GLOBAL eHEALTH TELEMEDICINE APPROACH

1
GLOBAL eHEALTH / TELEMEDICINE APPROACH

• F. Lievens 1,2,3, M. Jordanova 4,5
• 1 Board Member, International Society for
  Telemedicine eHealth (ISfTeH), Switzerland
• 2 Board Member, World Academy of Biomedical
  Science and Technology (WABT), France
• 3 Med-e-Tel International Manager, Belgium
• 4 Med-e-Tel, Coordinator Educational Program,
  Bulgaria
• 5 Solar-Terrestrial Influences Laboratory,
  Bulgarian Academy of Sciences, Bulgaria
• lievensf_at_skynet.be mjordan_at_bas.bg

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Terminology
3
Terminology

• Multiple definitions for eHealth / Telemedicine
  exist
• Very wide e.g. something to do with computers,
  people health
• Very narrow e.g. the healthcare industrys
  component of business over the Internet
• Focusing on various aspects
• Functions most cover multiple medical
  informatics applications for facilitating
  management and delivery of health care (e.g. data
  storage and exchange, patient-provider
  interaction, education, public health information
  etc). The common theme is communication
• Technologies specifying digital network
  technologies (Internet)
• Stakeholders healthcare providers
  organizations patients citizens
• Geographical focus from single organizations to
  global access

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Telemedicine or eHealth

• Till the middle of 90s the term Telemedicine was
  widely applied
• During the last decade, with more involvement of
  the electronic communication systems, the major
  international organisations
• WHO
• EU
• ITU
• ESA
• and others
• have officially adopted the denomination "eHealth"

5
eHealth

• "eHealth refers to the use of modern information
  and communication technologies to meet the needs
  of citizens, patients, healthcare professionals,
  healthcare providers, as well as policy makers
  (EU Ministerial Declaration, eHealth 2003, High
  Level Conference, Brussels 22 May 2003)
• eHealth is the official denomination used by the
  WHO, ITU, ESA, UNOOSA, EC and others
• The ultimate beneficiary of eHealth
  (Telemedicine) is the Patient/Citizen via the
  Healthcare Professionals
• Information Technology (IT) and Telecommunication
  are the tools to provide this service to these
  beneficiaries
• Welcome to
• MODERN COMMUNICATION HEALTH ENVIRONMENT

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eHealth

• eHealth has the potential to change our life
• People realize that and rank it high
• Five years from now, which technologies are going
  to be the breakout hits?
• 150 000 people from 104 countries answered this
  question during an IBM performed survey
• The company narrowed that list down to the five
  innovations that were the "most impactful and
  they are
• The 3-D Internet
• Mind-reading cell phones
• Nanotechnology for energy and the environment
• eHealth
• Real-time speech translation

Source http//cosmiclog.msnbc.msn.com/archive/200
6/12/28/23418.aspx
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eHealth is

• A practical solution, ensuring high quality
  affordable healthcare for all, at any time, any
  where
• eHealth is
• Efficiency decreasing costs
• Enhancing quality of care, including preventive
  care
• Evidence based effectiveness and efficiency
  should be proven by evaluation
• Empowerment of citizens and patients
• Encouragement of a new relationship between the
  patient and health professional
• Education of physicians and citizens
• Enabling information exchange and communication
  between all parties involved
• Extending the scope of health care beyond its
  conventional boundaries
• Ethical
• Equity
• In addition to these 10 es eHealth should also
  be
• Easy-to-use
• Entertaining (no-one will use something that is
  boring!)
• Exciting!

Source P.J. McCullagh, W.P. Patton eHealth
Tackling the Demand for Citizen Information On
The Internet
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eHealth is a State-of-Mind

• In a broader sense, eHealth is not only an
  application of technical achievements in
  healthcare, but it is also a state-of-mind, a way
  of thinking, an attitude, and a commitment for
  networking at all possible levels. eHealth is a
  global thinking plus the ambition to contribute
  to the improvement of health services at local,
  regional, continental and worldwide level by wide
  application of information and communication
  technology

eHealth affects a whole range of services in the
health sector - from general practitioner to the
hospital manager, from nurses to software
specialists, from social security funds to every
patient. This should also be reached through
international networking and joint efforts
Source G Eysenbach, Journal of Medical Internet
Research 20013(2)e20 http//www.jmir.org/2001/2/
e20/
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Are we Ready to Apply eHealth?

• Survey April 2007, N 52 eHealth experts from
  all over the world
• Are you ready to pay for eHealth service?
• How much will you pay for a tele-consultation?
• Are you ready to grant remote access to your
  personal medical data in order to expedite
  diagnosis?

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By and by

• eHealth
• Is becoming 3rd industrial pillar of the health
  sector
• (11 bn in 2004, 50 bn in 2010 in EU)
• Develops around 3 key objectives
• Global eHealth area
• Free patient mobility
• Empowerment of citizens

It is essential to

• Establish a payment system for eHealth
  performances (consultations, diagnosis, second
  opinion )
• Create an adequate eHealth nomenclature
• Develop international coordination of Public and
  Private Insurance Systems

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Bridging eHealth / Telemedicine and Medical
(Health) Informatics
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Medical Informatics

• "Medical Informatics is "the science underlying
  the acquisition, maintenance, retrieval, and
  application of biomedical knowledge and
  information to improve patient care, medical
  education, and health sciences research.
  (Charles P. Friedman, PhD 1998)
• From a computer science point of view, the
  question is
• How can systems within the area of MIT be
  constructed to meet the requirements of all
  stakeholders?

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What is Health Informatics

• Bioinformatics
• Computational biology
• Expression profiling and microarrays
• Genomics Genomic ontologies
• Neuroinformatics
• Pharmacogenomics
• Proteomics
• Clinical Informatics
• Careflow and process improvement systems
• Clinical systems communication
• Disease management
• Health information systems
• Integrated health and financial systems
• Education and Training
• Computer-assisted medical education
• Consumer health information, self-care
• E-learning and training
• Library information systems
• Professional education

• Innovative Technologies in Health Care
• Controlled terminology, vocabularies and
  ontologies
• Decision support systems
• Neural network techniques
• Pattern recognition/classification
• Intelligent data analysis and data mining
• Knowledge Management
• Security and data protection
• Software agents and distributed systems
• Nursing Informatics
• Nursing care systems
• Nursing vocabulary and terminology
• Nursing education / curriculum in nursing
  informatics
• Organizational Issues
• Management systems
• Cooperative design and development
• Economics of care
• Ethical and legal issues
• Organizational impact of information systems

Source Elmer V. Bernstam, MD, MSE, MS, Assistant
Professor, School of Health Information Sciences
and Internal Medicine UT Houston Health
Informatics
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Close Relations

• The links are everywhere
• In definitions
• In discussions and publications
• In the RT development

eHealth is an emerging field in the
intersection of medical informatics, public
health and business, referring to health services
and information delivered or enhanced through the
Internet and related technologies. G Eysenbach,
Journal of Medical Internet Research
20013(2)e20 http//www.jmir.org/2001/2/e20/
After Dr Claudia Pagliari, Senior Lecturer in
Primary Care, Division of Clinical and Community
Health SciencesSurvey What journals do ehealth
articles appear in? Results for yrs 2004-5
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Dual Relationship

• Interaction
• Interdependence
• Resulting in
• New tasks,
• New problems,
• New solutions,
• New perspectives
• New points of view

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Need for an Effective Fit
Clinical Treatment
Healthcare
Prevention Wellbeing
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Practically speaking, the mission of medical
informatics and eHealth (Telemedicine) is one and
the same - to "help people use information to
improve health.William W. Stead 1999
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International Organizations
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International Organizations Institutions

• WHO
• The recipiendary
• Major coordination role
• World wide (193 member states)
• eHealth Unit
• eHealth resolution
• Global eHealth Observatory
• ITU
• Telecommunication issues
• Standardization role
• Cooperation with WHO
• EU
• European Commission Information Society and Media
  Directorate General Unit H-1 IST for Health
• European Commission Directorate General Health
  and Consumer Protection Unit C2 Health
  Information - D.G. SANCO
• Major impact through its Framework Programs

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International Organizations Institutions

• UNOOSA
• Space issues
• Peaceful applications of Outer Space
• Action Team 6 Telehealth
• Organization of workshops in all continents
• WABT/UNESCO
• Educational, Scientific, Cultural and
  Communication issues
• NEPAD
• New Economic Partnership for African Development
• Important driving force for eHealth
  implementation on the African continent
• NATO
• Committee of Chiefs of Military Medical Services
  Telemedicine Panel
• Involved in advanced telemedicine technology
  research
• Etc.

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But

• Only WHO is fully dedicated to health issues
• Other organizations deal with health issues
  amongst several other activities
• Therefore WHO has the ultimate coordinating
  responsibility

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International Societies Associations

• Telemedicine - Around Healthcare Professionals
• Informatics - Around IT Professionals
• Telecom - Around Telecommunication Professionals
• Management - Around Management Professionals
• Patients
• More cooperation and coordination is vital!

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International Societies Associations

• AIM - Association Internationale de la Mutualité
• AMIA - American Medical Informatics Association
• APAMI - Asia Pacific Association for Medical
  Informatics
• CPME - Standing Committee of European Doctors
• EAHITM - European Association of Healthcare IT
  Managers
• EAHM - European Association of Hospital Managers
• EEHF - European eHealth Forum
• EFMI - European Federation for Medical
  Informatics
• EHMA - European Health Management Association
• EHTEL - European Health Telematics Association
• EHTO - European Health Telematics Observatory
• EuroPACS - European Society for the Promotion of
  Picture Archiving andCommunication Systems in
  Medicine
• HELINA - Health Informatics in Africa
• HIMMS - Healthcare Information Management
  Systems Society
• HINE - Health Information Network Europe
• HOPE - European Hospital and Healthcare
  Federation
• IAHSA - International Association of Homes and
  Services for the Ageing
• ICMCC - International Council on Medical Care
  Compunetics
• ICN - International Council of Nurses

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Interoperability

• Over the years, 2 main "Associative" structures
  were developed
• Medical Informatics (Engineers and Computer
  specialists)
• in the '80s - IMIA (www.imia.org)
• Telemedicine (Health Care professionals)
• in the '90s - ISfTeH (www.isft.net)
• Importance of improved and continuous
  cooperation and coordination
• The eHCC - eHealth Center of Competence has been
  created in Regensburg (www.eh-cc.de)

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International Networking Initiatives
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eHealth as Common Good

• Networking is crucial for every step of eHealth
  implementation
• The motto is Working together!
• Two major international forums help bringing
  experts and business as well as citizens together

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ISfTeH

• The International Society for Telemedicine
  eHealth
• http//www.isft.net

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ISfTeH
Mission Statement The ISfTeH exists to
facilitate the International disseminationof
knowledge and experience in Telemedicine and
eHealthand to provide access to recognized
experts in the field worldwide!

• Acting as
• Moderator in all aspects of healthcare
• Feeder for information and projects
• Coordinator between science, education and
  implementation
• Activator of networking and development

ISfTeH is the International representative body
of National and other Associations,
Institutions, Corporations, Individuals In
Partnership with WHO, ITU, UNOOSA,
WABT/UNESCO Liaising with other International
Associations
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ISfTeH

• National members
• Argentina, Austria, Bangladesh, Bosnia
  Herzegovina, Brazil, Canada, D.R. Congo, Croatia,
  Denmark, Finland, France, Georgia, Germany,
  India, Italy, Japan, Malaysia, Nigeria, Poland,
  Russia, Switzerland, The Netherlands, UK,
  Ukraine, Venezuela

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ISfTeH
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ISfTeH

• Corporate members
• Germany, Russia, Switzerland, U.K., U.S.A.

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ISfTeH

• Individual members
• Algeria, Australia, Austria, Belgium, Brazil,
  Egypt, France, Hungary, India, Indonesia, Italy,
  Japan, Moldova, New Zealand, Nigeria, Pakistan,
  Romania, South Africa, Spain, Sweden, The
  Netherlands, Turkey, Ukraine, United Kingdom,
  United States

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ISfTeH Students Members

• Members
• Brazil, Canada, France, India, Indonesia,
  Norway, Pakistan, South Africa, Sweden, Ukraine,
  United States
• A Working Committee "Students" has been started
  up within the ISfTeH to promote and follow-up
  specific eHealth activities amongst the student
  community worldwide
• Students Membership Applications are most welcome!

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Education

• Plays a crucial role but is underestimated
• Still needs to be developed much more
• Multidisciplinary
• New professional qualification eHealth
  specialist
• Dispensing
• Via Medical schools
• Via Technical and IT schools
• Via Management schools
• Via Multi-disciplinary courses
• Via Workshops and Seminars
• Already several master and post-graduate degrees
  available

35
ISfTeH and Education

• A Working Committee Education is now
  functioning under the umbrella of ISfTeH (chaired
  by Prof. M. Mars, South Africa)
• The mission is
• Listing already existing programs on
  Telemedicine /eHealth
• Establishing basic eHealth / Telemedicine
  templates for fundamental training programs
• Coordinating eHealth / Telemedicine educational
  efforts around the Globe
• Assisting the set up of new courses in eHealth /
  Telemedicine
• Defining the needs of universities and
  specialists for basic and continuous education

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2007 ISfTeH Participation in Major International
Events

• ICDS 2007 - TELEMED 2007 Guadeloupe, French
  Caribbean
• (05.01. - 07.01.2007)
• eHEALTH ASIA 2007 Putrajaya, Malaysia (06.02. -
  08.02.2007)
• NICTe 2007, Enugu, Nigeria (07.03. - 09.03.2007)
• TeleHealth 2007, Hannover, Germany (19.03. -
  20.03.2007)
• 3rd International Conference Telemedicine,
  Experience_at_ProspectsDonetsk, Ukraine (27.03. -
  29.03.2007)
• Med-e-Tel 2007, Luxembourg, G.D. of Luxembourg
• (18.04. - 20.04.2007)
• EMMIT 2007, Mangalia, Romania (03.05. -
  05.05.2007)
• Cross-border eHealth in the Baltic Sea Region -
  Healthcare delivery for the patients of today and
  tomorrow , Stockholm, Sweden (21.05. -
  22.05.2007)
• Telehealth 2007, The Third IASTED International
  Conference on Telehealth, Montreal, Quebec,
  Canada (30.05. - 01.06.2007)

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2007 ISfTeH Participation in Major International
Events

• TTeC 07, Tromsø Telemedicine and eHealth
  Conference, Tromsø, Norway (11.06. - 13.06.2007)
• Global Health Care Expansion Congress, Dubai,
  U.A.E.,
• (05.09. - 09.09.2007)
• International School for junior Scientists and
  Students on Optics, Laser Physics and Biophysics,
  SMF07, Saratov, Russia (26.09. 28.09.2007)
• Second Intensive Balkan Telemedicine and eHealth
  Seminar, Tirana, Albania (21.10. 23.10.2007)
• DGTelemed Fachkonferenz, Berlin, Germany
• (01.11. - 02.11.2007)
• Telemedicine Society of India, 3rd National
  Conference,
• XII-th ISfTeH International Conference, Chennai,
  India
• (02.11. - 03.11.2007)
• CST 2007 - SCT 2007 Annual Conference, St.
  John's, Newfoundland, Canada (04.11. -
  06.11.2007)
• CeHR 2007, Comprehensive eHealth, Regensburg,
  Germany
• (02.12. - 05.12.2007)

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Med-e-Tel

• Med-e-Tel
• (The International Educational and Networking
  Forum for eHealth, Telemedicine and Health ICT)
• http//www.medetel.lu

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Med-e-Tel 5 Years of Success

• The highly specialized international educational
  and networking forum for eHealth, telemedicine
  and health ICT
• It brings manufacturers and suppliers of specific
  equipments as well as service providers together
  with buyers, healthcare professionals,
  international organizations and association
  executives, institutional decision makers and
  policy makers from all over the world
• It provides them with hands-on experience and
  knowledge about currently available products,
  technologies and applications
• It is the forum where state-of-the-art products,
  services, ideas, projects, etc are presented and
  discussed
• It is the nesting place for developing existing
  relationships and establishing new co-operation
  and partnerships between individuals, scientific
  groups/institutions, small, medium and large size
  enterprises, etc

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Accreditation

• Med-e-Tel provides many educational opportunities
  through its extensive program of presentations,
  panel discussions, workshops and satellite
  symposia
• Med-e-Tel 2007 was accredited by the European
  Accreditation Council for Continuing Medical
  Education (EACCME) to provide maximum of 18 hours
  of European external CME credits for medical
  specialists
• EACCME credits are also recognized by the
  American Medical Association towards the
  Physician's Recognition Award (PRA)

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Med-e-Tel 2007

• Participants from 48 countries
• 38 companies and organizations present on the
  exhibition floor
• gt150 presentations from 45 countries
• Lists of exhibitors and presentations are
  available on the web http//www.medetel.lu

Countries represented at Med-e-Tel 2007
Proceedings with full text presentations were
published CD-ROMs and Hard copy available on
request Order forms at http//www.medetel.lu/inde
x.php?
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Format

• Exhibition
• Educational program
• Plenary session
• (WHO, Intel, TSI, ISfTeH, Meavita, WABT/UNESCO)
• Parallel sessions
• Satellite symposia
• Workshops
• Project meetings
• Media corner

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Supporting Organizations

• EC Information Society Media Directorate-General
  
• EC Health Consumer Protection
  Directorate-General
• European Association of Healthcare IT Managers
• Centre de Recherche Public - Santé
• International Association of Homes and Services
  for the Ageing
• International Council on Medical Care
  Compunetics
• International Society for Telemedicine eHealth
• Ministry of Health Luxembourg
• Solar-Terrestrial Influences Laboratory,
  Bulgarian Academy of Sciences
• U.S. Commercial Service
• WABT/UNESCO
• WHO
• ITU

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Results
Satisfaction
Follow up
Does Med-e-Tel represent a good value for money?
45
Next edition - 16-18 April, 2008 Do not forget
to tell your friends!
Med-e-Tel
46
ISfTeH and Med-e-Tel Working Together

• Two sides of the coin
• Lead the way from needs to practical applications
• Highlights quantitative numbers and results
• Serve networking meeting real people, real
  business, real achievements, real products,
  discussing real problems
• Education for business, science, practitioners,
  citizens

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The success of eHealth depends on teamwork
between all actors involved, between all of us!
48

• Thank you!