Telemedicine and Teleconsultation Project

Improving Clinical Consultation Skills

At this time, there is limited technological and communicative capabilities for the medical community of Mongolia. It is our plan to overcome these barriers to care by implementing a clinical tele-consultation project that will extend care from the pediatric hospital (MCHRC) in Ulan Bator to other regions of the country. This project will identify, purchase and implement telemedicine tools for collecting clinical digital information (e-stethoscope, e-otoscope, etc.), and implement an electronic case record for tracking patient care, (e.g., an electronic medical record, or EMR). The EMR will include lab reports, images, patient care notes, MD notes, nursing notes, etc. At present this kind of documentation does not exist at MCHRC. Introduction of the patient chart as a model is innovative in itself and represents an important upgrade of medical practice. Introduction of electronic medical equipment that collects clinical digitally is a giant step forward in contemporary healthcare. Project activities include creation of MCHRC and CHLA medical teams to utilize tools and consultation system. We propose to schedule bi-weekly tele-teaching and tele-consultation rounds based on cases populated with data collected by the tools documented in the electronic chart. The CHLA team will provide the first case as a model. The MCRHC team will create subsequent cases from actual patients. Teams access the case and work collaboratively via the internet. This is a real medicine but not a real time application.

The goal is to develop a pilot demonstration tele-consultation model in country using existing telecommunications systems (both public and private) to link 3 to 5 district health centers at the aimag (regional) level with the MCHRC utilizing a "hub and spoke" model. The MCHRC will serve as the source of change and information for outlying hospitals and physicians. This will provide an opportunity to identify strengths and weaknesses in such a system and allow for modifications and countrywide implementation. We anticipate that an initiative by the country office of WHO will link in necessary medical consultation support at the level of the soums (countryside administrative centers).