Evaluating Health Care Professionals' Readiness for e-Health Adoption in the Context of the COVID-19 Pandemic: A Georgian Perspective.

Background: The COVID-19 pandemic has accelerated the adoption of Electronic health (e-Health), leveraging technologies such as telemedicine, electronic health records, artificial intelligence, and patient engagement platforms. This transformation underscores e-Health's role in providing efficient, patient-centered care. Our study explores health care professionals' readiness for these technologies, emphasizing the need for tailored education in this evolving landscape. Methods: In our study, conducted between February and March 2023, we administered a questionnaire-based survey to 500 staff members (82.4% female, 17.6% male) aged 25-70 from medical universities in Tbilisi, Georgia. The structured questionnaire covered topics such as computer literacy, telemedicine awareness, patient data security, and ethical considerations. We employed SPSS v21.0 for data analysis, encompassing descriptive statistics and thematic analysis of open-ended responses. Results: Our study included 500 participants categorized into five age groups. Notably, 31% considered themselves computer "experts," while 69% rated their skills as "intermediate" or "advanced." Furthermore, 85% used computers professionally, with 33% having practical computer training. Interestingly, 59% expressed interest in information technology training. Regarding e-Health, 15% believed it involves remote communication between health care professionals and patients, while 42% considered it "correct," and 37% "might be correct." Concerning its application in managing patients, opinions varied. In terms of e-Health's integration into Georgia's health care, responses ranged. Regarding patient data safety, participants exhibited diverse views. Finally, opinions on the necessity of informed consent for e-Health applications varied among participants. Conclusions: Our study explores health care professionals' readiness for e-Health adoption during the COVID-19 pandemic. It reveals varying computer literacy levels, a willingness to learn, differing views on e-Health applications, and mixed opinions on its integration into Georgian health care. These findings emphasize the need for clear e-Health terminology, education, tailored approaches, and a focus on data privacy and informed consent. Overall, e-Health's transformative role in modern health care is underscored.

The HPV-TP53-MALAT1 Axis: Unravelling interactions in cervical cancer development.

INTRODUCTION: Cervical cancer, primarily driven by Human Papillomavirus (HPV) infection, stands as a substantial global health challenge. The TP53 gene's, Arg72Pro polymorphism has emerged as a noteworthy player in cervical cancer development, particularly among individuals harboring high-risk (HR) HPV types. Additionally, long non-coding RNAs (lncRNAs), exemplified by metastasis-associated lung adenocarcinoma transcript 1 (MALAT1), exert critical roles in cancer biology. This study delves into unravelling the intricate connections linking HPV infection, TP53 Arg72Pro polymorphism, and MALAT1 expression in the context of cervical cancer. MATERIALS AND METHODS: Within a cohort of cervical cancer patients, we discerned HPV infection statuses, executed genotyping for the TP53 Arg72Pro polymorphism, and quantified MALAT1 expression through quantitative reverse transcription-polymerase chain reaction (qRT-PCR). Statistical analyses meticulously probed relationships intertwining HPV infection, TP53 polymorphism, and MALAT1 expression. FINDINGS: Our investigation revealed a striking prevalence of the TP53 Arg72Pro polymorphism among HPV-positive subjects, accompanied by a robust and statistically significant correlation linking MALAT1 overexpression (p<0.01) and HR-HPV positivity (p<0.03). Importantly, a subset of MALAT1 overexpression cases unveiled a concomitant TP53 Pro72Pro polymorphism. In contrast, HPV-negative invasive cervical carcinoma samples exhibited no discernible shifts in MALAT1 expression. CONCLUSION: The contours of our findings sketch a compelling landscape wherein HR-HPV infection, TP53 polymorphism, and MALAT1 expression intertwine significantly in cervical cancer. The voyage ahead entails delving deeper into molecular underpinnings to decipher MALAT1's nuanced role and its dance with TP53 within HPV-associated cervical carcinogenesis. This expedition promises insights that may engender targeted therapeutic interventions and bespoke prognostic markers, tailored to the realm of HR-HPV-related cervical cancer.

Reproducibility of telecytology diagnosis of cervical smears in a quality assurance program: the Georgian experience.

OBJECTIVE: The study evaluated the reproducibility of telecytology diagnosis of cervical smears on a randomly selected 50 cases under the conditions of Georgia. MATERIALS AND METHODS: Fifty cervical smears (benign, 14; atypical squamous cells of undetermined significance [ASCUS], 14; low-grade squamous intraepithelial lesion [LSIL], 10; high-grade squamous intraepithelial lesion [HSIL], 12) were selected. The digital images were captured at a maximum resolution of 2048 × 1536 pixels and transmitted by electronic mail. Diagnosis of glass slides and digital images was done independently in a double-blind manner by three cytologists, versus the diagnosis of digital images followed by diagnosis of glass slides 3 months later. The procedure was repeated after 3 months. RESULTS: Diagnoses were recorded as benign, ASCUS, LSIL, and HSIL. Diagnostic accuracy and interobserver reproducibility were analyzed using an interclass correlation coefficient, which revealed good interobserver agreement for the first (0.82) and second (0.68) glass slide diagnoses and the first (0.80) and second (0.66) digital image diagnoses. The kappa values for interobserver variation between first and second glass slide diagnoses and first and second digital image diagnoses showed good to excellent agreement. CONCLUSIONS: Digital images are suitable substitutes for glass slides; telecytology can be used as an alternative method for the cytologic diagnosis of cervical smears, particularly in quality assurance programs.

Diagnostic accuracy and image quality using a USB digital eyepiece camera for telecytology-Georgian experience.

OBJECTIVE: this study is aimed at evaluating the effectiveness of digital images for telecytology diagnosis and compares it with routine cytology diagnostic under the conditions of Georgia. MATERIALS AND METHODS: gynecological cytology cases (n = 420) were taken from the clinical laboratory. Cases were diagnosed routinely by one of four certified cytologists who provided cytology diagnoses. Digital images were obtained on all cases and were evaluated as computer images by a panel of cytologists. RESULTS: there was 94% concordance in average between routine versus digital images diagnostic. Intracytologists concordance averaged 95.5%. Image sharpness and quality were rated "good" and "excellent" in 97% cases. With respect to image color, 96% of the images were rated as "excellent" or "good." CONCLUSIONS: digital images for cytology diagnostic are of adequate quality, with diagnostic concordance rates.

Application of medical information system for telepathology--Georgian experience.

INTRODUCTION: The field of healthcare informatics is rapidly evolving. The new models and protocols of medical information system (MIS) are developed. Despite obvious advantages and benefits, practical application of MIS in everyday practice is slow. Much progress has been made around the world in the field of digital imaging and virtual slides, but in Georgia telepathology is still in evolving stages. It revolves around static telepathology. OBJECTIVE: Practical application of MIS has been started in Georgia. The architecture of the mentioned system and its usage for telepathology will be presented. MATERIALS AND METHODS: The MIS has been created with .Net technology and structure query language (SQL) database architecture. It involves a multiuser Web-based approach. By this, local (intranet) and remote (Internet) access of the system and management of databases can be achieved. Two hundred electronic medical records illustrated by images were selected for telepathology consultations. These electronic medical records were written in Georgian. This predetermines organization of regional second opinion consultations. For security reasons all experts have been registered as users at MIS. RESULTS: MIS has been launched in Georgia. Its primary goal is patient management. However, the system can be successfully applied for static telepathology purposes. DISCUSSION: The ideal of healthcare in the information age must be to create a situation where healthcare professionals spend more time creating knowledge from medical information and less time managing medical information. The application of easily available and adaptable technology and improvement of the infrastructure conditions is the basis for telemedical applications. The usage of MIS holds the potential to realize telepathology in the effective and comprehensive mode.

Implementation of telepathology in the republic of georgia.

Telepathology in the Republic of Georgia is still evolving. Although much progress has been made around the world, especially in the field of digital imaging and virtual slides, telepathology in Georgia still revolves around static telepathology. The results of the NATO Networking Infrastructure Grant "ePathology-Virtual Pathology Center in Georgia as the continuation of Virtual Health Care Center" are presented. It is a practical implementation of telepathology in Georgia as a best practice example. Using basic methodology: idea-analysis-conception-implementation-test/deployment, the ePathology server was created for the establishment of telepathology in Georgia. Two main services were made available on the server: Simple Machines Forum (eConsultation) and Moodle (eLearning) under the premise "keep it small, safe, and simple." The ePathology server works well. By its application, introduction of the Pap-smear technique and 2001 Bethesda System for reporting cervicovaginal cytologic diagnosis has been done. The application of easily available and adaptable technology, together with the improvement of the infrastructure conditions, is the essential basis for telemedical applications. Telepathology is a very useful and applicable tool for consulting on difficult pathology cases. It has significantly increased knowledge exchange and thereby ensured a better medical service.

Virtual health care center in Georgia.

Application of telemedicine systems to cover distant geographical areas has increased recently. However, the potential usefulness of similar systems for creation of national networks does not seem to be widely appreciated. The article describes the "Virtual Health Care Knowledge Center in Georgia" project. Its aim was the set up of an online integrated web-based platform to provide remote medical consultations and eLearning cycles. The project "Virtual Health Care Knowledge Center in Georgia" was the NATO Networking Infrastructure Grant dedicated for development of telemedicine in non-NATO countries. The project implemented a pilot to organize the creation of national eHealth network in Georgia and to promote the use of innovative telemedicine and eLearning services in the Georgian healthcare system. In June 2007 it was continued under the NATO Networking Infrastructure Grant "ePathology--Virtual Pathology Center in Georgia as the Continuation of Virtual Health Care Center".