The main problems facing remote health care today are the lack of a clear legal and regulatory framework for medical activities and a system for training qualified medical personnel to work in remote areas. So says the director of the association "Institute for Remote Health" Andrey Karpov.
"I mean not only the training of personnel who have medical competencies. Here we should talk about broader problems: today there is virtually no life support system and support for the activities of personnel at remote sites, the purpose of which would be to reduce morbidity and premature mortality for staff who work in very difficult conditions, "said Andrey Karpov.
According to him, these problems are relevant for all countries that are engaged in remote health care. As for Russia, there are territories here whose population density is one of the lowest in the world. In addition, the potential for mineral development in our country is enormous.
"Today, about 800 thousand people are employed in the extraction of natural resources in Russia. This is the most active, able-bodied part of the population. It is the target audience for which these problems need to be addressed" says Professor Karpov.
Running for the departing train
Today, the problems of remote health care are solved in two directions. The first is the creation by private and state-owned companies of their own medical service to support the activities of the enterprise. The second is an invitation of third-party organizations, or training in accordance with their ideas.
Such a way does not allow to evaluate the state of human health and its reaction perfectly. As a result, emergency situations occur and it requires resuscitation and medical evacuation. This inevitably entails economic and reputational losses.
"The level of psycho- emotional disorders is not evaluated , which may again be useful in the development of emergency conditions and cause injuries. If we continue to solve existing problems as well as we solve them today, we will run for the departing train without any hope that we will catch it up, "said Andrey Karpov.
He believes that it is necessary to form an integrated life support system at remote sites, which will accumulate six components. First, it is necessary to assess the working conditions and the most significant occupational, personal and behavioral risk factors for the development of various occupational non-communicable diseases in humans. Secondly, it is necessary to assess the risk of developing the most significant diseases, taking into account the specific working conditions: climatic, geographical and behavioral. Third – it is necessary to analyze psycho -physical staff status of remote objects in the period of work in a remote location, and in the intervals between production cycles.
"In other words, when a person leaves a production facility on the mainland, each worker rehabilitates himself in the ways he considers necessary, this is wrong," said Andrey Karpov.
The next component is the development of a balanced system of nutrition and psycho- physical rehabilitation. It is also necessary to train medical and non-medical specialists to ensure an optimal life support system for personnel at a remote facility. And the last thing that Professor Karpov called, the development and implementation of targeted programs for the prevention of the most significant diseases, from which the personnel of distant facilities suffer more.
How are these problems solving today at "ССМ"?
These issues are dealt with by the Association of the Institute for Remote Healthcare, established in 2016 during the first conference "Remote Healthcare – A Modern Problem Solving". In addition, in November 2017, another special organization appeared – the Center for the Study of Remote Health Problems. This is a joint project of the Institute of Remote Health ( Inotzdrav ) and the Siberian State Medical University ( SibSMU ).
"The main educational modules that we are going to develop are in terms of assessing the risks of diseases, developing and implementing practical programs for occupational health and nutrition, the psycho-emotional state of workers, algorithms for providing emergency and emergency medical care, ensuring medical evacuations and using modern telecommunication technologies for diagnostics and treatment, "said Andrey Karpov.
In addition, the specialists of ССМ, on the basis of the concept developed by Inotzdrav , are engaged in creating a register of personnel for remote sites. This is a permanent system for collecting, updating, storing and analyzing individual employee data, which includes several information blocks.
As a result of the research, target programs for the prevention of the most significant diseases, scientifically-based standards of medical care and materials to supplement and improve educational programs will be developed in order to prepare universal specialists for working in the field of remote health care.
We add that the developers of "ССМ" created a device for the rapid passage of medical examinations, it is planned to launch its production in the near future.
Andrey Karpov – MD, Honored Doctor of the Russian Federation, an expert on the scientific activities of the company "ССМ". His research interests are oncology, pathological physiology, radiation epidemiology, and public health organization. Since 2009 – Professor, Department of Health Organization and Public Health, Siberian Medical University, Ministry of Health of Russia (Tomsk). In 2017, invited to the post of Director of the Institute of Remote Health.