Health Telematics (AIM) Final Report
  
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Updated: Feb 1, 97
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ACOSTA |
Accompanying measure on Health Care Telematics Consensus Formation and Standardisation Promotion
| Project Code: | | A2106 |
| Project value: | | 1200 KECU |
| EC contribution: | | 1200 KECU |
| No of partners: | | 3 |
| No of countries: | | 3 |
| Duration: | | 28 months |
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Contact:
Mrs Christine Thayer
CNEH
(Centre National de l'Equipement Hospitalier)
9, rue Antoine Chantin
F-75104 Paris, France
Tel.: +33-1-40.44.15.04
Fax: +33-1-40.44.82.34
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Overview
The ACOSTA Accompanying Measure was created as part of the AIM response to the difficult market situation in Europe: fragmented and heterogeneous, and faced by strong US competition in a context of severe limitations on health care expenditure. Industrialists anxious about the possible of a poor return on their investments were perceived to be hesitant, making difficult the achievement of a critical mass. The needs of users were poorly expressed because of uncertainties over the potential of the rapidly evolving communication technologies.
The likely organisational impact and the costs which might be involved were difficult to assess and they were worried by the possible incompatibility of the solutions for which they might opt with other applications which they might wish to investigate. In this context of poor co-ordination between the different actors, consensus formation was perceived as a useful approach to tackling some of these problems.
Purpose and objectives
The ACOSTA Accompanying Measure was created to respond to the above need for consensus formation. Its objective was to move forward on a number of fronts at the same time. It aimed to bring together, with a view to fostering consensus between them, the various partners involved in stimulating the health telematics market, namely health care managers and professionals, telecom operators and industrial companies from the sector including small and medium enterprises.
Although initially the three strands of the ACOSTA action, namely health policy, industry and standardisation developed separately, as the action progressed, increasing co-operation and synergy developed between the various parts.
The ACOSTA action consisted essentially of three key elements:
consensus-building activities , including promotion of standardisation, with an active role for user/industrial groups,
creation of an information base, a European state-of-the-art containing both health service and market information,
development of a strategy for the development of a market in health telematics.
Results
1. AIM Requirements Board Document
It made the following recommendations:
- that the 4th Framework Programme should concentrate very specifically on the development aspects of projects.
- that expansion of the health telematics infrastructure should be encouraged by promoting and linking "islands of excellence" thus stimulating demand for, and supply of, advanced services. Areas of special interest in this context might include activities such as quality assurance of business management, where consensus exists on the need for support through the systematic introduction of common services.
- that the programme should encourage activities of small and medium enterprises aimed at developing generic applications in partnership with user groups. The report particularly stressed user inputs and responsiveness, and placed special emphasis on impact evaluation.
- that support should be given to diffusion and technology transfer activities focusing on the exportation of projects implemented in one location to the health care sector of another region or country.
- that a series of concerted actions and accompanying measures should be used to create cultures of collaboration, demonstrating and diffusing project activities and promoting technology assessment.
- that different types of action should be included, each with a specific objective, and with rigorous evaluation procedures built in at every level.
2. Health Telematics Book
Its purpose was to inform health care professionals and managers of developments in the health telematics field, trying to explain the potential of these rapidly evolving technologies without glossing over the problems. A fundamental objective was to produce a book which people would want to read. The result was "Telematics for Health Care", which has been widely praised for its attractive and easy to read format. Two English language editions were produced, and to date 3,000 copies have been distributed, including a substantial number at the G7 conference in March 1995. 3,000 copies of a German language edition are due to be published in co-operation with the University of Hildesheim, and a French version is also due to be published.
3. Luxembourg Meeting (14-15/9/1993) and Other Standardisation Activities
The objective of the standardisation part of the action was the achievement of better co-ordination between the AIM research projects and the activities of CEN TC 251, EWOS/EGMED and NEEB MDS. This involved:
- ensuring that the priorities of the two programmes coincided to a substantial extent
- identifying priorities through consensus-finding amongst users, industry and the authorities
- making the pre-normative results of research known to the people involved in standardisation (working groups and project teams in CEN TC 251 etc.)
- promoting norms which were in the process of being developed or which had been adopted amongst the projects involved in he research programmes.
- promoting validation of research efforts and exploitation after standardisation.
4. Lisbon Meeting
A particular contribution was made to the organisation of two conference workshops and ACOSTA also organised the video conference between the Lisbon conference and the World Health Organisation in Copenhagen. As part of this overall effort, ACOSTA made arrangements for a meeting of CEN TC 251 within the framework of the Lisbon Conference. Finally, ACOSTA contributed substantially to the process of editing and publishing the proceedings of the Lisbon Conference.
5. Draft standardisation guidelines
Under the aegis of ACOSTA, draft standardisation implementation guidelines were drawn up on the basis of European standard and pre-standard documents. These resulted from collaboration with a large number of AIM projects and CEN TC 251 working groups. The guidelines were designed to bridge the gap between standards adopted and solutions implemented, and they were launched at the Lisbon Conference, both as a booklet but also in the form of a CD-ROM.
6. Promotion of active consensus
Taking advantage of CNEH expertise, a decision was taken to explore the possibilities of bringing together, initially in one country, a cluster of industrialists from the telematics sector, and asking them to invest their money and expertise in a shop window/laboratory where the hospital world could come and browse, discuss and ask questions. The aim was to create an environment where industry could show its products in a relatively realistic setting.
Industrial actors from the telematics sector were offered the possibility of a permanent showroom for key products. Overheads would be met by the CNEH, which would also offer its expertise and network of contacts in the hospital world. In return, the industrialists would pay an annual subscription for membership of the club. The idea was to develop an open, self-financing consortium with proper organisational rules governing its decision-making processes. An important feature of the arrangement was that it more or less guaranteed an immediate return on investment for the participants.
Since its official opening by senior Health Ministry officials on 28th September 1994, a substantial number of industrialists have signed the convention. A number of SMEs have also found the offer interesting.
The facilities offered within the Telecoms and Telemedicine Unit include video-conferencing equipment, work stations with imaging facilities, intelligent digital links, radio communications and an Internet link. Equipment up to a total value of 5 Million French francs has been installed, and in the year since it opened, the Unit has attracted nearly 600 visitors. These have included staff from many of the larger hospitals in France, professional associations, health insurance organisations, educational establishments, research institutions and ministries. These have also been a large number of overseas visitors from as far afield as Lebanon, Brazil, China and Japan. The Unit offers, in addition, as series of training sessions on telematics applications in health care.
List of Deliverables
- AIM requirement board options
- Telematics for Health Care. Its impact? Its future?
- Standards in Health care informatics and telematics. CEN TC251. (with a CD-ROM)
List of Participants
Jaap Noothoven van Goor(*)
N4G BVBA,
The Netherlands
(*)Deceased
| Prof Georges De Moor
RAMIT - State University Gent
Medical informatics department
De Pintelaan 186
B-9000 Gent, Belgium
Tel.: +32-9-140.34.36
Fax: +32-9-140.34.39
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