Health Telematics (AIM) Final Report


	Updated: Feb 1, 97
EDICON

A case study on the concept of the European Distributed Consulting Hospital

Contract No: 18006

Total cost: 200 KECU

EC contribution: 200 KECU

Duration: 9 months

Contact:
Ing. Girolamo Di Genova
SIP
Via Flaminia 189
I-00196 Roma, Italy
Tel.: +39-6-36.88.49.89
Fax: +39-6-36.88.99.46

Overview

The objective of this study was to investigate the feasibility of a network of Centres of Excellence, obtained by interlinking scientific Institutions, each providing mono-specialist health care services, via a high-speed backbone for transfer of voice, data and images.

The interconnection of these vertical structures, identified as the Centres of Expertise for their specific disciplines, suggests the concept of the "Distributed Consulting Hospital", able to provide consulting service to other health care providers (GP's, local hospitals, etc.) throughout the territory, irrespective of where the expertise itself is physically located.

Purpose and objectives

The purpose of the feasibility study was oriented to develop, in a transversal way, the above suggested actions through the implementation of a European distributed consulting hospital model. That model is justified by the high cost of sophisticated "excellent" consulting services throughout Europe and increasing health needs, mainly due to the complexity of clinical/health care administrative developments requiring rapid external expertise and communication for decision support; isolation of citizens in urban, rural and remote areas having specialised needs as the elderly, handicapped, socially deprived and those who are unable to get medical help at hand; training and self-education of patients on disease management (see AIM92), factors that make necessary the telematic application for consulting in health care of a very high level of quality care, and, at the same time, in order to balance the high costs, distributed on the territory not only at national level but also at regional and transnational level. So that it would be possible to promote the effective collaboration of all Health Care sector actors, to develop tools, techniques and practices that support a common European approach to Health Care Informatics and Telecommunications, to promote their acceptance in the community and by the market.

From this point of view, the objective of the EDICON project was to interlink the Centres of Excellence such as scientific Institutions in order to provide a consulting service for the health care actors (patients, nurses general practitioners, experts, etc.), throughout the territory, according to a "European Distributed Consulting Hospital" model. The main goal of EDICON project was then to demonstrate the possibility of realising such a model in an operational way.

Through the description of the architectural model, its interconnection elements, both horizontal and vertical links, the organisational interaction criteria at geographical level, the services and the functionalities were analysed. The specification for the working model, access criteria to the system, mechanism of access and context for usage are explored.

Identification and description of seven EDICON services and potential users for a Telematic European Network, identifying the areas where such services show the highest degree of potential usefulness, are identified, such as: Computer assisted co-operative work of medical professionals, Research oriented services disseminate, Education related services, Administrative services, Dissemination of information to patients and citizens, Healthcare monitoring and population surveillance.

Such identification of priority services in connection with users and health facilities aimed at identifying typologies common to users and facilities across Europe according to the current European health policy changes (trend towards clinic dehospitalisation, the new central role of the Health System played by the general practitioner etc.) and the current European standardisation of services. Moreover, the potential marginal benefits related to the better efficiency and operational cost effectiveness, to the frequency of utilisation, and to the positive fall-out effects, are described.

Results

User profiles have been analysed (characteristics and needs to patients, health care professionals and institutions) and the description of the specification for a working model for a European distributed consulting procedure.

An economic evaluation technique referring to the EDICON model were produced. Finally, various cases to validate the Distributed Consulting Hospital functional architectures were elaborated, such as the I.R.C.C.S. Italian network interconnection through a high-speed backbone to constitute a national network of Excellence centres; an economic evaluation of the Italian experience of Teledialysis as a model involving regional hospitals and the points of care distributed in the regional areas; the case study on the Italian architecture in the Heart Transplantation activity interconnected by Regional Backbone; finally, an example of an expensive technology housed in an excellence centre whose availability and use for local units is possible only via telematic systems. Also some connections with the European projects SHINE, FEST, MEMPHIS, EMDIS and the Italian Telecos project were given with final recommendations on the strategy implementation.



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