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News: Newsletter 18

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July 7, 2003

In this newsletter:

  • Telemedicine & Telecare International Trade Fair becomes Med-e-Tel
  • The contribution of ICT to health
  • Satellite's role in telemedicine
  • Speeding up standardization in ehealth
  • Bi-monthly newsletter launched by UKeHA
  • "Telemedicine 2010" project in Ukraine: Looking for medical equipment and methodological support
  • News from the Med-e-Tel media partners
  • Newsbriefs
  • Conferences


In the field of telemedicine there has been an ongoing discussion in recent years over the name and wording to be used for these kind of activities and applications: should it be called "telemedicine", "telecare", "telehealth", "ehealth" or even something else? There now is a general trend towards the use of the term "ehealth" to cover all these similar, yet diverse applications.
In the same sense and in order to better reflect the entire scope of the Telemedicine & Telecare International Trade Fair and to incorporate industry and market evolution, and also to include not only the pure "telemedicine" applications, but also a number of other medical IT applications and to foucs even more on the convergence of information and communication technology and medical applications, the event changes its name to Med-e-Tel:

in which "Med" stands for healthcare services and medical products and equipment; "e" stands for the electronic and IT industry and services (hard- & software, internet, e-mail); and "Tel" stands for telecommunications (whether it is POTS, ISDN, wireless, satellite, videoconferencing, or other). While the telemedicine component - which basically means delivery of healthcare services (monitoring, diagnosis, second opinion and eventually treatment), clinical information and also education via telecommunications - remains of course a very important part of this, the term has become too restrictive as an indication of the scope of the event. There is more to it than "telemedicine" and the event will also focus on other new and improved medical ICT applications that contribute to quality of care, cost reductions, workflow efficiency, and widespread availability of healthcare services.
The dates for the 2004 event are April 21-23 and in addition to the exhibition and educational program, several other meetings, workshops and conferences are being planned by some of the event's supporting and partnering organizations. The Med-e-Tel website www.medetel.lu will be updated shortly with more details about all this. If you already have any questions now about attending or participating in the show, contact us at or check our upcoming newsletters for more information.


The European Commission recently organised a high level ministerial conference on ehealth in Brussels under the title "eHealth 2003: The contribution of ICT to Health." The objectives of the conference were to provide European Health Ministers and the health public sector in general with validated information on which key implementation decisions on ehealth may be made and to reinforce the implementation and deployment of ehealth systems by European health service providers.
Among thirty ehealth projects and applications that were presented at the conference and exhibition (and that were previously selected through a call), four eEurope awards for ehealth were awarded in the categories:
- national or regional ehealth networks and services,
- hospital ehealth systems,
- telemedicine and home care ehealth applications,
- empowering citizens in management of health and well being.
The winners were: SJUNET (National IT Infrastructure for Healthcare) from Sweden, COHERENCE (Information System for Successful Hospital Restructuring) from France, EVISAND (Virtual Environment for Healthcare) from Spain, and NHS Direct (NHS Direct on-line website) from UK.
The participating Health Ministers from 33 countries recognised that ehealth applications can promote quality of and enhance efficiency in health care, shared the view that citizen involvement should be facilitated through widespread access to high quality information, and agreed to share experiences on the utilsation, efficiency and impact of ehealth applications. They supported concerted actions to address particularly the development of standards enabling interoperability of diverse systems and services and to especially explore the possibilities of open source applications for achieving this objective.
The full Ministerial Declaration can be found on the European Commission, Information Society (pdf) website.


In another recent symposium, organised by ESA at the European Space Research Institute in Italy, ways in which satellites can help improve health services were discussed. Several working groups were organised to cover various aspects of telemedicine, including:
- telemedicine and the elderly,
- telemedicine for disaster relief and emergencies,
- telemedicine for hospitals in remote areas,
- teleconsulting, 2nd opinion and regulatory aspects,
- telemedicine, medical education and clinical research,
- telemedicine technology development in satellite communications.
Participants concluded satellites are currently not being used enough in telemedicine, mainly due to a lack of awareness about the benefits.
Those benefits and advantages do include instant access to broadband services, swift response in disaster situations, powerful and relatively inexpensive tool (particularly for video links between multiple users). In addition, costs are constantly decreasing and satellites are a tried, tested and extremely reliable means of telecommunication.
In discussing telemedicine in general, the symposium participants agreed that although a promising start was made in many areas, its expansion was hindered by a lack of universal standards; the availability, quality and speed of information transfer; legal and ethical concerns; security of data; funding; and a general lack of support, at European and national level, to encourage doctors and hospitals to set up telemedicine services.
In the near future ESA will set up, via satellite, a user-driven telemedicine working group to define the actions needed to build a European, telemedicine via satellite program, pushing for standardization and interoperability, monitoring developments and encouraging further research and development. More info can be found on the ESA website.


The International Telecommunication Union (ITU) with the participation of WHO, ISO, IEC, and other Standards Development Organisations, recently held a workshop on standardization in ehealth and interoperability of different telemedicine systems (www.itu.int/ITU-T/worksem/e-health). Opening the workshop, Mr. Houlin Zhao, Director of the ITU Telecommunication Standardization Bureau, clearly stated that "...standardization in ehealth has long been sought as a key element in support of these activities".
However, according to Mr. Hamadoun Toure, Director of ITU's Telecommunication Development Bureau, "...experience acquired in developing countries shows that all vendors are promoting telemedicine systems of proprietary nature and unfortunately they are locked inside with almost no interoperability". Leonid Androuchko, Rapporteur of the special group within ITU dealing with the needs of developing countries for telemedicine services, confirmed that many telemedicine systems have been introduced in several countries but that there are communication problems between the systems due to incompatibility of software and even hardware.
Workshop sessions included a combination of case studies highlighting end-user requirements and discussion on the technical issues that needed to be addressed, and their priorities. Many speakers agreed that standardisation in ehealth is a way to increase levels of interoperability, but, most also agreed that there are too many standards and that these are often conflicting, introducing competing solutions for similar problems, or not deployed. A stronger coordination of standardization effort is seen by many as imperative. Most also agreed that more consideration of ‘use cases’ will lead to the creation of more meaningful standards.
An important conclusion of the event was the agreement to start a dialogue to create a joint coordination group for standardization in ehealth, whose task will be to increase information exchange about ongoing standards activities in the respective organizations, avoid duplication and enhance cooperation where appropriate. And subsequent to the event, ITU-T Study Group 16 has agreed to setup an ehealth project, which will look at standardization of multimedia systems to support telemedicine applications.


The UK eHealth Association (UKeHA), the UK’s only campaigning organisation for the effective use of technology for health, has launched a new bi-monthly email newsletter, ehealthcheck. The publication has been designed to be a major source of information on the ehealth marketplace and will be distributed to ehealth suppliers, healthcare professionals, government organisations, health journalists and industry-related bodies.
The publication will provide readers with the latest news on government policy developments, UKeHA initiatives, and ehealth developments and events around the world. The newsletter will also provide a platform for experts in the sector to air their views.
The launch issue includes details of a new military telemedicine and bioterrorism specialist interest group being created by the UKeHA, and Alasdair Liddell, an independent consultant in ehealth and elearning, gives his view on the benefits of a coalition of ehealth organisations.
If you are interested in receiving a copy of ehealthcheck in the future, please email your details to: . Alternatively, click on the following link to view the first edition of the newsletter: www.ukeha.org.uk/mayjunenewsletter/index.html.


Within the framework of the "Telemedicine 2010" project, a large scale medical examination of the rural population in Southern Ukraine (Nikolaev, Kherson, Kirovograd and Odessa regions) will be conducted between 2003 and 2006 by the Akson Diagnostic Center of Nikolaev.
The Center is still looking for European partners (universities, hospitals, telemedicine centers, associations) who could provide methodological and organizational support for this project and who could eventually also analyze, compare and evaluate the data once they have been obtained.
They are also interested in acquiring additional products and equipment like ECG monitors, EMG monitors, mobile laboratories, MRI, ultrasonography.
To obtain more information about the project or to discuss possibilities for cooperation, contact Prof. S. Bekalo, Director of the Akson Diagnostic Center, at


- For information on publications, journals, magazines and on-line information services that will help you to stay abreast of what is going on in the field of ehealth and to make better informed decisions in your daily business or healthcare practice, check out the list of Media Partners on www.medetel.lu.
- Home telehealthcare - or home healthcare delivered via telecommunications - is the focus of "Home Telehealthcare: Process, Policies, and Procedures", the fifth in a series of informational reports from home telehealth research firm, Information For Tomorrow. This new report investigates the potential for providing more and cost effective patient care in the 21st century and provides a practical guide for setting up home telehealth programs to do so.
"Many in healthcare are interested in telehealth but question how using it effectively in the home can be accomplished. This report is a planning guide for creating in-house home telehealth policies and procedures that can save providers and insurers money," says Audrey Kinsella, the report’s principal researcher and writer.
A contents page and samples of chapters are available online at www.informationfortomorrow.com.



To follow are links to several recently published articles and studies:
- A new device that continually monitors health is preventing falls and gives carers peace of mind (The Guardian)
- Picture phones save doctors time (BBC News)
- Technology Elite Are Focusing Next on Human Body (New York Times)
- City Selects Doc@Home for Remote Monitoring Trial (E-Health-Media.com)
- Internet-based Patient Self-care: The Next Generation of Health Care Delivery (Journal of Medical Internet Research)
- Eliminating the Paper Chase (Healthcare Informatics)
- Telehealth May Reduce Suicide Rate (ATSP)
- Building a PACS from Scratch With Limited Capital: A Mexican Case Study (Frost & Sullivan)
- Aussies test effect of nuclear medicine telediagnosis (Diagnostic Imaging)
- A Review of Decision Support Systems in Telecare (Journal of Medical Systems)
- Telemedicine for antenatal surveillance of high-risk pregnancies with ambulatory and home fetal heart rate monitoring - an update (Journal of Perinatal Medicine)
- Group Pitches E-health Definition (Health Data Management)
- Having It Your Way - Three physicians who were early adopters and who remain vocal EMR advocates share their insights about the utilization, challenges and benefits of EMR's (Health Management Technology)
- Systematic review of scope and quality of electronic patient record data in primary care (British Medical Journal)
- Telemedicine Awaits - Reimbursement will mean big change and real money (Healthcare Informatics)
- Implementing a new health management information system in Uganda (Health Policy and Planning)
- Norway advances toward fully digital healthcare (Diagnostic Imaging)


- The ATSP's seventh annual conference, Telehealth 2003, will take place September 16-18, 2003. It will be held in a teleconference format that will bring together the leading telehealth practitioners and experts to share their knowledge and insights about global telemedicine activity during the past 12 months. The theme of this year's conference is: "We Want Our ROI and We Want It Now: Re-Examining the Role of Telecommunications in Healthcare."
With the world in recession, the most important factor separating thriving telehealth programs from dead ones is an ability to show a positive return on investment (ROI). While nearly all telehealth technologies are of considerable use to patients and consumers, can the same be said for health care providers?
Provider acceptance and financial viability are the rate-limiting steps for the long-term survival of telehealth. The two are often related, since the majority of clinicians operate their practices as businesses. This year’s ATSP annual conference will concentrate on telehealth applications for which return on investment can readily be quantified. Also areas that have not received much attention in "conventional" telehealth thinking will be explored. Areas like medical billing, shared medical records, and dedicated patient education initiatives.
More details can be found on the Telehealth 2003 website at www.telehealthconference.org/telehealth2003.htm.
- The Biofeedback Foundation of Europe is holding its 8th annual meeting in Zurich, Switzerland on February 24-28, 2004. There will be choices of 1-day, 2-day, 3-day and 4-day workshops instructed by well-known clinicians from Europe and North America. These clinicians will demonstrate the latest biofeedback and neurofeedback techniques and technology for many applications. A scientific program on the third day, February 26th, will feature lectures, symposia, paper sessions, and poster presentations. There will be an exhibition area for commercial and non-profit organizations. For more information, contact: Danielle Matto at or see >www.bfe.org.
- HDL 2003: Health Digital Libraries Workshop 2003 will be held in conjunction with ECDL 2003: 7th European Conference on Research and Advanced Technology for Digital Libraries on August 21, 2003 in Trondheim, Norway.
The objective of this workshop is to provide an informal forum for researchers from academia, industry and health care institutions to present their work on digital libraries in healthcare, share their experience and discuss mutual technical and user-centred interests in order to bridge the gap between academic research and industrial and real-world project needs.
In particular, it will focus on information management in health-care digital libraries, health care information provision on the Internet, searching and Web crawling, personalisation aspects and end-user evaluation and needs for information in digital libraries.
For further information please see www.soi.city.ac.uk/~patty/HDL2003/HDL%202003%20Workshop%20Top.html or contact Patty Kostkova at .
- The DevMedicine Institute of Health Sciences (DMIHS) invites papers for the DevMedicine 1st Annual Scientific Conference (DMASC) which will take place in Nairobi, Kenya on December 1-5, 2003. The theme of the conference is: eMedical Schools Ways and Means - Telecomputing and Medical Education in Developing Countries. Focus is on ICT and medical education in developing countries. DevMedicine 1st Annual Scientific Conference will address the mechanisms of making information technology resources available, accessible and acceptable to medical professionals working in developing countries and emerging economies. More info is available at www.devmedicine.org/dmasc.html.

 
 

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