One of the central topics of the “Open Innovations” forum starting October 21 in Skolkovo will be digitalization in healthcare. During all three days of the forum, leaders and experts of the first Russian medical center managed by a foreign hospital, Hadassah Medical Moscow, as well as the Israeli central clinic, actively participate in discussions.
On the eve of the “Open Innovation”, the medical director of the Russian branch of Hadassah, Dr.Tatyana Zhelninova told Sk.ru what innovations in the organization of diagnostics are already available in the hospital, and what are the immediate plans of the clinic with which the work of the Moscow International Medical Cluster began. Part of the conversation took place in the administrative block of the medical center, part in the corridors and offices of Hadassah Medical specialists.
Dr. Tatyana Zhelninova: “I am here because there is an opportunity to help patients at Hadassah Medical Moscow.” Photo: Sk.ru.
In the department of gastroenterology and endoscopy, there is not one corridor system, but two: One for visiting patients and the other for medical staff. According to the anaesthesiologist Mesrop Poghosyan, the reason for the separation of flows along two parallel corridors is to ensure that the patient never encounters unsterilized equipment. This ensures the high level of hospital sterility and does not affect the psyche of a person who has come just for a health check-up.
Unlike what is accepted in most domestic hospitals, 95% of all procedures in the department are performed under general anaesthesia: this is the only way the doctor can appreciate the full picture.
The first (corridor arrangement) is related to the routing and flow of, i.e. to organize people; the second (manipulations under anaesthesia) - to ensure compliance of modern medical protocols, according to which Hadassah Medical Moscow works. According to the clinic’s medical director Dr. Tatyana Zhelninova, both are equally necessary for the medical center. Plus, advanced science at an international level, the best doctors and nurses, the possibility of conducting online consultations with specialists of the central clinic, and also, in the long term, modern targeted drugs that are not yet necessarily registered within the Russian Federation.
This was precisely the idea of creating the Moscow International Medical Cluster on the territory of Innograd: to enable Russian patients to receive medical care inline with the standards of the best clinics in the world, without leaving Moscow. The diagnostic building of Hadassah Medical Moscow is already in operation and a second therapeutic building is being built nearby.
“I am here because there is an opportunity to help patients at Hadassah Medical Moscow,” says the medical director. “And to provide them with the opportunity to receive quality medicines and medical care in line with international protocols and standards.”
Dr.Tatyana Zhelninova, a practicing cardiologist, began her professional career in the 90s at the Pskov emergency hospital, where as a 23-year-old graduate of St. Petersburg ‘Pavlov’ Medical University was in charge of the emergency room. During a quarter of a century of medical practice, Dr. Zhelninova has led clinics, including creating medical centres from scratch; studied science, participated in clinical research and taught.
The other day, the newspaper Izvestia published some disturbing data from the Ministry of Labour and the Ministry of Health, according to which, the personnel potential of Russian doctors is able to cover the country's need for doctors by a mere 4%. What the medical director of Hadassah Medical Moscow does today is also largely related to the search and selection of doctors. “Finding a good doctor is difficult,” says Dr.Tatyana Zhelninova. – “And we are looking for not just good specialists, but also motivated doctors. That is, people who would understand the prospect. The immediate prospect is this: before the end of the year, we will be sending 15 people to study at the central hospital. The duration of training depends on the specific doctor and specialty, for the first time - from two weeks to two months.”
Dr.Tatyana Zhelninova instructing during an open lesson at the Skolkovo International Gymnasium. Photo: Hadassah Medical Moscow.
In the view of the medical director, her doctor is a fairly young, established professional who speaks English, who understands modern medical protocols: “This is a multifunctional doctor who not only knows his specialty, but also can do diagnostics: after consulting with the patient, can then perform an ultrasound scan, advise further and then immediately make an ECG. "
Such requirements are related to one of the main characteristics of Hadassah Medical Moscow. While in the Russian market there is mainly either highly specialized expertise without comprehensive diagnostics, or multidisciplinary treatment without expertise at the required level, the branch of the Israeli university clinic provides constant access to expert Western medicine, along with highly qualified local specialists who make the initial diagnosis and consult the patient.
Recently, the famous paediatrician Eitan Kerem, head of the children's clinic in the central hospital, came to Hadassah Medical Moscow. Dr. Kerem delivered a lecture on Paediatrics ‘4.0.’ Saying earlier he had been consulting patients, and participating in interviewing doctors.
The clinic is recruiting a team of doctors in such relevant fields as haematology-oncology, mammology-oncology, gynaecology-oncology and urology.
According to the interlocutor of Sk.ru, the visit of Dr. Kerem was so in demand that in December, the Israeli paediatrician will return to Moscow again. Prior to this, another major specialist, Hadassah haematologist Vladimir Weinstein, will hold a reception at the Moscow branch, and then will also speak at the panel session “Let's talk about Medicine”, organized by Hadassah Medical Moscow in conjunction with the Moscow International Medical Cluster.
“The scheduled visits, currently being organised, of the Israeli doctors from the central clinic in the areas of paediatrics, oncology and haematology-oncology, possibly not just being of an advisory capacity, but also, in difficult cases, may include a clinical examination with the participation of Russian doctors,” emphasizes Dr. Zhelninova.
“This is always useful for the patient, because we are approached by people, including those who have not received an answer to their questions, if they have been diagnosed correctly if they have been consulted correctly, if their treatment regimens are set up correctly. In such cases, it is important not only to provide the patient with expert advice, but also to assemble our team of doctors, which will allow us to give comprehensive answers to the questions.”
The visits of Israeli doctors, therefore, have several purposes. In addition to actually receiving patients, they help the clinic solve personnel issues, and at the same time realize the educational function, which Hadassah Medical Moscow considers an important component of the work of the medical centre, which will be discussed later.
By the end of the year, the staff of the Moscow clinic will have its own Israeli specialists: therapists, nutritionists, dermatologists and orthopaedists. In the meantime, doctors from the central hospital advise patients via teleconference, and this function will continue to develop as an independent area of digital medicine.
“I would say we are busy building a virtual clinic,” says the medical director. - Now in the world one of the most pressing issues is the organization of telemedicine consultations, being able to obtain a second opinion online. In a number of areas, we already have agreements, and we have begun to provide online consultations. These are mainly video consultations. The patient comes to our doctor, who consults him, and we contact the Israeli doctors and get a second expert opinion.
Hadassah Medical Moscow, Russia's first medical center operated by a foreign hospital. Photo: Hadassah Medical Moscow.
In Israel, we have partners with whom we are actively cooperating in terms of building a virtual clinic. Not only teleconsultations of specialists are planned, but also a second opinion based on the results of MRI and CT scans. It is very important to be able to get a second opinion in digital pathology, those in digitized histological material. Incidentally, a digital laboratory for oncology diagnostics UNIM operates in Skolkovo , with which we cooperate in this area.
In general, it seems very important to us that our clinic is located on the territory of the innovation center, and this, by the way, is one of the reasons why I am here. An innovative ecosystem makes it possible to use various laboratories - not only histological, but also, for example, genetic, which is very important in medicine now. ”
International Educational Medical Center
Any innovation makes sense only when a trust relationship is established between the patient and the doctor. Eitan Kerem spoke about this as the most important factor in the success of the clinic.
“The question of the patient’s trust in the doctor is central to medicine, it brings with it answers to all other questions, including the organization of the process,” said Dr. Tatyana Zhelninova. - Now it’s fashionable to talk about the so-called 4P medicine; one of these “Ps” is patient-oriented medicine. In the world, the trend is not on evidence based medicine, but on value based medicine, i.e. medicine based on certain values.
In the Western educational process, today more than 20% of the time students learn how to communicate with patients. It is a whole science to inspire confidence. A lot depends on how the doctor can speak, and what competencies he has. ”
Hadassah Medical Moscow operates the most advanced medical equipment. Photo: Sk.ru.
But, of course, the main component of trust is a high level of medicine, based, inter alia, on research work. Dr. Tatyana Zhelninova speaks about this, “today a doctor cannot be just a clinician; a modern doctor becomes a truly serious specialist when he or she is engaged in research and is involved in the education process”
Hadassah Medical Moscow expects to develop both of these areas. In terms of research, the clinic’s management would like to join forces with AstraZeneca, which intends to open a laboratory in Skolkovo.
And in early November, the branch of the Israeli clinic intends to officially announce its new project - International Educational Medical Center. “I would really like this international educational center to become a postgraduate institute over time,” says the head physician. - One of the areas is the training of nurses, and there is something to learn from Israeli medicine, in which nurses have many of the same skills that our doctors have; it is with them that most of the work on receiving a patient lies. There are more doctors in our system than there are nurses; the situation is different there: for example, in the Hadassah head clinic there are twice as many nurses as doctors, and the head nurse is a doctor.
Israeli medicine is strong for its educational programs for nurses, in particular, the training of chief nurses, who, in addition to the medical disciplines themselves, are taught leadership skills, conflict management in medicine, and innovation. We are preparing such a program now, and the head nurse Elon Relie Rachel, she is the director of the hospital's innovation program, will come to us from the Hadassah central clinic.
Other interesting areas are anaesthesiology and resuscitation, radiation diagnostics. In these areas, we will invite reputable scientists from Russian universities, Moscow medical clinics, managers and experts from the central hospital. My task in this case is to build these horizontal connections and organize a platform for various formats: a seminar, a round table, a debate, clinical analysis.
Dr. Tatyana Zhelninova: “Do you do maintenance of your car once a year? Spend this on your body“. Photo: Sk.ru.
“We are also in the process of preparing documents for a radiation clinical research center, which we intend to launch in November. The Center, in particular, will acquaint doctors with the latest drugs in this area.”
Talking about drugs is a separate issue. Many of the modern targeted medicines are not registered in the Russian Federation. The idea of the Moscow International Medical Cluster is based on the ability to use within its framework not only the best medical protocols and equipment, but also use the most modern foreign drugs, in particular, in oncology. This issue should be resolved at the highest legislative level, which Hadassah Medical Moscow has high hopes for.
If we talk about the areas of today's work of the clinic, these are, first of all, check-ups, i.e. preventive examinations in line with the standards of Israeli medicine. “The doctor should be always available where and when the patient is still healthy, or if they are some problems, but you can help in time,” Dr. Tatyana Zhelninova formulates. Check-ups or screenings are carried out in our area of oncology, cardiology, and allergy ology. We organize a full examination - more than 15 procedures - according to the protocol, within one day. Part of the results is issued the next day.
We take into account that our patients, as a rule, are busy people, active people, leading an active lifestyle and able to pay for such services. There are different programmes; the optimal cost is 35-40 thousand roubles (we give discounts for Skolkovo residents).
I myself, as a cardiologist, often deal with a prior event - a heart attack, stroke, when we are engaged in secondary prevention, and the patient needs to wait for a long prescription. I always draw this analogy in conversations with my patients: “Do you do maintenance of your car once a year? How much do you pay for maintenance? And here we are talking about your own health. Have maintenance on your body. "