1. Assist.prof. Polina Mihova, PhD Health and social sciences department New Bulgarian University, Sofia, Bulgaria Historical overview of telemedical solutions at the Balkans

2. Definitions Telemedicine is composed of the Greek word τελε (tele) meaning 'far', and medicine. Telemedicine usually means transmission of information followed immediately by medical care. Telemedicine is defined by the Telemedicine Information Exchange (1997) as "the use of electronic signals to transfer medical data from one site to another via the Internet, Intranets, PCs, satellites, or videoconferencing telephone equipment in order to improve access to health care". In 1996 Jim Reid defined telemedicine in his book "A Telemedicine Primer: Understanding the Issues" as "the use of advanced telecommunication technologies to health information exchange and health services delivery across geographical, time, social and cultural boundaries". According to the Telemedicine Report to Congress (1997), "telemedicine can mean access to health care where little had been available before. In emergency cases, this access can mean the difference between life and death. In particular, in those cases where fast medical response time and specialty care are needed, telemedicine availability can be critical. For example, a specialist at a North Carolina University Hospital was able to diagnose a rural patient's hairline spinal fracture at a distance, using telemedicine video imaging. The patient's life was saved because treatment was done on-site without physically transporting the patient to the specialist who was located a great distance away". The report added, "Telemedicine also has the potential to improve the delivery of health care in America by bringing a wider range of services such as radiology, mental health services, and dermatology to underserved communities and individuals in both urban and rural areas".

3. The new technologies and mHealth There are identified 101 uses of cell phones in healthcare - categories of functions and services

4. The benefits of telemedicine Improved access to healthcare, e.g., obtaining second opinions; Improved continuity of care; Improved patient education, and timely treatment; Continuous monitoring of chronically ill patients; Reduced travel time for physicians, other healthcare providers, and patients; Better access for patients in underserved areas; Improved access to medical records and information, Promoting self-help by increasing the online availability of medical information; Knowledge-based self-diagnosis programs; Distance learning programs; and medical research data/information; Improved continuing medical education.

6. SWOT analysis

7. International Virtual e-Hospital (IVeH) Foundation

8. ROMANIA Romania's health system successfully handle applications and telemedicine programs. Time that the country managed to integrate innovation, advanced programs, equipment and management of technological innovation is about 20 years. Creator of emergency in Romania Dr. Read Arafat managed to coordinate and implement telemedicine in different services using a variety of means of transport: airplane, helicopters, ambulances and fire equipment like a mini ER. Cooperation of health professionals and institutions by means of this new technique in medicine leads to cost savings, reducing the need for new staff, increased life satisfaction and outcomes for patients in remote and inaccessible areas. Telemedicine is the basis of modern health care in Romania. The state is fully trusted its applications. In areas with a shortage of health professionals or in inaccessible and remote places people can get advice, diagnosis or treatment by trained paramedics who successfully coordinate emergency status and location of the patient. Innovative model marks the positive results, noting that since implementation of acute mortality has decreased. Dramatically increased the percentage of patients in critical condition who reached the hospital, the time from call to arrival of the ambulance in the cities is between 8 and 10 minutes, and in rural and remote areas to twenty. Response capacity also increased thanks to many trainings and seminars that show how the video link with emergency centers, firefighters, and rescue teams can give first aid and rely on

9. TELEMEDICINE IN THE EMERGENCY EMERGENCY MEDICAL SERVICES IN ROMANIA

10. MACEDONIA Foundation "International Virtual e-Hospital" (IVeH), in cooperation with the Macedonian Ministry of Health, which annually arranged forums and events that discuss innovative technological advances and new ways for the application of telemedicine in various sectors. She finds out and established itself as an integral part of the health care system of Macedonia, as an aid in disasters, accidents and emergencies in conflict areas where the battlefields as well as in everyday situations. Virtual e-Hospital of Macedonia in its structure and electronic library that enables Macedonian doctors planned corresponding materials and receive additional consultation and qualification of the most famous universities in Europe and the United States. Telemedicine successfully developed in recent years in the country by providing new ways to connect doctors and their patients. It is crucial for rural, poor and sparsely populated areas, where in the past there was a lack of quality and affordable medical care. Goals and aspirations of IVeH is to help rebuild the medical system in Kosovo and other developing countries by introducing and implementing the practice of telemedicine, telehealth and virtual educational programs. The main components of the virtual hospital: CME professionals, enhancing education and health culture through electronic medical library and provision of health Uslu by decisions of telemedicine. It is headquartered in Anchorage, Alaska. Its main goal is to share and perform various telemedicine programs through international cooperation. The organization's chairman, Dr. Rifat Latifi, deputy director of the Arizona Telemedicine Program. He has also helped establish exchange programs for physicians, nurses and technical professionals from Kosovo, Montenegro, Macedonia and Albania. "Sharing medical knowledge and spreading it among as many people off is the basic concept of telemedicine. I keep this concept as a key guidepost in my surgical academic career," says Latifi, quoted by "TelehealthNet news".

11. TELEMEDICINE PROJECT IN KOSOVO AND ALBANIA In order for a change in the health sector, services and practices on medical, Ministry of Health, United States Agency for International Development under the direction of Dr. Rifat Latifi, professor of surgery at the University of Arizona and founder of the Foundation "International Virtual e-Hospital" (IVeH), Albania is working to establish its first national Telemedicine Centre. Program integration and establishment of eHealth in Albania is worth 750,000 dollars, which will create a national center for telemedicine in hospital 'Mother Teresa' of Tirana and five regional centers in Kukes, Shkoder, Durres, Korca and Vlora. This program aims to provide quality health services continuously qualified and training of physicians and specialists. Albanian doctors work long telemedicine - by means of using the Internet network for project preparation and information search, communicate by email with their patients and use various innovative technologies. They have mastered the spirit of telemedicine, because in daily practice different forms of communication, which in turn will provide faster absorption and dynamic innovation in their work. The project consists of continuing medical education professionals in healthcare, electronic medical library and provision of health services through telemedicine solutions. National Telemedicine Center will be supported by the International Virtual e-Hospital, which will provide the necessary telemedicine equipment telestations and computer networks. International, virtual, electronic hospital will create a special theoretical and practical training programs conducted to help and facilitate the work of medical personnel. Like Albania, within five years Kosovo creates program, including national and seven regional centers for telemedicine. Thanks to IVeH that builds network for telehealth program was subsequently transferred to the University Clinical Centre of Pristina. Regional hospitals, doctors and patients have the chance to quickly and efficiently carry out consultations and exchange information about the status of their patients. Telemedicine Programme in Kosovo successfully found a place and integrated into the national health system

13. BALKAN MILITARY - TELEMEDICAL JOINT TASK FORCE At the Annual Congress of the Balkan Military Medical Committee (BVMK), held in Belgrade in 2012. to conclude an agreement to build a joint Balkan Medical Task Force to use and apply the funds and programs of telemedicine. Participation in the conference take about 200 medical experts from countries – membes - Turkey, Greece, Bulgaria, Romania, Serbia and Montenegro. Project should create joint medical teams to be trained and directed to act in emergency situations of natural and other disasters. The first part of the project will be completed by 2015 and fully prepared Task Force is scheduled to be fully operational by 2017. The agreement included the exchange of experts and the opportunity to better interoperability of military medical services through telemedicine. President of the Congress, Colonel Zoran Popovic described telemedicine as an innovation in health practices among all countries in the region that will improve knowledge and quality of treatment.It also provides an opportunity for specialized doctors to exchange images, information, advice and diagnostic procedures each other and in a very short time to receive a response from his colleagues in the Balkans and other countries. Telemedicine is the link between each of these countries, because helps coordinate and accompany medical practices, increases knowledge and experience of experts and create an interactive environment for the exchange of experience, ideas and information between doctors and nurses from different countries. And all this in order to improve the quality of health care, health outcomes and patients satisfaction.

14. GREECE TELEMEDICINE Implementation of the program began its initial development in 2006, and in 2008 has developed and expanded its reach in 17 regions coordinating with each other through a network and with the participation of the medical center in Athens, which is the central hospital. At the end of the training course, which specialized doctors from all communities participate are provided with equipment used to record vital signs (electrocardiograph, spirometer, oximeter, a device for measuring blood pressure and glucose-. Doctors through these devices have the ability to examine their patients to make their ECG and to transfer the results of research by the Greek Vodafone telecommunications network to the medical center in Athens. Due to this data transfer information is passed from specialist to specialist of the same or another specialty. Doctors successfully able to consult and guide in the decision of their patients health problems.

15. GREECE TELEMEDICINE http://galaxy.hua.gr/~varlamis/Varlamis-papers/BC2.pdf

16. BULGARIAN TELEMEDICAL INDICATIVES Development and innovation in technology and medicine create opportunities for renovation and modernization of health practices and hospitals. Telemedicine is the result of collaboration of medical information and communication technologies, good health practices and medical programs that create the need and necessity of doctors and patients for flexible, fast, efficient and effective medical activity. Exceptional is the speed of development and globalization of information and communication technologies and services that change the look and dialogue between doctor and patient, offering a new way for virtual consultation by medical information. Health information and telemedicine restructure the health care system and lead to the need for training, retraining and a new type of consumption of medical care. Telemedicine is used and managed to enter the medical practice of physicians and specialists through information and communications technologies and interactive environment that opens communication between doctor and patient. In recent years, this new movement is gaining momentum and successfully makes its way as a means of entering a virtual consultation platforms, technologies, innovations in medicine and various aids, equipment, programs and Bulgaria.

17. Thank you for attention! We expect interested colleagues from the Balkan countries for collective participation and application for European projects

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