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June 9, 2005

In this newsletter:

  • Med-e-Tel 2005 revisited
  • Med-e-Tel 2006 dates announced
  • World Health Assembly passes resolution on eHealth urging member states to develop and implement eHealth solutions
  • European Commission calls for better use of technologies that empower patients, improve healthcare and save lives
  • Aerotel unveils a new Voice Receiving Module designed for its Heartline Receiving Software
  • Med-e-Tel helps building trans-continental bridges
  • Telenursing survey finds telehealth could be a major factor in tackling nursing shortage
  • Teletrauma...From myth to reality?
  • News from ISfTeH
  • Med-e-Tel Matchmaker
  • News from the Med-e-Tel media partners
  • Newsbriefs


Nearly 400 healthcare professionals and industry, academic and government representatives from 50 different countries recently gathered in Luxembourg at Med-e-Tel 2005, the international trade event and conference for ehealth, telemedicine and health ICT, confirming once again that information and communication technologies are becoming increasingly important in healthcare applications.
Med-e-Tel focuses on the convergence of information and communication technology with medical applications, which lead to higher quality of care, cost reductions, workflow efficiency, and widespread availability of healthcare services.
Opening Ceremony
"eHealth is becoming the third industrial pillar for health, behind the pharmaceutical industry and medical imaging, to reach an estimated 5% of all healthcare expenditures by the year 2010", declared Prof. Dr. Jean-Claude Healy, Director of eHealth Strategy at WHO, during the Med-e-Tel opening ceremony. He went on to state that ehealth has the enormous potential to increase productivity in today's patient- and hospital-centred healthcare delivery systems, and will become an important instrument for engineering a new concept in tomorrow's citizen- and home-centred health systems.
During his speech at the opening session, Prof. Dr. Michael Nerlich, President of the International Society for Telemedicine & eHealth (ISfTeH), an association which is rapidly expanding and becoming an international knowledge and experience base in the field of telemedicine and ehealth, introduced the audience to a new intensive short course on Telemedicine and eHealth. This ISfTeH course, offered by the International Space University (Strasbourg, France) is a unique course in multidisciplinary and international education for the medical community. The inaugural course is planned for April 2006.
Conference Program
The extensive Med-e-Tel conference program went on with sessions dedicated to teleconsultations, ehealth implementation in developing countries, distance education, standardization and interoperability, ethical issues, use of handheld devices in hospitals, image transfer and internet ehealth applications.
Some presentations of note were:
- Evaluation of a South African pilot project testing the SIMpill - a wireless realtime pillbottle - in 150 patients. The effectiveness of the system in achieving improved compliance, decreased load on human resources, overall cost savings to the health care system, data collection, and acceptability and reliability of using the GSM network were reported;
- Experience of more than eight years application of telemedicine multitask network services in Russia;
- Implementation of e-Health applications through GRID technology in Georgia;
- Development of telemedicine and ehealth in Finland and current national Finnish project for interoperability between all the various electronic patient record (EPR) systems before the year 2007;
- Prototype web-based, patient-centric application that assists patients to navigate their way through the confusing and complex system of cancer care, from Grand River Hospital Corporation, Canada;
- Utilization of satellites and other telecommunication topologies to develop a telehealth system for a long term program of telemedicine in Ecuador with the support of the Medical Informatics and Technology Applications Consortium, Maryland, USA;
- Application of ICT to develop telecenters in Zambia and to facilitate communication, and the flow of health information between healthworkers in the districts and regions of Tanzania were discussed as part of sessions dedicated to ehealth in developing countries;
- Presentation of an e-mail/discussion forum as a low cost telemedicine support for remote areas in low resource areas by the Institute of Tropical Medicine in Antwerp, Belgium for patient management and distance education in a.o. AIDS care in developing countries;
- A session on eHealth Standardization led by the eHealth Standardization Coordination Group, bringing together representatives from ISO, ITU, CEN, IEEE, DICOM, HL7, WHO and OASIS.
European Projects
There was also a remarked presence on the exhibition floor of several European Commission co-funded ehealth projects, who also participated in a special conference session dedicated to "European 'ICT for Health' Research: From Managing Health Status to the Increasing Personalization of Health Diagnosis and Treatment":
- The DICOEMS project concentrates on management of patients health status, and on implicit risks involved in making critical medical and health decisions;
- COCOON identifies how semantic web services and information retrieval methods can support health management;
- ARTEMIS focuses on how sophisticated medical databases help to increasingly individualise healthcare and the treatment offered to citizens;
- BIOPATTERN and INFOBIOMED explore how the personalisation of diagnosis and treatment can be enhanced through the converging fields of medical informatics and bio-informatics;
- PALLIANET illustrates the emergence in palliative care of knowledge driven collaborative practices in healthcare networks; while
- CARE-PATHS reveals how the strict implementation of clinical pathways can contribute to the continuous improvement of the quality of care.
International Society for Telemedicine & eHealth
The ISfTeH presented national ehealth experiences and programs from Brazil, Croatia, El Salvador, Finland, Georgia, Poland, South Africa, UK and Ukraine. In addition the ISfTeH also represented member associations from Denmark, Germany, Norway, and Russia on its exhibition stand.
Presentations are published here.
Exhibition
The Med-e-Tel exhibition featured some 50 companies, projects and media showcasing the latest in vital signs monitoring, archiving and communication systems, digitization of clinical information, electronic data capturing and sharing, medical software solutions, and decision support systems.
Info World (Romania), specializing in IT applications responding to the specific necessities of healthcare facilities, offered a set of programs that cover the present requirements of healthcare systems such as a flexible and easy to use laboratory data administration system. The European INTREPID project consortium showed its achievements in developing a multi-sensor wearable system for the treatment of phobias and situational anxiety. Lincor Solutions (Ireland) presented its integrated solutions for the delivery and management of interactive digital media services in healthcare markets. Another EC co-funded project called SITE, aiming to increase the cooperation between Russian and EU researchers in the area of the IST Priorities, presented remarkable achievements of Siberian researchers in detecting cranial movements and elderly care. Aerotel Medical Systems, a leading telemedicine company, provided information on its services for the establishment of medical call centers! with emergency/monitoring services for private and/or institutional clients (connected and not connected to National Health Services). These centers provide diagnostic services to physicians, hospitals, private citizens, rural clinics and the like. They are used for any type of need: from a simple patient follow-up requiring a medical test, to chronically ill and high-risk patients suffering from heart disease and cardiac symptoms, hypertension, respiratory problems, SpO2, etc. Medtronic introduced its LIFENET EMS electronic patient care reporting system (ePCR) which assists in providing stellar patient care reporting in emergency situations with no pens, no paper, no unreadable handwriting, no mistakes, no omissions and no wasted time. Finally, the exhibition also featured a "media corner" in which more than 30 reports, books, magazines, scientific journals and online information services were represented. Throughout the past events, the media corner has been a popular feature among attendees, givi! ng them an opportunity to find new informational resources and to stay updated with the latest in telemedicine news and technologies.
For further details and proceedings, log on to www.medetel.lu or contact .


Med-e-Tel 2006 is scheduled for 5-7 April 2006 at Luxexpo, Luxembourg. Details will shortly be available on the Med-e-Tel website www.medetel.lu. You can already contact now to register your interest.


The 58th World Health Assembly, held at WHO headquarters in Geneva in May, passed an important resolution that will firmly and permanently put eHealth on the agenda of national governments and of the WHO itself.
The resolution urges member states to draw up a long-term strategic plan for developing and implementing eHealth services in the various areas of health sectors, including health administration, which includes an appropriate legal framework and infrastructure and encourages public and private partnerships. States should develop the infrastructure for information and communication technologies for health as deemed appropriate to promote equitable, affordable, and universal access to their benefits, and to continue to work with information and telecommunication agencies and other partners in order to reduce costs and make eHealth successful. The Assembly also recommends establishing national centres and networks of excellence for eHealth best practice, policy coordination, and technical support for healthcare delivery, and implementing national electronic public-health information systems to improve the capacity for surveillance of, and rapid response to, disease and public-he! alth emergencies.
WHO itself should facilitate the development of model eHealth solutions and provide technical support to Member States in relation to eHealth products and services by disseminating experiences and best practices, in particular on telemedicine technology; devising assessment methodologies; promoting research and development; and furthering standards through diffusion of guidelines. WHO should also facilitate the integration of eHealth in health systems and services, including in the deployment of telemedicine infrastructure in countries where medical coverage is inadequate and in the training of healthcare professionals and in capacity building, in order to improve access to, and quality and safety of care.
The full text of the resolution is available at www.who.int/gb/ebwha/pdf_files/WHA58/WHA58_28-en.pdf.
The eHealth Report by the WHO Secretariat, which served as a basis for the resolution, is available at www.who.int/gb/ebwha/pdf_files/WHA58/A58_21-en.pdf.


Also the European Commission calls on governments and the private sector to make better use of information and communication technologies in Europe's healthcare systems.
Speaking ahead of a recent gathering of health ministers and IT experts from across Europe in Tromso, Norway, European Commissioner Markos Kyprianou (Health and Consumer Protection) said: "eHealth can empower patients and improve healthcare. Even more importantly, by reducing the scope for medical errors, it can save lives. We need a partnership between health ministers, technology providers, patient groups and health NGOs to release the full potential of eHealth in Europe."
"The European approach to eHealth should be about spending euros on patients not on paperwork!" stated Commissioner Viviane Reding (Information Society and Media). "For example, electronic medical records can help doctors to diagnose illness and prescribe treatments more accurately, thus reducing medical errors. It also means cutting down paperwork to improve efficiency. Electronic patient referrals in Denmark are saving €1 million a year and could rise to €3.5 million a year, if all referrals were sent electronically."
Europeans increasingly want to play an active role in decisions relating to their health. eHealth can give them the easy access to high quality health information that they need to achieve this. As part of its current eHealth action plan, the Commission will launch an EU Health Portal later this year, providing a "one stop shop" for health information produced by the EU and a gateway to the websites of national and regional health authorities and civil society groups in the health field.
For more information on EU policies and actions on eHealth, see http://europa.eu.int/information_society/qualif/health/index_en.htm.
For information on EU supported eHealth projects that were represented at Med-e-Tel 2005, check out the list of Med-e-Tel 2005 exhibitors and sponsors and the Med-e-Tel 2005 conference program.


Aerotel Medical Systems (www.aerotel.com) one of the world's leading manufacturers of cutting-edge diagnostic telemedicine systems - introduces its new Voice Receiving Module (VRM), the HRS-VRM. The latest tool for the company's HRS (Heartline Receiving Software) designed to receive ECG transmissions from patients via the telephone.
HRS is installed in various types of Medical Service Centers. With the new HRS-Voice Receiving Module, medical centers can now receive a phone transmitted ECG without the use of an operator. All the patient has to do is call the Medical Service Center telephone number and the HRS-VRM will automatically answer the call and instruct the patient on how to identify himself by punching in his ID. Once identification is validated, the module then guides the patient on how to transmit an ECG.
With the introduction of HRS-VRM, Aerotel is once again pursuing its goal to streamline healthcare services. Currently, ECG transmissions require a conversation between the patient and either the HRS operator, nurse or doctor. By incorporating Aerotel's new Voice Receiving Module into the HRS program, the need for an online operator is eliminated and a full ECG transmission is automatically received, edited and stored into a file along with the patient's ID, transmission time and date. The recorded file is then saved in the HRS Inbox so that it can be interpreted and edited. The patient's transmitted ECG is reviewed later on by either a physician at the medical service center or a doctor in a remote location with internet access.
Aerotel Medical Systems is a world leader in cost-effective, high quality, user-friendly, medical diagnostic systems and devices for the home care, eHealth and telemedicine markets. The company provides a complete disease management package, including transtelephonic devices, a hardware and software platform; plus phone and web-based software.


We would like to share with you the following testimony from the people of Fonomed, El Salvador(www.fonomed.com) who attended Med-e-Tel 2005:
We wish to thank our hosts and co-participants at Med-e-Tel, for making the event a success, and for opening opportunities and promoting education, for the private, public, and academic sectors, as well as for individuals.
Fonomed, and ultimately our franchise, is based on direct medical consultations via POTS (Plain Old Telephone Service), whereby a patient may contact a doctor to obtain courses of action or second opinions, which may include pharmaceutical recommendations of "over the counter medication", referrals to specialists, labs, hospitals, or other required entities. The patient is always educated in relation to his/her medical question, preventive measures are always discussed, and personal health knowledge and administration is promoted.
At Med-e-Tel, Fonomed gave a presentation titled "Country Building Efforts for the Developing World using Telemedicine", which allowed the audience to obtain a more in-depth understanding, of the immediate advantages for developing countries that a professional, inexpensive, and high social impact program like the one presented can have. The presentation was based on the experience garnered over the last four years in El Salvador.
We were kindly reattributed by attending our colleagues' conferences, which permitted us a glimpse at the significant advances, great needs, obstacles, and current context situation of Telemedicine in our world.
It was most pleasing for us, that in spite of cultural or political differences, there is an evident and shared sentiment that orients all that were present, towards the continual pursuit of projects, aimed at decreasing the inequalities that exist in access to basic health care within populations at large.
Our greatest accomplishment at Med-e-Tel was the initiation of inter-company and personal relationships, during the course of the three days we were present. We aspire to maintain the budding friendships, and to amplify them into trans-continental wealth and knowledge sharing.


Results of the 2004 International Telenursing Survey, commissioned by the Division of Nursing of Mount Aloysius College (Cresson, Pennsylvania, USA) and by the International Council of Nurses (Geneva, Switzerland) have been released.
Telenursing is defined as the use of telemedicine technology to deliver nursing care and conduct nursing practice. Through telenursing, a nurse can provide monitoring, education, follow-up, remote data collection, remote interventions, pain management, family support, and multidisciplinary care in an innovative fashion.
The purpose of the survey was to identify 1) telenurses' satisfaction with their current telenursing role 2) specific telenursing knowledge and skills 3) perceptions about effectiveness of telehealth as a nurse extender 4) demand for telenurses worldwide 5) types of knowledge and skills needed by telenurses.
A web-based survey was developed and targeted those telenurses who were actively practicing in telenursing at the time of the survey, OR who were working for an organization that supported telehealth/telemedicine (i.e. vendor, public policy, etc.). There were 719 nurses from 36 countries who completed the survey. Largest group of respondents (78%) were from the U.S. and Canada.
The telenurse most likely received on the job training in telehealth to achieve her expertise. This nurse is highly satisfied with telenursing, based on assessments of factors such as autonomy, interaction, professional status, pay, task requirements, and organizational policies. Survey respondents believe that currently the demand for telenurses is moderate, however a sharp increase in the demand is expected within three years (due to budget cuts, plans to expand telehealth programs, and an increase in aged population and chronically ill patients). As a matter of fact, 75% of telenurses believe that telehealth is useful in overcoming the nursing shortage. It allows to take care of more patients in less time, although the technology is not quite there yet. Telehealth helps the nurse deliver, manage, provide better education, keep patients out of the hospital, provide better outcomes, decrease hospitalizations, save nursing time, recruit and maintain nurses.
The vast majority of the telenurses surveyed are not certified in telemedicine, telenursing, or nursing informatics, but 3 out of 4 telenurses believe that certification in telenursing is important, and would be interested in achieving certification and nearly 90% believe that telenursing should be a part of basic nursing education.


In an interview by Bob Pyke Jr., Dr. Rifat Latifi presents his views on the future of teletrauma and telemedicine in general. Dr. Latifi is a.o. Director of the Southern Arizona Teletrauma and Telepresence Program (SATT), Founder of the International Virtual e-Hospital and Director of the Telemedicine Project of Kosova.
With the SATT program, Dr. Latifi and his team will serve more than 1.2 million people in rural Arizona, once the program is fully operational. In addition, they serve lots of patients who cross the border from Mexico and need trauma and emergency care services.
For Dr. Latifi one of the most natural uses of telemedicine is post-op care or follow-up and monitoring in the ICU: "Stabilization of the patient before the transfer (if needed), and then post-operative follow-up is the best use of telemedicine in trauma and emergency care. This is the perfect use of telemedicine. Once the infrastructure becomes more widespread, we can do all the above: monitor the patient in the small hospital intensive care unit, and become true partners with rural doctors and other healthcare providers."
Dr. Latifi hopes to have the entire SATT network completed in one year. In another 5 years all trauma centers should perform teletrauma as part of their outreach programs. "Using telemedicine will become a routine practical issue in 10 years. At that point, use of telemedicine will not be news any longer," according to Dr. Latifi.
In order to promote telemedicine/teletrauma, the work done needs to be published, development persisted, and every case documented. Networking and pushing the industry to lower prices are also important factors to Dr. Latifi. "The day will come that if a trauma patient dies in a small hospital that does not have a trauma surgeon, someone will ask: did you use your teletrauma system for help to call the regional trauma center? No one should die because there was no trauma expertise in a small hospital. No one!", he concludes.
Full interview can be found at www.eurasiahealth.org.
More information about Dr. Latifi's activities can also be found from his presentations at Med-e-Tel 2005: "Tele-trauma and Tele-presence Resuscitation in Rural America: Southern Arizona Experience" and "International Virtual e-Hospital Initiative" (see www.medetel.lu/index.php?rub=educational_program&page=program_2005).


n this section of the Med-e-Tel newsletter, we report news from the ISfTeH (International Society for Telemedicine & eHealth), supporting partner of the Med-e-Tel event.
- The ISfT (International Society for Telemedicine) General Assembly which took place on April 6th at Med-e-Tel voted in favour of a name change. The Society will now be known as International Society for Telemedicine & eHealth (ISfTeH) henceforth.
- ISfTeH hosted a well attended session at Med-e-Tel (April 7, 2005) on "National Experiences in Telemedicine and eHealth". The session featured presentations by ISfTeH members from UK, Poland, El Salvador, Brazil, South Africa, Georgia, Finland, Ukraine and Croatia. Information about the presentations is available at www.medetel.lu/index.php?rub=educational_program&page=program_2005.
- The 10th ISfTeH International Conference will take place in Sao Paulo, Brazil on 23-26 October 2005 in conjunction with the meeting of the Conselho Brasileiro de Telemedicina e Telesaude (www.cbtms.com.br). Preliminary program can be found at www.cbtms.com.br/congresso/2005/programaeng.asp. Registration form is available at www.cbtms.com.br/congresso/2005/fichaeng.asp.
- For more information or to contact ISfTeH, see www.isft.net or send an e-mail to .


The Med-e-Tel matchmaker aims to facilitate contacts and links between various telemedicine and ehealth professionals and providers around the world. To obtain more details about the request(s) below or to provide your services, contact us at and we will put you in touch with the source of these requests. If you would like to submit a request of your own, and we will publish it in a next newsletter.
- Ukraine: looking for home telemedicine/wireless decision support systems and equipment for skeletal trauma and orthopedics patients.


For information on publications, journals, magazines, reports 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 were featured at the Med-e-Tel Media Corner during Med-e-Tel 2005 or that will be featured at Med-e-Tel 2006:

- IHE (International Hospital Equipment & Solutions) is Med-e-Tel's main international media partner. To learn more about IHE as well as about the markets and areas served by IHE with its regular 27,000+ high quality BPA audited circulation, go to www.ihe-online.com.

- European Hospital points at trends and developments in the European healthcare market - be it solution business strategies and hi-end development in medical technology or innovative approaches in logistics, personnel, finance and management. And it goes without saying that we care for care, from wound management to IT solutions.
Hospital administrators and managers, medical and nursing directors and senior staff in 34 European countries turn to European Hospital for in-depth coverage of the healthcare market. Some of the topics in our next issue: Software solutions revolutionise the laboratory - automation und robotics speed up laboratory procedures while reducing costs and error quotes. Speech processing is about to conquer the hospital: texts dictated by physicians are digitalised quickly and integrated into the data processing systems and thus ensure a smooth workflow across departments. Molecular imaging the cutting-edge innovation in radiology. Read an interview with Siemens on developments of this technology as well as an assessment of the Cardiac Centre Berlin on the role of molecular imaging in cardiology.
Since we consider the personal exchange between the different players in the healthcare business extremely important, we are pleased to announce that also in 2006 we will organize the "Hospital Administrator Forum" in cooperation with the European Congress of Radiology.
For more information, contact: European Hospital Verlags GmbH, Daniela Zimmermann, phone +49 211 7357 531 or e-mail: [email protected].

- International Journal of Healthcare Information Systems & Informatics (IJHISI) is a quarterly, peer-reviewed scholarly journal, published by Idea Group Publishing. The inaugural issue will be published in January 2006. Advancing technologies from management perspective on the one hand and their applications in clinical settings on the other hand will drive interests in IJHISI. Therefore, the journal brings together experts in public health, health information systems, and medical informatics to establish a new paradigm for developing health information systems and informatics. Topics will include: healthcare, IT security and privacy issues, clinical decision support design, development and implementation, management of emerging health care technologies, virtual health technologies, role of informatics specialists and more. To submit papers or reviews to this upcoming journal, visit its webpage at: www.idea-group.com/ijhisi.

- A new installment of the Home Telehealth Community of Care page from Information for Tomorrow focuses on home assessment for home telehealth (see www.informationfortomorrow/community/homefirst.htm). Tools for getting things right, advice for nurses on working with new technology from several experienced designers and planners, and other relevant information for helping people get started on making home telehealth work well are provided.
Also available from Information for Tomorrow is a new home telehealth and telehospice listserv. It's a place where people who are interested in these frontier fields of telehealth service delivery can informally share information. Interested people can sign on for the list at www.informationfortomorrow/community.

- New issue of the Ukrainian Journal of Telemedicine and Medical Telematics with free full-text articles is available at www.telemed.org.ua. Good Practice Models for Telemedicine and eHealth by the Dept. of Informatics and Telemedicine of the Donetsk R&D Institute of Traumatology and Orthopedics are available at www.telemed.org.ua/BPM/bpmtm.html.

- A new Teleneurology book is available from the Royal Society of Medicine Press. The fifth in a line of best selling telemedicine titles edited by Richard Wootton, Teleneurology is written by experts from four continents, providing a succinct introduction to teleneurology. The book combines comprehensive reviews of each topic with practical advice on all available telemedicine techniques and on navigating the internet for the most up-to-date neurological information. It should prove invaluable for practicing neurologists in particular, but also for general practitioners, paramedical staff, health service managers, and IT staff. More details and ordering information are available at www.rsmpress.co.uk/bkwootton5.htm.


  • Taking the pulse of Europe's e-health market (Medical News Today)
  • Remote healthcare monitoring not so distant (Medical News Today)
  • Telemedicine room design (Journal of Telemedicine and Telecare)
  • Organizational cooperation in teleradiology (Journal of Telemedicine and Telecare)
  • Introduction to the practice of telemedicine (Journal of Telemedicine and Telecare)
  • Healthcare Information System Vendors Focus on Developing Business with New Clients (Frost & Sullivan)
  • Automated spoken dialogue system for hypertensive patient home management (International Journal of Medical Informatics)
  • What Is eHealth (4): A Scoping Exercise to Map the Field (Journal of Medical Internet Research)
  • Information on telemedicine (Journal of Telemedicine and Telecare)
  • Advances in Telemedicine and Patient Care Technology matching up with Evolving Patient Needs (Frost & Sullivan)
  • From Paper Piles to Efficient Files (Healthcare Informatics)
  • A review of telemedicine in Uzbekistan (Journal of Telemedicine and Telecare)
  • Council Members Seek 'Telemedicine' Advances (Scotsman)
  • Wales At The Forefront of Telemedicine Says First Minister (A2MediaGroup.com)
  • telederm.org: Freely Available Online Consultations in Dermatology (PLoS Biology)
  • PACS installations in U.S. hospitals top 1300 (Diagnostic Imaging)
  • Telemedicine and 'stroke Box' Initiatives Are Helping Acute Stroke Victims Get Better Access to Life-saving Thrombolysis (PharmaLive)
  • Security Concerns Drive Advances in Wireless Applications for the Healthcare Sector (Frost & Sullivan)
  • Web-based image access empowers Austrian patients (Diagnostic Imaging)
  • Electronic health record interoperability collaboration gathers steam (Diagnostic Imaging)
  • Singapore doctors treat Jakarta patients through telemedicine (Channel NewsAsia International)
  • Telemedicine the future of care in Scotland, says report (E-Health Insider)

 
 

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