Dr. Youri Anastassov

Curriculum Vitae

  • Licenciado en Medicina, UNAM (Méjico) y Universidad de Sofía (Bulgaria), 1986
  • Especialista en Cirugía Plástica y Reconstructiva, H.U. de Sofía (Bulgaria), 1996
  • Doctor en Medicina, Universidad de Sofía (Bulgaria), 2009 - Tesis sobre Pacientes con Anomalias Faciales
  • Profesor Asociado de Cirugía Plástica
  • Director de varias tesis doctorales relacionadas con el tratamiento de pacientes fisurados
  • Ponente especializado en fisuras faciales durante congresos en Austria, Bulgaria, España, EEUU y Francia
  • Premios recibidos por Smiletrain (2000) y International Cleft Palate Foundation (2005)
  • Jefe de Servicio, Cirugía Plástica, H.U. Saint George, Ploviv, Bulgaria

ABSTRACT

Registro electrónico de los datos para anomalías faciales (EMRFA) en Bulgaria

Y. Anastassov, K. Gigov, R. Khater, R. Velikova, M. Kazakova, N. Hashova, M. Bojinov, P. Petrov, At. Gyulev, V. Marinov, H. Zhelyaskov, P. Radev, R. Gerganov, P. Tcarvulanova

An original software platform and a national network for trusted specialists have been developed by the Cleft and Craniofacial Center in Plovdiv, Bulgaria thanks to the support of the nongovernmental association for facial anomalies ALA (www.ALA-BG.org). The EMRFA gives the possibility for communication between the Center, the specialists, the parent-patients in real time and allows them to keep thе information safe in servers with backups.

In 2017, more than 900 patients and 65 specialists (plastic, maxillofacial, ENT or pediatric surgeons, ophthalmologists, neurosurgeons, speech therapists, orthodontists, feeding specialists, psychologists) from different geographical regions are included in the EMRFA.

There is a free access to EMRFA for a dynamic epidemiology and statistics.

High level of protection of personal data is ensured and ALA has the governmental authorization to administrate personal data files. The patient-parents sign a voluntary consent form for participation in the EMRFA. The parent-patients specifies which specialists from the network can have access to their personal data files. The patient and his family are in charge of their own personal data and can write comments as text, upload pictures and videos to their files. Participating in EMRFA is not mandatory but patients who disagree to participate are considered at risk for poor follow up (out of sight).

In case of agreement which is 99% for 900 patients the information is accessible by all members of the Center and only by the authorized specialists chosen actively by the parent-patients.

In the secured part of the platform the information is presented in chronological “posts” on the “wall” of the patient’s file, in the section “files” - as a brief description of the events by dates and as a collection of all the uploaded pictures - in the section “gallery”. Only the surgeons from the Center are authorized to define and write the main (and secondary) clinical (s) diagnose(s).

The system provides the possibility for one or more diagnoses for the same patient according to the ICD-11. An additional coding for sub phenotypes is proposed for cleft lip and or palate. For this pathology the standards of documentation proposed by EUROCLEFT is applied. Each specialty has an individual form to describe and code the present state and the therapy for the patient.

Individual (for the tasks) and automatic (according to age) electronic reminders are sent to the Center, the concerned specialists and the patients.

Depending of some psychosocial risk factors patients are divided in 3 groups – normal, low and high risk.

The “out of sight patients” are classified in this group when they have missed their appointments for more than one year. Filters using different criteria gives the opportunity to study different groups of patients according to the diagnose and sub phenotypes, type of defects, type of therapy, age, geographical region, risk groups, name of the specialist, key words, etc.

Extension for other pathologies requiring long term follow up is possible as well as an interaction with other electronic medical records.

Intercentric and international comparative studies becomes easier with standardized documentation and easy access by Internet.

An export of the skeleton of this platform and the construction of national specific requirements is possible.

Some clinical examples are presented showing particular details of the surgical protocol for cleft lip and palate applied in Bulgaria in the last 20 years.