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Visit to Ecuador, December 2001

During the first week of December 2001, Ronald Merrell, M.D., Stephen Cone M.D., Mr. Russ Hummel, and Pat Escandon, M.D., from Yale University, traveled to Ecuador to conduct fieldwork in the MITAC telemedicine test beds underway there. The objective of this latest trip was the addition of patient monitoring to the MITAC-developed Rapidly Deployable Telemedicine Unit (RDTU). The RDTU was integrated with web-based software developed by TeleVital, which was used for remote anesthesia monitoring by Lynn Gehr M.D., a VCU anesthesiologist. Adjustments made to the hardware and software in the area should allow faster communications, and, therefore, better patient care. Work continued on evaluating the use of high frequency radio for transmission of medical records and images.

During the visit, Dr. Merrell addressed many of the provincial community leaders and medical personnel to further strengthen relations and to relate our goals for continued work in the area to the benefit of the Ecuadorian people. His lecture and the trip were well received by all participants


Collaborations in Telemedicine with Chisinau, Moldova, October 2001

Mr. Charles Doarn and Dr. Gregory Itskovich visited the Republic of Moldova from October 22 - November 2, 2001 at the invitation of Minister Andrei Gherman, Minister of Health. In his letter of invitation, Minister Gherman expressed his willingness and enthusiasm for how MITAC might partner with the Ministry in health care reform in Moldova by providing guidance and expertise in the integration of information systems and telecommunications technologies. Meetings with Dr. Gherman were focused on the World Bank grant for Health Care Reform in Moldova and were very productive.





During the visit, Mr. Doarn and Dr. Itskovich visited with a number of key stakeholders in health care for Moldova. These included meetings with Mr. Valerian Christea, Deputy Prime Minister of Social Affairs for Moldova, Dr. Victor Savin, Director of the Chisinau Department of Health and Dr. Ion Ababbi, Dean of the State Medical University of Moldova. This trip provided an opportunity for Mr. Doarn and Dr. Itskovich to visit a number of remote medical facilities including hospitals in Beltz' and Soroca. The hospital in Soroca is nearly 200 years old. The chief medical doctor/administrator was extremely please with the visit and possibilities of integrating new technologies to enhance the delivery of health care in her region.

Mr. Doarn was invited to give a presentation on MITAC activities a symposium held in Beltz with physicians and anesthesiologists. Presentations were given to a number of other individuals as MITAC explores the appropriate process for working with the Ministry of Health and the World Bank. Dr. Itskovich was invited to attend a National Health Conference of Moldovan Health Ministers. During this conference, Dr. Itskovich gave a presentation to the President of Moldova, Vladimir Voronin.


Ecuador Telemedicine Test Beds Push New Boundaries, July 2001

On July 30, 2001, Dr. Merrell traveled to the far eastern regions of Ecuador to evaluate the concepts and possibilities of establishing a mobile medical facility linked via telemedicine that could be capable of traveling on the waterways of Ecuador. During Dr. Merrell's excursion, he collected data on river flow, river depth, his position on the river via GPS, and select photographs of locations along the river (linked to GPS). All data collected by Dr. Merrell was accomplished from a small boat on the river.

Dr. Merrell utilized an array of tools to obtain data, including an Iridium telephone to communicate with the outside world. Dr. Edgar Rodas accompanied Dr. Merrell on this data collection event. Dr. Rodas is working closely with the MITAC to validate telemedicine technologies in these remote locations.

Dr. Merrell also visited Taisha to obtain data and images of indigenous plants used for medicinal purposes. These digital images will be integrated in to the MITAC-developed pharmacopoeia of tropical medicine and used via telemedicine to support health care needs.


MITAC Interaction in Moscow, June 2001

A MITAC team consisting of Mr. Charles Doarn, Executive Director of MITAC, Ms. Doris Farquhar, Director of Academic Affairs in the Department of Surgery, Dr. Vladimir Lavrentyev, MITAC Post Doctoral Fellow, and two medical students from the Virginia Commonwealth University's Medical College of Virginia, Ms. Sheila Khianey and Ms. Anna Leung traveled to Moscow, Russia, June 10-17, 2001. The main objective of this visit was the continuation of ongoing bilateral collaborations with the Moscow State Medical and Dental University (MSMDU) clinical site Railway Hospital #3, the Central Clinical Hospital of the Ministry of Railroads, the ZIL hospital, and the Space Biomedical Center (SBC) for Training and Research. This involved addressing current projects and future prospects in the fields of telemedicine and distance education. The second objective was to familiarize VCU medical students with the Russian health care delivery and education system through both student-student interaction and firsthand hospital experience.

At MSMDU, Mr. Doarn, Ms. Farquhar, and Dr. Lavrentyev collaborated with Dr. Prazdnikov and Dr. Tolstykh to view and collect data on lectures prepared for the purpose of distance learning. This data is now under analysis to determine the most effectual mode of distance learning. Mr. Doarn gave a warmly received impromptu lecture to students and professors on the 'Concepts of Telemedicine.' Mr. Doarn and Ms. Farquhar also addressed questions on the importance of international telemedicine, the benefits of distance learning, and the intricacies of the US medical education system. The US medical students interacted with Russian students in various discussions, surgeries, and lectures. The team also had the opportunity to meet with the Rector of MSMDU, Academician Dr. Sokholov. Additional executive meetings were held with Dr. Prazdnikov, Dr. Rozumny, Dr. Ovcharov, and Dr. Tolstykh.

The MITAC team toured the facilities and telemedicine lab of the Central Clinical Hospital of the Ministry of Railroads and the ZIL hospital. At the ZIL hospital, Mr. Doarn and Dr. Lavrentyev met with Dr. Podoltsev, the Chief Administrator to discuss on going activities in telemedicine. The team also visited the SBC facility at Moscow State University. Mr. Doarn spoke with Dr. Reviakin and Mr. Isaev about collaborative efforts on papers, patents, and Telecollaboration On-line Database (TOLD) modification, while the VCU students talked to Russian medical students about the telemedicine course offered at SBC. The trip concluded on June 17 with a debriefing that included the MITAC team, Dr. Prazdnikov and Dr. Tolstykh. Dr. Prazdnikov's upcoming visit in September 2001 to Richmond, the Endoscopic Surgery Conference in Moscow, currently scheduled for April 2002 and next steps were discussed.


Collaborations in Telemedicine with Moldova

On April 1-5, 2001, MITAC representatives, Dr. Ronald Merrell, Mr. Charles Doarn, Dr. Vladimir Lavrentyev and Dr. Gregory Itskovich, visited academic and clinical sites in Chisinau, the capital city of Moldova. As guests of the International Independent University of Moldova (ULIM) and the City of Chisinau Department of Health, the MITAC team's overall purpose was to explore collaborative activities in telemedicine and distance learning initiatives with ULIM and the city Health Department. Meetings were held at ULIM with Mr. Andrei Galban, Director of the ULIM and Dr. Victor Savin, Director of the Chisinau Department of Health.

Dr. Merrell gave a lecture to academicians and physicians at the State Emergency Hospital on April 3. Mr. Doarn gave a lecture to over 175 students at the ULIM on the concepts of telemedicine. The MITAC team also visited with Dr. Ion Ababii, rector of the State Medical and Pharmaceutical University named after Nicolae Testemitsanu. Meetings were also held with Mr. Vasile Parasca, Minister of Health and Mr. Ilie Vancea, Minister of Education and Science. The MITAC team was also honored with a meeting with the Mayor of Chisinau, Mr. Serafim Urechean.

The outcome was the creation of a standard Memorandum of Understanding between MITAC, VCU Surgery, and ULIM as well as MITAC, VCU Surgery, and the City of Chisinau Health Department. The visit highlights earlier meetings with the Ambassador Ceslav Ciobanu and Mr. Andrei Galban, Director of the ULIM in Richmond and a recent meeting with Mr. Andrei Cucu, Deputy Prime Minister of Economy and Reforms for Moldova. MITAC is looking forward to working closely with several sites in Moldova to help integrate telemedicine and distance learning in the health care system as well as the educational system of Moldova.


Collaborations with Moldova

On March 19, 2001, Mr. Charles Doarn, Executive Director of the MITAC met with Mr. Andre Cucu, Deputy Prime Minister for Economy and Reforms for the Republic of Moldova, Mrs. Andre Cucu, Mr. Ceslav Ciobanu, Ambassador of Moldova to the United States in Washington, Dr. Stephen Ayres, former MCV Dean and Dr. Gregory Itskovich in Washington to discuss potential collaborations in telemedicine and distance learning. The Moldovan government is very interested in exploring the application and integration of information and telecommunications technology in health care and would like to partner with VCU and MITAC in applying for grant dollars that might help in making this interest a reality.



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