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News: Newsletter 24

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March 4, 2004

In this newsletter:

  • Join exhibitors, attendees and speakers from over 35 countries around the world at Med-e-Tel
  • Speeding up ehealth standardization
  • Justifying higher levels of healthcare IT investment
  • Telemedicine cooperation connecting medical society in Lithuania, Sweden and other Baltic countries
  • Speech input for medical mobile devices
  • Net-based education in the medical field
  • ISfT also in on Telemedicine and eHealth Directory
  • News from the Med-e-Tel media partners
  • Newsbriefs
  • Conferences


Make your plans now to travel to Luxembourg next month (April 21-23, 2004) to join a diverse and qualified audience of healthcare, government and industry decision makers and to network with representatives from many national and international organizations and institutions at the Med-e-Tel Conference and Exhibition!
Visitor registration includes access to the exhibition for 3 days, access to the information-packed seminars and conferences, access to the social events and an opportunity to meet and network with colleagues and organizations from around the world. Go to www.medetel.lu and pre-register to avoid queueing at the entrance.
Highlights of the event include:

  • an exhibition with products and services related to picture archiving and communication, electronic records, secure data exchange, telemonitoring, wireless and mobile applications, videoconferencing, surgical systems and software, speech recognition and processing, telemedicine applications in pathology, cardiology, dermatology, wound care, radiology, and more;
  • a series of plenary sessions devoted to "Tracking eHealth Evolution in Europe", "Telemedicine in Hypertension", and "PACS & EPR";
  • a series of parallel sessions on topics such as cost-benefit studies, business models, current ehealth realizations and telemedicine projects, distance education, home monitoring and homecare applications, ehealth integration into routine medical practice, and telemedicine applications in various medical disciplines;
  • several satellite conferences and meetings held in conjunction with Med-e-Tel on topics such as "From Electronic Patient Record to Health Portal", "Standardization in eHealth", "Telemedicine in Developing Countries", "Medical Mobile Devices", "Wearable Health Care System", "Telemedicine Needs and Opportunities in Africa";
  • a media corner where information will be provided about publications, magazines, journals, reports and online news and information services in the fields of ehealth and telemedicine;
  • two evening receptions to unwind after a hard day's work and yet to continue the discussion and interaction in an informal way;
  • participation of a wide variety of national and international players who are active in the field of telemedicine and ehealth, which makes Med-e-Tel an unprecedented networking event.

More details are available at www.medetel.lu.
Hotel reservations can still be made at specially negotiated rates. Check out the list of hotels at www.medetel.lu and submit your reservation now in order to take advantage of the special deals.


In May 2003 the International Telecommunication Union (ITU) together with the World Health Organization (WHO) organized a workshop on Standardization in eHealth. Other standard developing organizations such as the International Organization for Standardization (ISO), the International Electrotechnical Commission (IEC) also participated in the meeting.
The most important conclusion of this Workshop was the agreement to set up a joint eHealth Standardization Coordination Group (eHSCG), whose task it would be to increase information exchange about ongoing standardization activities in the respective organizations, speed up the application of generic standards in multimedia communication to ehealth, avoid duplication and enhance cooperation.
The first meeting of eHSCG group will take place in conjunction with Med-e-Tel in Luxembourg on April 20, 2004. The morning session of an ITU/WHO seminar during Med-e-Tel (on April 22, 2004) will also be devoted to Standardization in eHealth and will feature contributions from several eHSCG members on topics such as New International Activity Towards eHealth Standardization; Review of ITU Recommendations on Multimedia Systems; Potential Impact of New Effective Method of Image Coding on eHealth Systems. More details are available at www.medetel.lu.


Over the past 25 years, healthcare has fallen far behind other service sectors in terms of IT investment. Use of IT has delivered major transformational change in many business sectors, together with significant increases in personal productivity of service providers. These changes are reflected in different facets of modern society, and provoke the question of why has this not happened in healthcare.
The answer lies partly in the nature of healthcare business processes themselves and partly in reluctance of consumers to demand significant improvements in service provision. Healthcare is one of the last major "unreconstructed" industry sectors in the western world. Despite emergence of amazing new medical technologies, healthcare service delivery processes actually changed very little during the 20th century.
Healthcare business processes differ fundamentally from other service sectors. Healthcare is significantly more complex - and less amenable to a conventional IT systems support due to widespread lack of process standardisation. Health information is difficult to collect at the point of care and can change rapidly over time, causing problems with storage, retrieval and manipulation of large amounts of time series data. Care delivery involves complex and sensitive "one on one" personal encounters which rely on implicit trust by patients in the knowledge and skills of their care providers.
Despite considerable efforts to cost justify higher expenditure, investment levels in healthcare IT have remained static for ten years at between 1% and 2% of total revenue. Recognising the need for more effective deployment of IT to improve healthcare delivery, governments in Europe are resorting to use of a new set of shared political imperatives to justify infrastructure projects to help deliver:

  • better protection of patient safety and wellbeing;
  • wider consumer access to health information and services;
  • radical improvements in service productivity;
  • effective ways of coping with increased complexity.

Major national investments in shared "active" infrastructure are helping to provide the platform needed to support exciting new transformational eHealth applications. The resulting explosion in eHealth technologies is set to drive IT expenditure up to 4% of total healthcare revenue by the end of this decade.
These and other topics will form the basis of a plenary sesssion during Med-e-Tel entitled "Tracking eHealth Evolution in Europe", presented in cooperation with HINE (Health Information Network Europe). See www.medetel.lu for more information.


The Litmed2 project, initiated at the end of 2002, is a business oriented health care project within the discipline of pathology. The vision of the project has been to be part of a long-term ehealth development process of in the Baltic Sea Area, by:

  • establishing a well-functioning IT support for the pathology department in Kaunas, Lithuania;
  • encouraging Swedish health IT-businesses to demonstrate their products and services;
  • initiating a network between pathologists in the Baltic Sea Area;
  • developing useful telemedicine support for pathology departments.

The results from the project are well in line with these goals. The implemented administrative system is working in routine procedures and has been proposed in other Baltic hospitals. The system has been adjusted to fulfill local and national demands in Lithuania. It will also be possible to store images in DICOM compatible format. This product will be demonstrated during Med-e-Tel in Luxembourg in April 2004. Two software tools to help the medical profession with imaging handling and analyses have also been developed during the project. The first software, Medipas, is a interactive conference tool, where a distance consultation of digital images can be achieved in an effective way. It is possible for both participants to show region of interests and make other image adjustments, which will be seen on both sides simultaneously. The other software is a Labeling Index software which can be reached as a web-service. It calculates the proportion of malign cells compared with normal cells in an image. Both of these products will be presented at Med-e-Tel as well.


Healthcare professionals need information at the point of care. This need is starting to be satisfied by the emergence of new group of solutions called Medical Mobile Devices. They are based on mass consumer market technologies such as internet, wireless networks and affordable portable computers. A number of research projects have been completed which are at the point of mass market adoption. The MEMO project was established to promote this technology to healthcare professionals and identify any remaining stumbling blocks.
A significant stumbling block to the rapid adoption of medical mobile devices is the human user interface of hand held computers. These interfaces are particularly limited, even compared to desktop computers. Their input-output capabilities are constrained by the size and quality of their screens and their lack a full size alphanumeric keyboard. The MEMO project has investigated the impact of equipping these devices with speech recognition systems accompanied by Natural Language Understanding software. Many advantages were identified for speech recognition. They included its use in situations where eyes and/or hands are otherwise occupied or are not functioning properly (e.g. elderly/disabled users) and selections from long lists of possible alternatives: a common occurrence in healthcare.
Medical mobile devices are the cornerstones of an emerging class of applications more useful for healthcare professionals and readily accessible by patients and citizens. Their success is dependent on the successful evolution to new and innovative user interfaces which include speech recognition assisted by natural language understanding.
MEMO project partners will provide more information at the Med-e-Tel exhibition (Luxembourg - April 21-23, 2004). A special MEMO workshop is planned on Friday April 23rd. See www.medetel.lu for more details.


Since 1994, the Norwegian Centre for Telemedicine (NST) has tested the use of technology (a.o. videoconferencing) as a tool for competence training within Health Services in Norway. A number of collaborative and pedagogical models have been tested, for instance teaching, counselling, collaborative-meetings, consultations etc., with very good evaluations and results. During the process, NST has been responsible for the technical equipment in the institutions, and for developing an organizational model around the activities. All the lecture series, courses and programmes are published in a Norwegian Catalogue for Distance Education. The Catalogue is published and edited twice a year and is distributed both in paper and at www.telemed.no.
NST also established international collaborations with a.o. the Regional Hospital in Arkhangelsk, Russia for the purpose of sharing knowledge and exchange experiences between the countries.
NST is now in the process of developing a Learning Portal on the Internet (www.helseutdanning.no) with the aim of becoming a portal or gateway to health-related education nationwide. The portal will offer web-based courses, it will also broker courses and programmes delivered by universities and university colleges, and in addition deliver online services to the health sector. Further Experiments are now being conducted with streaming and video broadband at lower bitrates, thereby making education more accessible.
These and other telemedicine activities will be highlighted by the NST during their participation at Med-e-Tel in Luxembourg (April 21-23, 2004).


The International Society for Telemedicine (ISfT) has joined the International Telecommunication Union (ITU) and Med-e-Tel in the production and dissemination of the Telemedicine and eHealth Directory 2004. The directory will become a valuable resource for anyone who is looking to source telemedicine and ehealth products or services, or who wants to establish contacts with colleagues and organizations abroad, or who is trying to obtain more information about ongoing or completed projects. The directory will include listings of companies, service providers, associations, media and projects that are involved in the research, development, manufacturing, funding, implementation, promotion or publication of telemedicine and ehealth related products, services, projects and information.
The Directory will be introduced at the upcoming Med-e-Tel event in Luxembourg (April 21-23, 2004) and will be available on the ISfT, ITU and Med-e-Tel websites and distributed at various ISfT and ITU meetings and events. The document will also be updated regularly with new data.
To secure your listing in the Telemedicine and eHealth Directory, contact .


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. To follow is a review of just some of the publications that will be featured at the Med-e-Tel Media Corner during Med-e-Tel 2004 (April 21-23, 2004):

  • IHE's April 2004 issue will give special emphasis to telemedicine, patient monitoring and urology. As the international media partner of Med-e-Tel (Luxembourg, April 21-23), IHE will report on the latest advances in telemedicine in its April issue and bonus copies will be distributed at the Luxembourg event. To learn more about IHE's extended offer in April, contact IHE at .
     
  • IOS publishes the book series "Studies in Health Technology and Informatics". This book series was started in 1990 to promote research conducted under the auspices of the EC programmes’ Advanced Informatics in Medicine (AIM) and Biomedical and Health Research (BHR) bioengineering branch. A driving aspect of international health informatics is that telecommunication technology, rehabilitative technology, intelligent home technology and many other components are moving together and form one integrated world of information and communication media. The complete series has been accepted in Medline. This year books are planned on E-Health, Telemedicine and MEDINFO. In the future, the SHTI series will be available online. Next to the book series, IOS published two related journal titles, "Technology and Health Care" and "Technology and Disability". For more information, please visit www.iospress.nl or send an email to .
     
  • A new home telehealth information service is now available for home care service providers and planners, equipment designers, and industry watchers who need to keep abreast with developments in today’s rapidly emerging home telehealth industry. Called the Home Telehealth Community of Care, this bi-monthly topical page provides targeted installments on key options for effective home telehealth delivery. It is available at www.informationfortomorrow.com/hottopics.htm, and topics in 2004 will range from tele-obesity over telehospice to telerehab services. The current installment focuses on new means for managing the growing epidemic of obesity: "Obesity and Telecare, or 'Tele-Obesity': A Workable Solution.” The Home Telehealth Community of Care is developed by Information For Tomorrow. According to research director, Audrey Kinsella, this new page provides the opportunity for busy viewers to get targeted information on selected topics in home telehealthcare. "People want to know what's out there, what it costs, and what works in home telehealthcare." The Home Telehealth Community of Care is aiming toward providing this single-source venue, through its bi-monthly presentations and targeted links to additional necessary resources on home telehealthcare.
     
  • Hospital Post is GIT VERLAG's bi-monthly publication for decision makers in European hospitals - with a circulation of 25,000 copies, from Lisbon to Minsk, and from Oslo to Palermo. It provides a forum to opinion leaders in all healthcare-related fields and covers the major hot issues in medical technology, IT, general management, facility management, and clinical diagnostics. Ask for your free sample at www.hospital-post.com.
     
  • In its 23rd year, Management & Krankenhaus addresses 43,000 decison makers in German hospitals each month. Themes covered range from medical technology, IT, general management, facility management, to clinical diagnostics. Readers include leading medics, IT, technical, and facility managers, head administrative staff, and laboratory directors. Free sample upon request at www.management-krankenhaus.de.


    To follow are links to some interesting and recently published articles and studies (if you know of any articles of notice, feel free to send details to and we will include a link in a next newsletter):
    - Interhopsital teleconsultation and referral (British Medical Journal)
    - Telemedicine education in accident and emergency (British Medical Journal)
    - Identifying undiagnosed dementia in residential care veterans: comparing telemedicine to in-person clinical examination (International Journal of Geriatric Psychiatry)
    - Connecting for Health creates incremental roadmap for achieving electronic connectivity in health care (Virtual Medical Worlds)
    - PACS embraces images from multiple disciples (Diagnostic Imaging)
    - Motorcycle-based Wireless Internet Provides Health Care Network in Cambodia (ATSP)
    - Hospital imaging systems: A tough sell (ComputerWorld)
    - Heart attack early-warning system tested: With a new device, paramedics can send EKG results ahead so the hospital is ready (The Sacramento Bee)
    - Stroke Patients Evaluated Via Wi-Fi (Mobile Health Data)
    - The Economic Effect of Implementing an EMR in an Outpatient Clinical Setting (Journal of Healthcare Information Management)
    - D.C. police, EMS to get broadband (USA Today)
    - Europeans look to EMR as healthcare consolidation tool (Diagnostic Imaging)
    - Hospital of the future: High-tech system helps improve quality of care (San Francisco Chronicle)
    - $86-Billion Savings from Standardized Info Exchange, CITL says (Health-IT World)
    - Your Daily Digital Doctor: Advanced analysis of home medical data can offer continuous care for patients with diabetes and other life-threatening chronic diseases (Technology Review)
    - Harvard Physicians Push Research on Tech for 'Non-Visit Care' (Health-IT World)
    - A Nurse Across Town Will See You Now (Hartford Courant)
    - Continued IT evolution boosts teleradiology (Diagnostic Imaging)
    - Teleradiology softens high volume, coverage demand (Diagnostic Imaging)


    - The Central Hospital, South Eastern Railway, Kolkata, India is organizing the 1st national workshop MIDCON 2004 on "eHealth & Healthcare - Exploring Issues & Opportunities". The event takes place under the aegis of the Indian Association for Medical Informatics (IAMI) on May 8-9, 2004 at the Hospital Auditorium. The event will attract around 125 guests from all over India and abroad and is expected to provide an ideal platform for discussion through videoconferences, lectures, seminars and exhibition. More info is available at www.iamindia.org.
    - The Health Informatics Society of Australia (HISA) will hold its HIC 2004 conference in Brisbane on July 25-27, 2004. It is Australia's biggest annual and most significant health ICT conference. This year's theme is "Let's Make a Difference with Health ICT" and the call for papers is currently open. Further information is available at www.hisa.org.au.
    - The Royal Society of Medicine in association with the eHealth Alliance UK will be staging the TeleMed and eHealth '04 conference under the theme of "Citizen Centred Care". Taking place on November 29-30, 2004 in London, this event will include sessions on integrating health and social care, helping people stay at home, delivering cancer care, optimising chronic disease management, ehealth clinical trials/studies, reducing inequalities, e-education, telenursing, healthcare via the internet and empowering the citizen. Call for abstracts and workshop submissions is now open. For more information, see www.rsm.ac.uk/telemed04.

     
     

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