Global Ring Network for Advanced Applications Development

International Medical Information System (IMIS)

The largest clinics of USA, Russia and Japan are extremely interested in creation of a general medical information media to unite their information resources, medical experience, diagnosing hard and software. Within the frames of IMIS it is possible to carry out medical consultations, analysis of the most complicated situations, exchange with statistical data regarding the procedure and results of the most important and complicated procedures and operations. In order to reach the above mentioned aims it is necessary to have a possibility to hold on-line tele- and video-conferences, to exchange with electronic records of patients, with medical diagnosis images (X-ray, ultra sound examinations, and tomography) and angiographic films. The strictest measures should be undertaken in the INIS to guarantee confidentiality of medical information in order to prevent unauthorized access to the servers of medical institutions. Creation of IMIS will be exclusively beneficial for all the participants of this project. IMIS will make it possible to disperse experience in health care, the latest achievements in medical instrumentation, methods of diagnosis and treatment of the most complicated diseases.

In Russian Federation there has been created a hard-and-software complex DIMOL by the developers of the Russian research Center “Kurchatov Institute” in cooperation with the Scientific and Practical center of Intervening Cardiology. The DIMOL complex is intended for automation of medical procedure processes in cardiological clinics. Such complex has been working during more than five years at the Scientific and Practical center of Intervening Cardiology in Moscow.

Fig.1. Author of the project DIMOL.From left to right: Gnedenko V.G., faineberg E.M.,Iosseliani D.G., Velikhov E.P.

Cardiology is one of the main and most rapidly developing directions of treating cardio-vascular diseases. The methods of intervening cardioangiology are intended for mass implementation; they are distinguished for being low traumatizing, provide patients to recover during minimum possible period of time. The positive results obtained and the high capacity of the method are caused mostly by the degree of its automation and computerization. The DIMOL complex provides practically full automation of this process, reduce the time required to make right decisions by doctors. It allows providing the appropriate methodological accompanying any diagnosis and curing procedures. The effectiveness of the method is proved by the fact that so far more than 20 thousand patients with hard cardio-vascular disorders have been successfully treated, the grade of lethality at the clinic was three times as less as compared to the average level in Moscow and the capacity of the clinic got increased 1.5 fold. The electronic archive of records is widely used both by the doctors of the clinic and by foreign specialists who regularly visit Moscow for fulfilling operations of aorta-coronary shunting as well as for training doctors from various regions of the Russian Federation.

The DIMOL technology is well compatible with the international medical system and can be used as a basic element of the medical segment of the GLORIAD system.

Russian Research Center “Kurchatov Institute” (RRC “KI”) incorporates 12 Research Institutes. The Research Institute of High Technologies and Experimental Machine Building is one of those units. It was founded 10 years ago. The priority fields of activities are as follows:

1. Automation of medical technologies;
   
2. Processing radioactive, medical and municipal waste;
   
3. Developing and designing technical means for antiterrorist activities (special devices for disclosing hidden explosives, robots for evacuating and/or destroying explosives and others).
   

Beginning the early 90’s the Institute has been carrying on works aimed at developing and implementation of new information technologies of medical intent. As a first priority task there was determined the problem of automation of medical technologies used for diagnosis and t reatment of cardio-vascular diseases. The importance of this task is caused by the fact that (according to the statistics available) the lethality rate caused by this kind of diseases amounts to 50% of the total lethality of the population in Russia. In 1993 at the cardiological ward of the Moscow City Clinic _15 (the head is Professor David Iosseliani) the first DIMOL complex was installed. In 1998 there was established the Moscow Scientific and Practical Center of Intervening Cardioangiology (SPC IC) and professor Iosseliani was appointed Director of the Center. Under the auspices of Moscow Government developing DIMOL (DIMOL-IC) complex for the Center was launched. Beginning 2000 the complex was fully completed and put in operation. In 2003 the complex incorporated both the hospital and the polyclinic in the unified information system. At present it is possible to get released from the electronic archive of the complex unique data about the methods and the procedure of treating cardio-vascular diseases of more than 20,000 patients for the period of more than 5 years. The data available in the archive can be useful both for Russian and foreign specialists who are engaged in research of the problems of cardioangiology and treating cardio-vascular diseases.

Fig.2. Hard and software of DIMOL complex.Main concept.

The efficiency of implementation of the information technologies in the activities of the SPC IC turned out to be above all expectations. Thanks to the high qualification of the doctors, implementation of sophisticated equipment including the DIMOL-IC complex the lethality rate because of hart attacks decreased 3 – 3.5 times as compared to the average level around Moscow.

The plan of further developing the DIMOL-IC complex stipulates incorporation of the far-off Cardio and Diagnostic clinical examination Center into the unified information system of SPC IC. In order to fulfill this intention it is necessary to have a city network with capacity of 100 Mbt/s. The unified data base of the complex including the archive of the electronic records, archives of angiographic films, X-ray and tomographic images should be accessible “on-line” in the course of patients being examined by the doctors. Later the DIMOL-IC complex is planned to incorporate the Rehabilitation Cardiological Center located outside Moscow city. The capacity of the channel of communication in this case should be 100 Mbt/s.

International communications of the RRC”KI” need serious information support. In particular, SPC IC keeps many years communication with the Saint Luc Hospital in the city of Miluoki, USA and with the Wisconsin Heart and Vascular Clinics, S.C. One of the leading doctors of this clinic Dr. Wann supports creation of medical information system and considers that it would facilitate introduction of American technologies in Russia and other countries.

French cardiosurgeon Lean Charle Vernet of Saint Augustan Hospital who regularly visits Moscow f or waging operations of aortocaronary shunting at the SPC IC gives very high evaluation to a perspective of getting diagnostic data from Moscow onto his working place. If a channel of communication between Moscow and France is established with capacity of 100-155 Mbt/s then the surgeons at the Saint Augustan hospital will be able to get prepared for the forthcoming operations by having studied the information about the patients available in the data base of the DIMOL-IC complex.

In parallel with running DIMOL-IC further works are being carried on at the RRC “KI” to implement the medical information system DIMOL-CB6 at the multipurpose Clinical Hospital 6 (CB6) belonging to the Ministry of Health Care of the Russian Federation. Clinical Hospital 6 is distinguished for treating the major part of the patients injured in the result of Chernobyl NPP disaster. A unique medical experience in treating irradiated patients has been accumulated at the Clinic. Normally the hospital treats regular patients. Beginning 2003 the first stage of DIMOL-CB6 complex is being successfully run at the hospital. In future a sanatorium is supposed to be incorporated into the complex to provide rehabilitation of irradiated patients while the sanatorium is located in Goluboe settlement outside Moscow. The main purpose of this incorporation is to provide exchanging between the facilities with data from electronic records, diagnostic images, films and other video information in “on-line” regime.

Fig.3. the protocol of composing conclusion on the results of antiorgraphic procedure in DIMOL complex

There are planes of unification of both clinics with rapid communication channel. The servers and work-stations, soft ware and mathematical support of DIMOL-IC and DIMOL-CB6 complexes will make it possible to create joint information media for the doctors at work.

Based upon the GLORIAD technology it is possible to unite a number of leading Moscow and Russian clinics into a united information media which is necessary for consolidation of doctors’ efforts to improve the system of giving qualified health help for the population. A number of Moscow clinics are pretty well computerized and will be interested in being incorporated into the international information medical system.

Fig.4. the protocol of composing conclusion on the results of antiorgraphic procedure in DIMOL complex

Availability of a communication channel with capacity of 155 Mbt/s will make it possible to unite the clinics of separate prefectures and the city of Moscow as a whole into a unified information media.

It is especially important to incorporate regional clinics into the unified medical information system. This way the medical personnel of those clinics will get an opportunity to get known about the unique practical experience of the best medical institutions, to get training from the leading Russian and (by means of GLORIAD) worldwide specialists for the most sophisticated methods of diagnostics and treatment. The capacity of such channel should be not less than 622 Mbt/s.