Russian Physician Pioneers Telemedical Practices

Russian physician Nikolay Matveev’s experience at Harvard University, as part of the  Edmund S. Muskie Graduate Fellowship Program (Muskie), has enabled him to make powerful professional impact since returning to Moscow. Through his work at the Moscow Research Institute for Pediatrics and Children’s Surgery he has innovated the use of telemedicine in treating children in the far regions of Russia.

The Muskie fellowship, a program of the Bureau of Educational and Cultural Affairs (ECA) of the US Department of State and administered by IREX, provided Dr. Matveev with the opportunity to study occupational and environmental health while attaining his master’s in public health at Harvard University. After receiving his MPH, Dr. Matveev returned to Russia to further develop telemedical practices there.

There are two main types of telemedicine: live videoconferences and the “store-and-forward” method, where a patient’s data are sent to the consulting doctor in advance (e.g., via email). Dr. Matveev utilizes both types of telemedical technologies in his professional practice, but videoconferencing is becoming more and more common.

At the Research Institute for Pediatrics and Children’s surgery, 10 percent of telemedical consultations are considered urgent, and are provided within 15 minutes after the original call.

In one case, Dr. Matveev’s institute consulted for a one-year-old baby girl in a distant region of Russia. The local hospital had effectively treated her for meningitis. The physicians there, however, discovered some abnormalities that did not improve despite intensive therapy with antibiotics. In a video consultation, three specialists from the  Institute of Pediatrics, as well as a professor in St. Petersburg, determined that the girl suffered from a severe reaction to the medication used to treat her meningitis. After the discussion, local doctors agreed to take the baby off the medication and use an alternative treatment method.

Telemedical centers exist in approximately two-thirds of the Russian territories. However, the number of pediatric institutions with telemedical centers is much smaller. Dr. Matveev’s institute currently works with 25 pediatric telemedical centers throughout Russia, from Sakhalin to Kaliningrad and from Yakutsk to Vladikavkaz. The institute also provides consultations for children in other countries—in the Baltic States, the Caucasus, and Central Asia.

Dr. Matveev says over 50 percent of the babies his institute provides consultations for are in Siberia or the Russian Far East. “In most of the cases our specialist just provides the local doctors with accurate diagnosis, and it helps” he explains. But he says that about 20 percent of the consulted children have to be transferred to his clinic after the telemedical consultation, as the best treatment often cannot be provided locally.

The development of telemedicine practices in Russia demonstrates the innovation and problem-solving skills Muskie alumni bring home to their countries. It has allowed Dr. Matveev to share the best of his Muskie experience with his fellow physicians, improving the practice and availability of medical expertise across Russia.

Dr. Matveev recently defended his Doctor of Sciences thesis, devoted to innovations that allow gaining even higher diagnostic accuracy in telemedicine. Currently, he is a recipient of the Careers for Alumni in Public Service (CAPS) award for his ongoing work with telemedicine. In 2007 he helped organize a telemedical conference in Moscow that allowed specialists from Russia, the United States, Ukraine, Germany, and Denmark, as well as representatives from the Russian Ministries of Health and Communication, to share best practices. Travel of the US participants to Moscow was partially funded through the ECA Alumni Small Grants program.