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Posted 10/24/2015

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By Vince Little
USACE


TIRANA, Albania – Albania’s telemedicine network is completely integrated and functional following a large-scale effort by U.S. and Albanian partners to overhaul a dozen facilities around this small country in southeastern Europe.

U.S. Army Corps of Engineers Europe District, in partnership with U.S. Embassy Tirana’s Office of Defense Cooperation and U.S. Agency for International Development, managed renovation of 12 telemedicine centers over five years in a $1.9 million venture funded through European Command’s humanitarian-assistance program. The final four facilities went online earlier this year.

Officials and program administrators say the system, which is run by the Ministry of Health, has greatly improved care and capabilities at national and regional hospitals, allowing for faster diagnosis in local communities via teleconsultation with specialists while significantly cutting down on the number of patient transfers across Albania.

“Today, we have made Albania a stronghold of telemedicine and a model for developing countries and other areas around the world,” said Dr. Rifat Latifi, president of the International Virtual e-Hospital Foundation and director of the telemedicine programs in Albania and Kosovo. “Without [the U.S. military’s] help and support of the American people through USAID, this would have been an unfulfilled dream. We appreciate the professionalism and collaboration in which it was done. Every corner of Albania is now covered by the telemedicine program.”

Latifi, also a professor of surgery at the University of Arizona, inaugurated and established Kosovo’s telemedicine center in 2002 before bringing the concept to his native Albania. Improving trauma and emergency medical services is the network’s primary objective.

“Albania has great physicians, but many are concentrated in Tirana,” he said. “Sometimes, there are not many in remote areas of the country. Trauma patients can be kept waiting. If they are not seen in a very short period of time, the consequences are devastating.”

Specialists and other health care providers can expand their reach through telemedicine, officials said. Long term, it’s expected to significantly lower health care costs in Albania by allowing rural patients to stay in their local communities and not travel long distances for care through easier access to specialty services.

“In that kind of environment, you want to do what you can to help them provide better care for those people who are in need of specialists but are far removed from the capital,” said Marc Ellingstad, general development officer for USAID in Albania. “Something like this really affects the entire country. All the citizens benefit from this type of assistance. … Generations of patients will see this every time they go through a telemedicine facility. It’s something intangible. You can’t buy that kind of goodwill.”

Arian Boci, the Telemedicine Center of Albania’s program coordinator, said the network has drastically reduced patient transfers, particularly the need for emergency helicopter medevacs to the “Mother Teresa” Tirana University Hospital Center. About 90 percent of trauma patients can now be treated at a regional hospital instead of being transferred to the capital.

Live consultations with a doctor have been lowered on average from an hour to five minutes, he added. Evaluations in trauma cases are now delivered in less than 10 minutes.

“You can see improvement related to referring patients,” said Agim Kociraj, a USAID health specialist. “Many patients are not referred or transported without first having a teleconsultation with the main central hub or national trauma center in Tirana. This is very important.”

Latifi calls telemedicine a “window to the world of medical expertise.”

Through it, doctors and nurses in every part of Albania and Kosovo benefit from an e-health program featuring interactive distance-learning seminars, virtual education and other tools spread along the system. Boci said a vast e-library also is available to medical professionals and researchers.

“We are in the same network with Kosovo [and] also use the same language, so our doctors and nurses can attend the same education programs and workshops,” Kociraj said. “It’s very cost-effective. We save a lot of money in organizing training events and seminars.”

EUCOM’s piece of Albania’s telemedicine transformation involved the upgrade of 10 regional centers, one at Tirana University trauma hospital and the Telemedicine Center of Albania, the central hub at “Mother Teresa,” said Artian Dautaj, humanitarian-assistance program manager for the U.S. Embassy’s Office of Defense Cooperation. In addition to renovating administrative, computer, training and examination rooms at each location, USACE Europe District constructed auditoriums in the Durres, Vlore and Mother Teresa hospitals.

Doug Wesemann, a Europe District special projects engineer based in Germany, made site visits to Lezhe, Berat, Elbasan and the Tirana trauma hospital as the effort was completed. He said he worked with Lesna contractors through design, construction and final inspections.

“The contractor fulfilled contract requirements and had a high buy-in for safety. They also finished on time,” he added. “We were able to renovate poor and unusable facilities … creating an atmosphere for a clean working environment for the telemedicine program in Albania. Newly renovated and newly built facilities always help provide trust and competence in the people they will benefit.”

The refurbished technical infrastructure, combined with a team of experts leading the telemedicine network, provides a solid foundation that will elevate the quality of health care in Albania, Dautaj said.

“This project helps reinforce host-nation capacity to provide essential services to the public,” he said. “This network will dramatically improve the capability of the regional hospitals to provide the best care to their patients. … The fact that the end users are satisfied with their renovated telemedicine centers is also significant for the role played here by USACE.”

Ellingstad said the long-term partnership yielded great results and was crucial in bringing the project to reality.

“This is one of those times when cooperation between the military and civilian sides of our government worked quite well,” he said. “It’s something we could not have done ourselves.”

Humanitarian-assistance endeavors like this for the Albanian people are a small trade-off for the Balkan country’s long-running contributions to U.S. and NATO operations around the globe, including Iraq and Afghanistan, said Army Maj. Richard Karcher, bilateral affairs officer for ODC-Albania.

“Bottom line is: Albania, from a military standpoint, is always willing to raise its hand for whatever effort NATO or the U.S. has going on,” he added. “Albania is a very good ally for us – not just a partner, but an ally – and our relationship is strong. That’s one of the reasons I think it’s important to EUCOM that this telemedicine program happened.”

Albania Artian Dautaj Doug Wesemann Dr. Rifat Latifi e-health EUCOM Europe District european command humanitarian assistance Marc Ellingstad ODC Office of Defense Cooperation Richard Karcher telemedicine Telemedicine Center of Albania Tirana Tirana University Hospital Center U.S. Agency for International Development U.S. Army Corps of Engineers U.S. Embassy Tirana USACE USAID Vince Little