Telemedicine in Kazakhstan: smart health services delivery

31 January 2019

Kazakhstan is the largest landlocked country in the world, spanning nearly 3 million square kilometres. Its geographic size means that much of the population lives in rural settings, far from the country’s main medical centres.

In view of this, Kazakhstan is investing in new technologies to deliver health services to people in rural areas. A telemedicine network, launched in 2004, helps rural populations access specialized medical care, with general practitioners and specialists providing teleconsultation.

As one intensive care doctor puts it, “Now we can contact any specialist in Kazakhstan any time – and save more lives.”

The telemedicine network is part of the strategic plan of the Ministry of Health for 2017 to 2021. The Government intends to develop the network further, to introduce “smart medical services” such as mobile applications for disease management, prevention and treatment, and to generally scale up digital health.

Like many countries in the WHO European Region, Kazakhstan faces a growing burden of noncommunicable diseases. This means that a significant number of the remote sessions delivered through the network are designed to support the management of chronic conditions.

In 2016, experts in 15 regional hospitals, the children’s regional hospital of Shymkent and 14 state clinics conducted over 28 000 telemedicine and video consultations. Of these, over 26 000 were conducted by regional hospitals and about 2000 by state clinics. Reflecting the growing burden of noncommunicable diseases, the most frequent teleconsultations were for cardiology, pulmonology and neurology.

Jerome Flayosc

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Kazakhstan’s telemedicine network was established to help deliver health services to rural communities across the country. It has gradually expanded and now comprises 209 health facilities at district, regional and national levels.

With the inclusion of the Republican Coordination Centre for Sanitary Aviation, which provides air ambulance support, medical assistance transport, disaster care initiatives and a network of mobile pharmacies, the telemedicine network provides rural citizens with improved access to health services.

WHO/Jerome Flayosc

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Tleuberdy Kuandykov is Head of the Intensive Care Unit at the Syzganov National Scientific Centre of Surgery in Almaty. In addition to performing surgeries, the Centre provides teleconsultations and follow-up sessions to colleagues from across the country. It also broadcasts surgical procedures to students for educational purposes.

Kuandykov remembers, “In the 1990s, when I worked in the district clinic in Turkestan in southern Kazakhstan, if I needed my supervisor’s or other experienced colleague’s advice, I would send a hospital car to the regional clinic and hoped that they would come to see my patient. Now we can contact any specialist in Kazakhstan any time – and save more lives.”

WHO/Jerome Flayosc

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Timely diagnosis and treatment through telemedicine allow health professionals in Kazakhstan to arrange emergency medical services to patients promptly, reduce the costs associated with travel for care, and reduce the complexity of accompanying patients with multiple health conditions to regional or state clinics.

WHO/Jerome Flayosc

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A pulmonologist, a heart surgeon and a recovery specialist from the Research Centre of Paediatrics and Child Surgery in Almaty consult their colleagues from a state clinic in the Aktau region in West Kazakhstan about a young patient in intensive care. The patient in question had infectious pneumonia and also a form of heart disease. Specialists from the Centre adjusted the treatment plan, agreed on medications and planned a follow-up appointment the next day.

The Centre has used telemedicine on a daily basis since 2012. Irina Vyatkina, Technical Specialist of the Telemedicine Unit, says that initially they expected up to 5 teleconsultations per month – but demand has grown fast. “I cannot imagine our work without telemedicine now. It has proven to be effective and timely,” she says.

In 2016, specialists from the Centre provided telemedicine sessions for 123 children. By 2018, that number had grown to 320 children across Kazakhstan. Each week, the Centre organizes remote lectures on current topics for primary health-care practitioners, specialists from regional clinics and clinics in rural areas.

Scientific Research Institute of Traumatology and Orthopaedics

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Trauma surgeons Bagdat Balbosynov and Gulzhanat Korganbekova from the Scientific Research Institute of Traumatology and Orthopaedics in Astana were contacted for a teleconsultation about a patient in the remote Zhambyl region in southern Kazakhstan. They study the first X-rays of the patient, who suffered multiple injuries and head trauma from a road accident. Following the teleconsultation, the patient was delivered by air ambulance to the Institute.

The Institute provides tertiary and specialized medical services to patients with injuries and diseases of the musculoskeletal system. In 2018, traumatology, orthopaedics and other related specialists held 68 telemedicine sessions. Very often, the Institute deals with acute cases. Telemedicine sessions are usually organized within 24 hours of the receipt of a request from a regional clinic.

WHO/Jerome Flayosc

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Damu Med, Kazakhstan’s official digital health application, has been introduced in 15 regions and had nearly 2 million registered users in 2018. The application helps people make an appointment to see a specialist, archive prescriptions, follow a treatment plan, receive laboratory tests and find medication. It will also help patients in risk groups, for example, those with arterial hypertension, cardiac insufficiency and diabetes, to self-manage their health and to take timely action when needed. More than 200 000 patients in Kazakhstan have already enrolled in the self-management programme.

WHO/Jerome Flayosc

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Kazakhstan’s telemedicine network not only provides clinical support – specialists in medical universities, scientific research institutes and national centres also use the network to provide lectures and seminars on diseases for training health workers in regional and district hospitals.

WHO/Jerome Flayosc

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Second-year students in the Faculty of General Medicine at Kazakh National Medical University in Almaty engage with their tutor Aliya Nurmukhanbetova via webinar. The University created a space for students to follow remote lectures and access university courses on a single secure learning platform. The University’s professors, residents, interns and researchers also use the network to connect with their colleagues in other parts of the country to develop skills, exchange data and share experience.

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