Accessible infrastructure in medical institutions, including for people with special needs, implementation of tools that facilitate patients’ access to primary and specialized medicine, as well as the expansion of the spectrum of services offered are the objectives set by the local authorities in Chisinau in the field of primary health care. These measures are being implemented gradually. The IPN reporter discussed the latest trends in primary medicine and the new telemedicine service with Vladimir Bolocan, deputy head of the General Medical and Social Assistance Division of Chisinau municipality.
Services offered by LMAs
In the municipality of Chisinau, there are five Local Medical Associations (LMAs) attached to 14 polyclinics and the Muncești Health Center. The number of provided services increases year after year. In addition to family medicine and consultations of narrow-profile specialists, laboratory services, imaging services, medical rehabilitation services and other types of consultations are offered. “In several LMAs we have evaluated the activity and we have seen that there is room to increase the spectrum of medical recovery services, in other parts we have noticed that there is a growing tendency to consult the gynecologist, to supervise the pregnancy, which means that we need to provide high-quality imaging services, especially in pregnancy surveillance,” stated Vladimir Bolocan.
The decentralization of the oncology service is one of the priorities. Vladimir Bolocan noted that the establishment of the municipal oncology service is absolutely necessary as patients lose a lot of time when travelling to benefit from certain examinations at the Cancer Institute, which they can easily access at the district polyclinic. By February-March 2025 at the latest, the municipal oncology service should become available. In each Diagnostic Advisory Center, there will be an oncologist who, within the limits of their competences, will manage the case.
The creation of a single community assistance service for people who need help at home is under discussion. “We need to create a separate tool, which will come to the aid not only of the doctor, but also of the patient,” said Vladimir Bolocan.
Digitalization of health system
The Telemedicine project, an innovative service for the Republic of Moldova, will be launched soon. Registration on the platform will be possible through the user’s email address, or through the user’s Facebook account. The patient will first interact with the family doctor, who, depending on the case, can refer the patient to the health specialist. At the end, the patient will receive a validated medical report, signed by the doctor, which they will be able to present to other specialists in physical format. The report will be sent both by email and to the patient’s office. Consultations will be possible in writing and also by videoconference. The platform will be accessible from anywhere, including by patients who are abroad. The doctor will consult them and guide them where to go to get the final diagnosis.
Vladimir Bolocan said that there are currently many fragmented units in the field of digital medicine, such as the Automated Information System “Primary Medical Assistance”, the Automated Information System “Hospital Healthcare”, laboratory systems that each institution developed individually. It is necessary to create a center for processing medical data, so that epidemiologists, specialists in narrow fields have access to these data and can work with them.
Prophylaxis of noncommunicable diseases
Hypertension and diabetes mellitus are two noncommunicable diseases that have a very high impact, including budgetary, on the health system in the municipality of Chisinau and beyond. Cardiovascular diseases and diabetes affect more younger people, along with obesity, which is a serious issue even among children. Diseases are getting younger and there are factors that aggravate some diseases. In this situation, the role of the family doctor in disease prevention is decisive.
Vladimir Bolocan stressed that when there is a logical chain of measures to promote a healthy lifestyle for all ages, the impact will be greater. Programs for young people are needed, implemented through youth centers. There is a need to organize multidisciplinary events for adults, for people with certain conditions, such as diabetic or asthmatic patients, to stage interest clubs. The active ageing program is also important.
Improving conditions in medical institutions
The authorities plan to create new access roads and parking spaces near polyclinics, to ensure the dry trees in the adjoining territory are cleaned. Networks and basements will be inspected repeatedly in order to avoid water leaks and, in this way, unjustified expenses. The winners of the projects to rehabilitate Family Doctors’ Centers No. 5 and No. 8 are to be decided. The sewage system at LMA Râșcani and the basements of Family Doctors’ Center No. 12 will be repaired. Also, the contract for the purchase of an X-ray device for AMT Center will be signed. The elevators at Family Doctors’ Centers No. 5 and No. 2 were replaced and such works will continue.
Milena Macarciuc, IPN
