Bridging Innovation, Health and Society: Educational capacity building in Eastern Europe Neighborhood Area
The “Bridging Innovation, Health and Society: Educational capacity building in Eastern Europe Neighborhood Area” (BIHSENA) project has been funded with support from the Erasmus program and the European Commission to develop an education program in the interdisciplinary field of health, innovations and society in Russia, on the basis of Tomsk State University and Siberian State Medical University
Current health problems (drug resistance, disease dissemination, caused by way of living, etc.) are distinguished by their complex nature. The solution of these problems involves access to medical knowledge, as well as social science advances.
In this regard, training of professionals, who can work in interdisciplinary and cross-sectoral cooperation and apply interdisciplinary and systematic approaches, will ensure the effectiveness of the healthcare system.
The main aim of the project is the development of new educational opportunities for training of specialists, who can develop and apply interdisciplinary and systematic approaches to meet up-to-date challenges in medicine and healthcare system.
SibMed Project coordinators
Maria Shevchenko – МВА, Director of Institute for International Research and Education, Siberian State Medical University.
Olga Fedorova – MD, PhD, Professor of Faculty Pediatrics Department, Siberian State Medical University.
Marina Fedotova – PhD, Assistant of Faculty Pediatrics Department, Siberian State Medical University.
Denis Tyufilin – Project and Program Manager, Siberian State Medical University.
Nikolay Tabakayev – Project and Program Manager, Siberian State Medical University.
Igor Pimenov – Expert, Institute for International Research and Education, Siberian State Medical University. Chairman of the Therapeutic section of the Council of Pirogov Students' Scientific Society, Siberian State Medical University.
Olga S. Kobyakova – MD, PhD, Professor, Head of the Department of general practice, Siberian State Medical University.
Ivan A. Deyev – MD, PhD, Professor of Faculty Pediatrics Department, Siberian State Medical University.
Alexander V. Kholopov – PhD, Head of the Department of Health Care of Tomsk Region.
Nadezhda Ya. Nesvetaylo – Acting Head of the Department of Health organization and Public health, Siberian State Medical University.
Ivan P. Shibalkov – Assistant of the Department of Health organization and Public health, Siberian State Medical University.
Anton A. Dmitriev – Assistant of the Department of Health organization and Public health, Siberian State Medical University.
BIHSENA is the 3-year project, which lasts from October 2015 to October 2018.
About the project
BIHSENA is the 3-year project, after which in Russia a new education program will be launched, uniting health, innovation and society issues.
Participants of the program (students, as well as practitioners) will gain relevant knowledge from different disciplinary areas, which is necessary for systematic understanding of changes at different levels, innovations in medicine and their management.
Audience members will receive analytical competencies, due to which they will be able to create new solutions to improve public health. They will also master some practical skills for successful work under conditions of rapid technological and social reforms.
An additional outcome of the project will be the building of communication links between different disciplines, as well as the academic community and practitioners (management experts and healthcare workers).
It will also contribute to the formation of interdisciplinary discussion platforms, where problems of medical innovation development and training of healthcare specialists in the field of medicine will be discussed at the international level.
Area of project expertise: student-oriented approaches to study; creating of interdisciplinary courses and programs in the field of healthcare system; competence-based approaches in specialist education in the healthcare system and medicine; innovations in the healthcare system and medicine; cooperation between disciplines and sectors at different levels for innovation development.
Initiator-coordinator: Maastricht University; Main contractors: Tomsk State University, Kyiv-Mohyla Academy (Ukraine); Partners-project participant: Siberian State Medical University, Vinnitsa National Medical University, Andrzej Frycz Modrzewski Krakow University, Plovdiv University.
External partners: members of the international academic council (medical education researchers, researchers of the health care system in Eastern Europe), non-for-profit institutions in Russia: Academy of Evidence-Based Medicine, Center of Cluster Development of Tomsk Region.
University of Maastricht, the Netherlands
Tomsk State University, Russia
University of Plovdiv, Bulgaria
National University of Kyiv Mohyla Academy, Ukraine
Andrzei Frycz Modrzewski, Krakow University, Poland
Executive coordinator: Maria Shevchenko
Email: email@example.comTel.: +7 (3822)901 101ext.1619
Science, Technology and Medicine: Global Challenges
The goal of this network is to expand and sustain collaboration between Norwegian and Russian researchers to address global challenges in science, technology and medicine in society. The network brings together scholars from the Russian Federation and Norway as well as from third countries to jointly address current health challenges and advance the interdisciplinary research area of the social studies of science, technology and medicine.
About the project
Global health challenges in society include risks due to antimicrobial resistance, persistent environmental pollutants, and changing needs in healthcare provision with aging populations, to name a few. Developments in technoscience, systems biology, new ‘omics’ approaches, personalized medicine, e-health, robotics in healthcare provision have challenged previous ways of studying these and given rise to societal concerns. Citizen science, popular epidemiology and new publics emerging with social media demand novel ways of engaging with health and biotechnology matters. Ways to address global health challenges locally need to be grounded in an in-depth understanding of the relations between knowledge, technologies and societies.
Our network and collaborative research project aims to contribute to the above field by opening up the societal aspects of responding to these global health challenges. A transnational approach with a focus on the Russian Federation and Norway has great potential to enrich previous research into societal issues in science, technology and medicine in this area. The relationships between science and the state, health registries and data technologies as well as the organization of healthcare services are distinct and have been co-shaped by post-socialist conditions in Russia and the Scandinavian welfare state in Norway.
The network especially aims to bridge the fields of Science and Technology Studies (STS), health policy studies, and medical humanities. STS has emerged as a vibrant field of research that can make key novel contributions into addressing global health concerns. The value of these contributions lies in going beyond approaches that focus solely on technological, biomedical or policy-making domains and providing analytical resources to address and respond to the public health challenges. The network helps facilitate conditions in which collaboration can be sustained and joint innovative research developed. The network comprises senior and junior scholars from different disciplines related to the social studies of science, technology and medicine.
Contact: Susanne Bauer: firstname.lastname@example.org
Website Norwegian-Russian network
IHOD underpins improved healthcare outcomes and preventative approaches to chronic disease by modernising the HE curriculum in the partner countries with the broad objective of modernising the curriculum supported by innovative courses and methodologies at masters level in public health studies.
SibMed Project coordinators
Maria Shevchenko – МВА, Director of Institute for International Research and Education, Siberian State Medical University.
Regina Malykh – Executive coordinator for the project. Expert, Institute for International Research and Education, Siberian State Medical University.
Igor Pimenov – Project manager. Expert, Institute for International Research and Education, Siberian State Medical University.
Chairman of the Therapeutic section of the Council of Pirogov Students' Scientific Society, Siberian State Medical University.
Anna Kovshyrina – Program developer. Expert, Institute for International Research and Education, Siberian State Medical University.
Vadim Poletika – Program Developer, Institute for International Research and Education, Siberian State Medical University.
Olga S. Kobyakova – MD, PhD, Professor, Head of the Department of General Medical Practice, Siberian State Medical University.
Sergey Fedosenko – MD, Professor, Department of General Medical Practice
Elena Starovoytova – MD, Professor and Doctor in the Department of General Medical Practice
IHOD is the 3-year project, which lasts from October 2017 to October 2020.
- University College Dublin, Ireland
- Universita degli studi di Pavia (University of Pavia), Italy
- Universitat Politècnica de València (Valencia Polytechnic University), Spain
- Lithuanian University of Health Science, Lithuania
- Moscow First Medical University (Sechenov University), Russia
- Federal University of the Far East, Russia
- Kazan Innovative University, Russia
- Tashkent Medical Academy, Uzbekistan
- Bukhara State Medical Institute, Uzbekistan
- Hanoi Medical University, Vietnam
- Thai Nguyen University, Vietnam
Executive coordinator: Maria Shevchenko
Email: email@example.comTel.: +7 (3822)901 101ext.1619
Why does the consortium wish to undertake this project?
The World Health Organisation (WHO) says chronic disease is now the major cause of death globally. Not only in richer countries such as Russia, but also in middle income countries such as Uzbekistan and Vietnam, the three partner countries in this project, life-style and environmentally related conditions are causing chronic, non-communicable diseases (NCDs), such as cardio-vascular, chronic respiratory disease and diabetes. Already in 2015, 6% of Vietnamese, 6,6% of Uzbeks and 9,2% of Russians have been diagnised with diabetes.
In addition to the human cost, the 2016 WHO ‘Global report on diabetes’ explained ‘Diabetes and its complications bring about substantial economic loss to people with diabetes and their families, and to health systems and national economies through direct medical costs and loss of work and wages’. In Vietnam in 2015 it cost $167 a year to treat the average diabetic patient when the average monthly income was just $150 (International Diabetes Federation). Russia's Federal Program on Diabetes expects significant savings from diagnosing diabetes and treating its complications early. Four million people have been diagnosed with diabetes in Russia, and almost 6 million people are unaware of their disease. The burden on the economy is considerable. The annual cost of caring for diabetic patients is $12.5 billion. (IDF).
This new health crisis demands that public sector health providers adopt a radically new approach, they are no longer treating acute illness through surgery or the use of pharmaceuticals, instead they need to radically change their treatment concepts, acquire new competences and adopt new organisation methods to educate patients, health workers and policy makers of the need to change life-styles. “Diabetes education is thus a radical innovation” (Windrum, Garcia-Goni & Fairhurst).
All the partner governments have prioritised action to tackle diabetes and NCDs. Russia and the WHO are collaborating to extend capacity for prevention and control of NCDs in the region, including Uzbekistan. Uzbekistan has a national NCD Action Plan, focusing on primary care. Vietnam has a multi-sectoral strategy for NCDs for 2015-2025. However, the WHO notes that training health care staff at primary level is inadequate to deal with diabetes and that it is necessary to develop patient-centred care for chronic disease. The costs to society of treating chronic disease, WHO says, need to be reduced by underpinning preventative initiatives.
To address this, a cadre of healthcare professionals, specialising in patient-centred care and preventative approaches needs to be trained at post-graduate level. In the EU, some HEIs offer programs and the Europubhealth project has developed a cross cultural approach to public health in general. But although there are Masters courses in public health available at a very small number of institutions in the partner countries, they concentrate on the training of clinicians. There is currently very little, if any, capacity in the partner countries to provide state-of-the-art, post-graduate education in the provision of primary healthcare and prevention.
This project proposes to develop courses targeted at a broad range of healthcare professionals, clinicians, nurses, health promotion and public health specialists having a cross-disciplinary nature, joining patient care and public health approaches. In line with EU best practice, the courses will use a core curriculum along the lines developed by the Agency for Public Health Education Accreditation (APHEA) including modules such as Public health methods, the Determinants of population health, Health policy, economics and management, health education and promotion, supported by cross- disciplinary themes and practical research projects.
This subject area was selected due to the urgent need to improve healthcare outcomes in chronic disease, a growing problem and in recognition of the fact that enhancing HE curricula is beyond the remit of international agencies like the World Health Organisation. IHOD supports the strategies of all the partner governments to address the challenges posed by chronic disease management and prevention, by raising the competence levels of those involved in the sector and complements national and international initiatives in partner countries and those of the EU itself, such as Joint Action on Chronic Diseases (CHRODIS) and the European Innovation Partnership (EIP) on Active and Healthy Ageing (AHA). IHOD assists in harmonising the approach to training in health issues with international best practice, by developing international partnerships between leading HEIs with a specific focus on improving healthcare. It promotes the modernization and relevance of higher education as part of life-long learning by developing inter-disciplinary Master Programs in the area of health studies using international cooperation and ensuring the program meets ECTS guidelines and stakeholder requirements.
The cross-disciplinary Masters course proposed here, combining patient care and public health content, is an innovative approach to address improving healthcare outcomes in chronic disease. A cross- disciplinary approach based on a change in the training mind-set so that synergy can be forged between the traditionally separate competences is needed.
The wide spectrum of healthcare professionals that the course aims to recruit and its focus on primary care are also innovative in the context of educational capacity building for improving chronic disease outcomes in the partner countries. This is also true for the flexible mode of course delivery that will enable healthcare workers to obtain a post-graduate qualification without giving up their job, and so not stretching the often limited resources in the partner countries.
Innovative practices using interactive, team based training and assessment methods help to break down the barriers preventing synergy. ICT is used to encourage the transfer of knowledge and develop practical competences. Innovative teaching tools are developed including “Need to change” to enhance transversal change management skills, an interdisciplinary competition to resolve public health issues and “To the university’s health” providing parctical experience to students of managing a public health program in their own university. Stakeholder involvement in the project, based on the rigorous analysis of their needs allows the clear definition of required competences enabling the development of programmes that will have the best chance of being sustainable. The use of the modular and credit based approach outlined in the ECTS guidelines assists in developing the required synergy between participant HEIs, allowing for individually designed learning paths, the accumulation of credits from different learning centres and the flexible acquisition of those competences required for varying applications.
Opisthorchiasis is an inflammatory disease caused by liver flukes of the trematode family Opisthorchiidae; eating raw or undercooked fish are the main risk factors for infection. Opisthorchis felineus (O. felineus) infection occurs in different parts of the Russian Federation. The prevalence rates may reach up to 60-80% in endemic regions, which is up to 1,000 times higher than in the European part of Russia. A number of studies demonstrate the carcinogenic potential of this worm, and World Health Organisation classifies opisthorchiasis, the resulting liver infection, among important emerging public health problems. The interdisciplinary integrative project was initiated in SibMed in frames of the international Tomsk OPIsthorchiasis Consortium (TOPIC) activity. The specific areas of the project include not only development of the new diagnostic tools and treatment, but epidemiological assesment of the prevalence and risk factors, and sociological approach - from field work to the development of educational programs and community work in endemic regions. The participatory modelling in conversation with other types of data and approaches can improve the efficacy of this One Health interventions.
Russia is one of the countries where rates of multidrug-resistant tuberculosis (MDR-TB) have become alarming. MDR-TB patients require prolonged and costly treatment with toxic second-line drugs, and rates of treatment failure and mortality are high. In line with previous research our study demonstrated co-productive relationship between the social and the biological where the processes of marginalization, isolation, increased poverty, alienation from formal support services, and an increased individual burden in taking care of family and oneself place persons at risk of contracting MDR-TB while contracting MDR-TB further exacerbates these processes. These results underlie importance of developing socialised medicine instead of biology-focused medicine. At the same time, in biosocial approaches to MDR-TB more attention needs to be placed to the roles and movements of such nonhumans as different kinds of TB drugs and bacteria itself and their interactions with humans.
Recent problems with availability of important medical drugs in Russia have induced a peculiar array of patient activist actions. For example through informally reorganizing state drug distribution system people living with HIV/AIDS managed to take action to avoid triage and meet health needs of at least some in their community, filling few gaps formal healthcare system couldn't fill. Surely, this is participation. Patients reshaped and contributed into the functioning of the state healthcare system. But they did it, first, through materiality of drugs and their flows and, second, using informal ways. Those looking for a public debate and participation in institutionally sanctioned spaces would look in vain. It is, then, crucially important that we widen our conceptions of and approaches to study participation, to include such ‘wilder’, hidden, informal ways in which citizens engage with science, technology, and politics, especially where they are persistently discouraged from doing so.
Pharmaceutical market and clinical trials (CTs) industry are growing rapidly in Russia, but little is known about perceptions of patients involved in medical experimentation, about their expectations regarding trial participation, and associated fears and reservations. Despite active development of the pharmaceutical market and clinical trials industry in Russia, there has been little systematic research of perceptions of patients involved in medical experimentation, of their expectations regarding trial participation and of their associated fears and reservations. However, availability of this information would help those who organize and conduct trials to identify the factors that are critical to making decisions on participation, be more responsive to patients’ needs, and to avoid antagonizing patients’ expectations. A multicenter cross-sectional study was conducted (since February 2014 to February 2016), which involved nine clinical research centers in different cities of the Russian Federation and overall 184 patients. The study was performed using a single protocol in accordance with the principles of good clinical practice. Results of the study showed that expectations, motivation and experience of participation of patients in clinical studies in the territory of the Russian Federation are comparable with the world's data. The findings suggest a significant role of the physician in virtually all aspects of patient participation - taking decisions on participation, introduction to the informed consent, the motivation to continue clinical trial. And even after the end of the study the majority of respondents are in touch with the researcher. On the one hand, revealed specifics of the relationship between researcher and patient in Russia are in the form of close interpersonal contact, creating an atmosphere of trust that allows comfortable conditions for participation, a sense of security and quality health care, on the other hand, is likely to cause potential ethical conflict.
One of the factors determining the quality of care is the health professionals’ efficacy. It often decreases with the professional burnout syndrome among them (PB): for example, the high level of PI in health professionals increases the amount of medical errors and the outflow of staff from healthcare system. Methods reducing PB with understanding its mechanisms demonstrate the opposite effect but such events cannot be provided in Russia because research on this issue was conducted either without use of international validated instruments or on small cohorts. Aim of the study was to build the PB model on a large cohort for development of measures reduce its prevalence. The study included health professionals in Tomsk region who completed the questionnaire for the period from October 2015 to September 2016. Questionnaire consists of the MBI-questionnaire for PB and questions on characteristics such as the qualifications, intensity of work and the environment of professional activity. The study involved 4155 medical workers: 1669 doctors and 2486 of other medical personnel. It was revealed that "rural" doctors work more intensively and are more prone to PB. The other medical personnel from the "village" showed less intensity of work and a lower level of PB compared to the "city". In addition, some gender differences in the intensity of work and the level of PB have been revealed. Still database that we have allows us to find out more reasonable impacts of certain factors on professional burnout and moreover – to predict and prevent this syndrome.
Modern society requires deeper involvement of patients into process of diagnostics and treatment of diseases. This concept is called patient-centered care. While such model is being implemented in many countries, doctors and patients are at different sides of the pond in view on how should this model be performed. Doctors expect informed patients, accurate diagnosis and standardized treatment strategies. At the same time patient requires comfortable space, polite staff and proper information on all stages of healthcare provision. We use patient satisfaction to assess relevance of patients’ expectations and provided healthcare services. Satisfaction measurement is aimed to identify gaps in healthcare and then use such data to plan the modernization measures. Furthermore, we use satisfaction evaluation to assess progress and then update plans of healthcare quality improvement. Nowadays there is no valid standardized instrument for patient satisfaction with healthcare measurement in Russian Federation. Intending to improve healthcare quality and availability we initiated research aimed to: development of satisfaction assessment instrument; development instrument of healthcare provision gaps indication; implement standardized plan of patients satisfaction improvement. Our survey enrolled about 13000 patients from Tomsk region. Respondents filled questionnaire after discharge from hospital or after the service is received in outpatient department. Digital platform was used for that purpose. Data analysis demonstrated that most of respondents were satisfied with received medical aid and personnel professionalism. Neither way majority of patients did not feel themselves as a key figure for their hospital. Surprisingly, Main problem identified was inability to reach answer by telephone. Other gaps included problems at reception, absence of comfortable place to wait for an appointment, long waiting time, impolite staff and, finally, huge lines. Next step was the pilot project “Entry lobby” developed in collaboration with Tomsk regional healthcare department. Based on the survey results project included 5 major parts: call centers, reception improvement, corporate identity implementation, improvement of personnel communication skills and new patients’ flow logistics system. Pilot project was initiated in 13 outpatient departments 16 months ago. First results show that reception comfort increased by 10%, while answer awaiting average time shortened from 20 to 5 minutes. Overall satisfaction increased as well for 25 %. Patient satisfaction is a dynamic parameter that requires further maintenance and improvement. For that reason we continue development of our project and for now apply deeper intervention into management of outpatients department work.