Mikhail Natenzon is the Chairman of the Board of Directors of the National Telemedicine Agency, a member of the Board of the Russian Telemedicine Consortium, and a senior researcher at the Russian Academy of Sciences. In 1972, he graduated from the Moscow Institute of Electronic Engineering (Moscow State Institute of Electronics and Mathematics) with a degree in Applied Mathematics. He is a co-author of the project of the National Telemedicine System of the Russian Federation. In 2014 he initiated the establishment of a working group of experts from BRICS countries in the field of telemedicine.

In an exclusive interview with TV BRICS, he spoke about the essence of telemedicine and its development in the BRICS countries.

As far as we know, telemedicine is the provision of medical care at a distance, and besides, it is an interaction between an attending physician and a doctor of higher qualification. Speaking of patients, what kind of examinations can they receive with the help of telemedicine? And which patients can get such help?

Let us start with simple things. Telemedicine, as a modern technology of medical assistance, is absolutely unique, universal and mass. Therefore, anyone can benefit from such assistance. The BRICS countries are huge in their territories and have a large number of inhabitants. Telemedicine is primarily important for patients living in remote, hard-to-reach areas, where infrastructure of in-patient medical centres is underdeveloped in comparison with capitals and large cities. All BRICS countries have their own national programmes for the development of telemedicine and artificial intelligence.

The trigger, of course, was the coronavirus pandemic, which forced states to implement these technologies massively. Now in Moscow, all 250 polyclinics, most of the city’s clinical hospitals, have radial diagnostic equipment, X-ray machines, fluorographs. They are connected to the Scientific and Practical Clinical Centre for Diagnostics and Telemedicine Technologies of the Moscow City Health Department. All information flows there through communication channels. Specialists, using artificial intelligence programmes, process a gigantic flow of medical images.

Now doctors have the concept of a “medical decision support system”. The doctor is given information and recommendations. The computer does not have the right to make a diagnosis, but the artificial intelligence programme has various useful options, which help the doctor. Special studies conducted by the Moscow Department showed that for tuberculosis, for example, 99.24% is normal, 0.76% is pathological. And a doctor has to describe everything. He describes, for example, 200 scans, and only the 200th one turns out to be a patient’s scan. Firstly, he spends a huge amount of time, burns out, loses his qualification. And since the programme can now determine the norm with an accuracy of 99.99%, it is perfectly safe to relieve the doctor of this routine and give him the opportunity to examine a really sick person.

In his recent speech, the Russian President mentioned primary medical care and the introduction of mobile medical complexes. These are “clinics on wheels” that we also offer to the BRICS countries in our project. They actually make it possible to get to any populated area and carry out an examination there.

Telemedicine has been developing in Russia for a number of years. What achievements in this area can we talk about today?

First of all, I would note the development of the legislative and regulatory framework, which is extremely important for healthcare. Within the framework of the Commonwealth of Independent States in 2010, Russia came forward with an initiative to create national telemedicine systems in the CIS countries. This memorandum was discussed by all countries and, in 2010 it was signed at the Meeting of CIS Council of Heads of Government in Chisinau.

The package of documents, which was also adopted at the CIS Interparliamentary Assembly and the CIS Heads of Government meeting, is the first document in the world regulating telemedical consultations and the provision of telemedical services.

What is the situation with the development of medicine in the BRICS countries?

Each of the BRICS countries has now adopted its own national telemedicine development programme. India has a very interesting national programme for the development of telemedicine. Like China, they have a National Telemedicine Association. India regularly holds congresses in this area. They have an excellent national telemedicine centre in the city of Lucknow, in the state of Uttar Pradesh.

They have developed their programme to create a telemedicine network of 1,500 clinics in rural areas and to launch a special satellite to link these clinics. In Brazil, a telemedicine network of Brazilian universities had been established. It was so effective that clinics all over the country, hundreds of hospitals joined it, and then the network grew to become the telemedicine network of Latin America and the Caribbean.

India and Brazil, in my opinion, have achieved a very broad coverage, but the depth of services, the list of services, can be improved and added to. And this is where Russia could be a very good partner. Vladimir Putin presented the country with a mobile medical complex, which was brought to the town of Nkandla in the Uthungulu district of KwaZulu-Natal province. So here, in my opinion, everything is very promising. The main thing is that the base is prepared. Now we can develop that.

The full interview is available on the TV BRICS website.

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TV BRICS