| Telemedicine consulting-future of small towns and vilage E-clinic |
Results of the decade of introduction of the remote telemedicine consulting and lecturing technologies based on videoconference communications equipment prompt us to select further ways of developing the medical services rendered to the people in Russia. Based on the experience of cooperation with regional clinics, all participants of telemedicine project were once again convinced that various medical institutes of this country may be fairly diverse in terms of the nature and quality of medical training, which may hinder interaction between the consultant and the specialist receiving the consulting services on the initial stage of their cooperation. Organization of first telemedicine lectures became the basic instrument for liquidation of the abovementioned discrepancies. While lecturing on the latest achievements in diagnostics of any specific ailment, the consultant introduced regional specialists in the sphere of his/her scientific interests, apprising them of the terms and definitions adopted in his/her scientific center, techniques and the emerging practices for examination of the patient and justification of the choice of treatment methods (surgery, therapy, combined treatment). However, a new problem emerges here. |
|
 |
| Telemedicine Staff Training - our marketing tool |
| Practice of the first years of development of telemedicine project “ Moscow – Russian Regions” prompted us to seriously consider the issue of staffing the regional telemedicine centers. The biggest problem was that technical experts capable of servicing videoconference systems lacked expertise for the solution of specific medical problems, whereas physicians obviously lacked technical background for operating the complex electronic devices adequately. In the long run, our search for the optimum method of training of specialists for such high-tech sphere as telemedicine lead us to organize the annual International School “ Modern Aspects of Telemedicine” . The eighth issue of personnel trained for the regional telemedicine centers within framework of the
Russian Telemedicine Association educational project took place in late May 2007. The International Telemedicine School is operating on the basis of the Russian standards of postgraduate training with students taking a 72-hours’ course of telemedicine theory and practice within 10 days lectured by the leading Russian and foreign specialists. The successful graduates receive the relevant certificates and IDs. |
|
|
|
| Pathways towards better coordination and quality of care |
| Historically, healthcare facilities and practitioners have always been developing a number of more or less institutional and formal artifacts and tools to support the process of disease diagnosis, caregiving and its documentation so as to manage the unfolding of multiple and concomitant clinical cases towards a fast and definitive recovery (cf.
e.g., [3,16])). At the very beginning of last century, clinical records were introduced by hospital management to increase communication between clinicians, improve collaboration and retain into narrative records their ability to daily solve even complex problems of their patients [5]. At first doctors were very averse to the new assignment of
documenting care for others than themselves and to the new interference in their job that required them additional secretarial work. Nevertheless, doctors slowly reconciled to the record.
They slowly began to see this tool as an indispensable resource to cope with the whole set of patients they were responsible of and the with
complexity of each single case that grew in parallel with the development of the pharmaceutics industry and the complexity of its supply. |
|
| A grid approach to distributed data management for evidence-based pharmacology |
The paper describes XML-based meta-models and software services intended to search, collect and aggregate data of drug clinical usage. These tools and information structures enable detailed and actual information accumulation about possible adverse events related to drug administration to support the evidence-based pharmacology. Gridtechnology provides environment to implement services using multi-agent system technology and to operate with distributed and loosely coupled data and metadata in a transparent way. Keywords. Data management, clinical data, gridservice, XML meta-model Information about drug usage in everyday clinical practice is being accumulating in many sources all over the world. These are public sources (webpages and public services like MedLine) and private ones (databases of information systems of hospitals, pharmaceutical companies and universities). These data could be considered as results of a broad-based clinical testing in real conditions. Considering the thin balance between pro and contra in administering of many modern drugs, these data could be the very valuable for healthcare professionals, when been prepared and consolidated in an appropriate way. |
|
|
|
| The e-Gov RTD2020 Project |
In the last 17 months , EIPA-CEFASS has been deeply involved in the activities of a really exciting project called “ Roadmapping eGovernment RTD 2020: Visions and Research Measures towards European Citizenship and Innovative Government” ( called eGovRTD2020) and focusing on the possible developments of eGovernment at 2020. This Project or, to be more precise, this Specific Support Action co-financed by the European Commission’ s 6th Framework Programme of IST (Call 4, Priority: 2.4.9 - ICT research for innovative government ) saw the collaboration of 9 International Partners ( 7 from Europe, 1 from USA and 1 from Australia ) who strongly cooperated to the success of the project. In the following paragraphs of the article I’ ll be pleased to hjghlight the aim, the objectives, the methodology and the key results of the project (with also the Final Recommendations and Conclusions ) that, and I want to state this extremely clearly, were achieved thanks to the strong efforts of the all partners of the project and that are ( these results ) a propriety of the eGovRTD2020 Project Consortium but also a richness for everyone who will have the opportunity of reading them. AIM OF THE PROJECT Identify and characterise the key research challenges, required constituency, and possible implementation models for holistic and dynamic governments in Europe and around the world in 2020 and beyond. |
|
| What about near field communication technology? An overview with possible future telemedicine applications |
Near Field Communication (NFC), jointly developed by giant players in the consumer electronics arena such as Philips and Sony, is the last in a series of ever evolving wireless networking technologies for data transfer. The impacts and the potential uses of this technology (ECMA-340 standard) in the medical device field, and telemedicine as well, are analyzed and compared with existing wireless technologies for data and signal transfer. The intrinsically very short range of NFC is all but a limiting factor indeed. Having the communicating devices to be placed intentionally close to communicate, an higher level of security is obtained: a must for medical privacy sensible data exchange. Furthermore, NFC data rate can go as fast as a few hundreds of thousands of bits per second so to provide a channel wide enough for real time biomedical signal transmission. The extremely low power required for NFC operation, which reaches zero on the target in the passive communication mode, is an extra bonus in modern battery operated, and very much battery life concerned, medical devices. It seems that NFC technology may enable new products having new functionalities and new man-machine interfaces in the future telemedicine systems to come. |
|
|
|
 |
Telemedicine, as part of e-Health, is the interactive transmission of clinical data, signals and biomedical images, in order to enable patients, living in remote locations, to receive the best possible treatments. The World Health Organization (WHO) in Geneva on 1997 adopted this definition: “ Telemedicine is the delivery of health-care services, where distance is a critical factor, by health-care professionals using information and communication technologies far the exchange of valid information far diagnosis, treatment and prevention of disease and injuries, and far the continuing education of health- care providers as well as research and evaluation, all in the interests of advancing the health of individuals and their communities.” Telemedicine can be distinguished from telehealth, in the sense that this last is the provision of health administrative services (booking medical visits, health ticket payment, receiving lab test results, etc.) to users who are at a distance and are not necessarily ill or wounded. The common element in these different aspects is the use of telecommunications to deliver health-care services to persons wherever they are located (telemedicine and telehealth can be considered as parts of e-health). In general, e-Health regards electronic applications to the whole field of health sector, by means of intelligent and connected data systems in different activities (medical record design, clinical/ epidemiological data base management, hospital/health information systems architecture, teleconsulting/telediagnosis process, etc.) So, e-Health includes medical information systems, public health surveillance, e-learning for health professionals, telemedicine and telehomecare in particular on the following disabled and elderly people. Today the ageing of the population (in particular in the developed countries) poses significant economic, social and health-care challenges. The elder age is characterized by high incidence of chronic multi-pathologies and disabilities, such as diabetes, hypertension, heart disease, chronic respiratory failure, asthma and neurological disease as Alzheimer or Parkinson. However, such diseases can be managed away from the hospital at home. Home care is becoming an increasingly important part of the healthcare services, allowing the so called “ Continuity of care” . |
|
