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doi: 10.1097/01.NT.0000406022.50213.9d
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Global Neurology: Mateja de Leonni Stanonik, MD, PhD: Telemedicine Pioneer and Slovenia's First Surgeon General

Rukovets, Olga

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Slovenia gained its independence from Yugoslavia in 1991. Shortly after that, Mateja de Leonni Stanonik, MD, PhD, also left her native land in search of independence — in the form of an expanded education.

DR. MATEJA DE LEONNI...
DR. MATEJA DE LEONNI...
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As a budding clinical investigator, Dr. de Leonni Stanonik is gaining a lot of ground in her quest to improve neurological care worldwide. After finishing high school, she came to the US in order to pursue a medical career, completing a PhD in neuroscience at the University of Tennessee in 2002. Four years later, Dr. de Leonni Stanonik received her MD from the Saba University School of Medicine, and just this year, in 2011, she graduated from an adult neurology residency at George Washington University.

But in a development unique to graduating residents, Dr. de Leonni Stanonik was recently named the first Surgeon General of Slovenia, a country of two million in Central and Southeastern Europe touching the Alps and bordering the Mediterranean. She brings to the position the knowledge she has gained studying both in the US and abroad, on several telemedicine projects — including a mission along the Amazon River (from Atalaya in Peru to Belèm in Brazil). In her new role, she said, she is most excited for the opportunity to develop new procedures and methods for early detection and treatment of cerebrovascular diseases in Slovenia.

Neurology Today spoke with the accomplished investigator about her recent homecoming and what she hopes to accomplish within the realm of telemedicine.

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WHY NEUROLOGY?

“I have been fascinated by human behavior, specifically the brain, ever since I can remember,” Dr. de Leonni Stanonik told Neurology Today: I saw it as “a miracle — one that, despite being challenged, our village Priest [in Slovenia] just could not reproduce or explain.”

As a master's and PhD student, Dr. de Leonni Stanonik worked to develop tests for mild cognitive impairment and attention problems, and subsequently entered a residency in psychiatry at University of Virginia Carilion Clinic.

But Dr. de Leonni Stanonik quickly learned that her passion was in neurology. Thus, completing her adult neurology residency, she became a Fellow in Stroke, Neurocritical Care and Interventional Endovascular Neurology at the Texas Stroke Institute — and never looked back.

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TELEMEDICINE ON THE AMAZON

In 2007, in an effort supported by the late second president of Slovenia, Janez Drnovsek, MD, Dr. de Leonni Stanonik was invited by a family friend, competitive swimmer Martin Strel, to be his physician on an expedition across the Amazon River — an initiative that would not only culminate in a world record for Strel, but would also change Dr. de Leonni Stanonik's life and neurological practice.

She found an “enthusiastic co-worker” in Dr. Rifat Latifi, a trauma surgeon of Kosovar origin who is a professor of surgery and vice chair of international relations at the University of Arizona. Together, they formed the Amazon Virtual Medical Team, which provided medical support throughout the length of the trip with the aid of telemedicine. The journey became a pilot run for the telemedicine initiative, and the two physicians planned and raised funds for the entire expedition, choosing the necessary equipment very carefully. (For more information on the Amazon River swim, visit: www.amazonswim.com.)

“The boat had an entirely outfitted emergency room with telemedicine units, and we used temporary access to portable satellites,” Dr. de Leonni Stanonik said. The project was not limited to assisting only Strel and his team, but also locals, mainly children, who may never have seen a doctor before.

One of the most difficult and memorable patients we treated during the trip was a 22-year old male with odontoid fracture, which he sustained while diving into the Amazon River, Dr. de Leonni Stanonik told Neurology Today. He suffered from paralysis of the arms, legs, and diaphragm, and eventually respiratory failure. At the family's request, Dr. de Leonni Stanonik accompanied the 22-year-old to his hometown in a non-pressurized small plane without doors while he was in a Halo brace, performing “mechanical ventilation with a bag” for two hours because the patient became extubated during turbulence. The patient did not survive the landing; and Dr. de Leonni Stanonik faced the painful task of informing his nearly 60 friends and family who were awaiting his arrival.

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A VIRTUAL HOSPITAL

After her involvement with telemedicine during the Amazon River Swim, Dr. de Leonni Stanonik became the vice president of the International Virtual e-Hospital (IVeH), Dr. Latifi's organization, which has now opened a dozen regional telemedicine centers in the Balkans and trained nearly 50 doctors and nurses from Kosovo, Macedonia, and Montenegro at its facilities in Alaska and Arizona, in initiatives funded by grants from the US State Department's Bureau of Educational and Cultural Affairs.

The main goal of the IVeH is to create self-sustaining telemedicine and e-health programs in developing countries worldwide. “I simply fell in love with its concept,” she said.

Dr. de Leonni Stanonik told Neurology Today that she views the vehicle of telemedicine as “a paradigm shift in diplomacy” with far-reaching capabilities of improving global health, in particular neurology needs, as well as international relations — particularly in conflict areas and resource-poor environments.

The IVeH experience shows, she said, “that the telemedicine efforts really have to be undertaken in full collaboration with the (regional) ministries of health and other health authorities” so the countries can adapt the technology to best suit their needs.

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HOMECOMING

When the Slovenian Minister of Health, Dorijan Marušič, MD, asked Dr. de Leonni Stanonik to become the chief executive of the National e-Health and Telemedicine Program of the Republic of Slovenia, she decided to return home.

In Slovenia, a country slightly smaller than New Jersey, there is a government-run public health care system, Dr. de Leonni Stanonik said. Since the “system cannot handle all of the [public's] needs, especially those for specialist care, other alternatives had to be devised,” she said. For example, the waiting period right now for a non-urgent brain MRI is approximately a year.

The Minister of Health is currently working on what he deems “an upgrade of the health care system” in Slovenia, and Dr. de Leonni Stanonik was invited to bolster this process. Her main mission as Surgeon General is the e-Health project, which, she said will open up model avenues for treatment and break down spatial boundaries between countries.

The short-term goal of the e-Health project, she said, is to implement e-prescription, teleradiology, and e-referrals by the end of 2012, while adding supplemental programs and e-health services gradually. Ideally, the project is to be completed nationally by 2015. She hopes these initiatives will improve neurological care in Slovenia. ‘She is enthusiastic about the challenges ahead, but, she said, her overall feelings on returning home are bittersweet.

“The US has certainly afforded me professional and personal opportunities in life which I could have only dreamed about had I stayed in Europe,” she said. “Yet, I've always felt this incredible connection to my home roots which has helped define my life path.”

©2011 American Academy of Neurology

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