peripherals, connected via high-speed internet (fiber-optic and ViMax) providing 5/2 Mbps of bandwidth. The medical peripherals include: 5-parameter vital sign monitor (BP, HR, SaO2, 3-lead ECG, and body temperature); digital stethoscope with Bluetooth connectivity (3M™ Littmann®) and tele-auscultation software (Zargis Cardioscan™); standard 10-MP, 10-optical zoom digital still camera; and an ultrasound device with ultrasound digitizing and sharing software (Symotec). As telemedicine encounter management software the system utilizes Microsoft SharePoint™.

Patients presenting to the referral site are examined and triaged by primary care physicians, and scheduled for teleconsults. Patients' data, including demographics, history and physicals, lab and instrumental studies, are either recorded for subsequent review by the specialist, or transferred live when appropriate. Direct tele-consultations are available in the following specialties: cardiology, pulmonology/respiratory medicine, endocrinology, rheumatology, gastroenterology, dermatology, neurology, general surgery, urology, reproductive health, and pediatrics; teleconsultations also provide the primary care physicians with CME content in verbal, electronic or printed format.

During the period of operation of the system and upon completion systematic assessment is to be conducted, evaluating project's feasibility and impact on primary health care. Based on results of comparable projects in other countries, it is expected that the system will allow reducing by 60-70% patients' visits to remote specialists, allowing timely diagnosis, improving treatment outcomes, increasing patients' satisfaction, ensuring primary care personnel's professional growth, reducing health care costs, and contributing to overall development of target rural community.

Within the frameworks of the project the AATM jointly with the PHCR organized one-day seminar "Telemedicine for Family Physicians" on May 6, 2010, aimed at dissemination of general knowledge about Telemedicine and eHealth, as well as about AATM and its activities, among primary care physicians in Armenia. During this educational event AATM president, Dr. G. Chaltikyan delivered an introductory lecture via live videoconferencing from Los Angeles, USA, followed by presentations by other AATM board members and Association's partners. Seminar culminated in a lively discussion on possible pathways of implementation of telemedicine and eHealth in Armenia.

Armenian Association of Telemedicine (AATM) is the leading non-governmental, non-profit organization in the country, dedicated specifically to promoting development of Telemedicine and eHealth. AATM's partners in this project are: Ministry of Health of Republic of Armenia; Primary Health Care Reform (PHCR) project; Union of Information Technology Enterprises (UITE) of Armenia; Armenian Medical Association (ArMA); Microsoft-Armenia; Sourcio; Cornet; GNC Alfa; and Symotec.

For further information, please visit:
http://www.armtelemed.org