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Updated: Feb 1, 97 |
MARIA | |
| Contact: Din Ghani MARI Computer Systems, Unit 22, Boldon Business Park Witney way Tyne and Wear NE35 9PE, U.K. Tel.: +44-191-519.19.91 Fax: +44-191-519.19.90 |
Methods used
Several preparatory studies were made to prepare the ground for the Demonstrators, investigation organisational, technical, and practical issues in medical telematics provision, including confidentiality and security. Development of the European Demonstrator then focused on provision of World Wide Web services, while the Regional Demonstrator focused on networked multimedia solutions which can be provided at low enough cost to ensure widespread clinical adoption.
Oncology in Europe is weakened by a de-focusing of research through a geographical spread of patients and cancer centres, a slow rate of dissemination of best practice, inconsistencies in quality assurance and differences in outcomes between treatment centres.
Telematics has a vital role in providing a "research institute without walls", promoting dissemination of best practice through guidelines and decision support, supporting audit and outcomes studies to identify cost effective treatment and delivering continuing medical education and health promotion programmes. Telematic networks and services exist, but the approach is fragmented, knowledge of facilities is not widespread, and the busy clinician who has no interest in IT is not given an appropriate 'user view' to quickly locate and use services.
Description of Demonstrator
Within the above context, the overall objective of the MARIA project is to demonstrate and raise awareness of the potential of medical telematics, particularly in the area of oncology. MARIA takes a two-pronged approach, focused by two demonstrator systems. The Regional Demonstrator facilitates the uptake of telematics systems in paediatrics and paediatric oncology on a regional basis, particularly through conferencing and affordable multimedia workstation technology. This is based around a Research Centre being constructed by the Children's Foundation charity. The European Demonstrator is concerned with European-scale services, particularly in cancer clinical trials, the appropriate support of users in different European Member States, and with structured access to available cancer telematic services .
MARIA provides working examples of an integrated telematic service network to provide appropriate 'user views' which allow, for example, the clinician in a regional hospital to both use and contribute to European-wide specialist services. The emphasis on practical demonstrators will focus attention on real, existing systems, evaluate them in everyday use and form a model for future developments. The MARIA demonstrators will promote and focus awareness of medical telematics and provide foundations for developing future integrated networks. MARIA is also working actively with other projects and organisations, with the intention of fostering collaboration and providing a practical framework for future telematics development by the European oncological community.
The European demonstrator entitled TeleSCAN : Telematics Services within Cancer, bring together the requirements of a large body of users with existing advanced telematics services, and provide a basis for a comprehensive European Oncology Telematics network to serve a broad range of user groups, including oncologists, general physicians, general practitioners, medical trainees, nurses, and eventually patients, families and the lay public.
TeleSCAN is an integrated network facility providing information access, dissemination and telematics services for the European oncological community. It has been developed using generic information exchange tools from the Internet community. The system is intended to bring together, cancer telematics service providers in the areas of research, treatment, education, screening and prevention, with a critical mass of users, ultimately extending from oncology specialists through clinical trials data managers, the pharmaceutical industry, secondary and primary care actors and patients. In the framework of the MARIA project, TeleSCAN will demonstrate 4 types of telematics services:
TeleSCAN itself represents a major advance in providing a unified access point to a range of services, and an opportunity to provide information on available services to the prospective user. It contributes particularly in research oriented services (e.g. register of trials, randomisation of patients into trials), but is an ideal vehicle for dissemination of best practice guidelines, outcome studies, epidemiology etc.
Potential benefits
The demonstrator systems will illustrate how access can be provided to appropriately presented information and allow distribution of specialised medical expertise over a wide geographical area. Through the operation of the systems, crucial information will become more widely distributed, and new services will become available. MARIA has started a process of integration, directed towards establishing a grouping of projects, based on existing projects and user organisations, which it is hoped will form the basis for the telematics network which will take cancer research and clinical practice forward through the 1990s. Such a network would offer a number of major benefits to healthcare in Europe:
1) Industrial Impact.
In a context, the MARIA project has increased our "know how" capability, enabling us to transfer Telematics based technologies such as Videoconferencing, Desktop conferencing, Routers, Bridges, Networks etc. into several areas of the Health care sector, where previously had very little implemented.
In the UK, the Telecommunications industry in the Health care sector, has adopted the WAN strategy based on services provide by British Telecom, Mercury and Racal(Syntegra, HealthLink), in order to facilitate users.
We are currently in consultation with the NHS Executive Committee as to how the MARIA as a model can help promote the uptake of the services.
The MARIA project, because of its potential for Clinical effectiveness, received Regional Governmental funding for the extension of its services.
2) Health/Social Impact.
As a direct result of MARIA Regional Demonstrator, was the formation of a Regional multidisciplinary Health Sector Group.
This Group made of participants from the Health Management as well as the Clinical and Social Scientists, on assessing how to utilise the MARIA Telematics based services for the overall development and cohesion of the interdependent activities.
Current progress is now being made, following meetings of the Health Sector Group, into developing a Palliative Care Regional Network. We are also embarking into further development by extending the network to support delivery of medical training to Regional based Post Graduation centres within the major teaching hospitals.
Further enhancement currently under consideration are Teledermatology, linking Regional Dermatology centres to Primary care doctors and assessing the possibility for Public Access Terminals in health care. 3) Obstacles and difficulties.
An obstacle that we had to overcome in the MARIA project was the general lack of awareness of the capabilities of the technology as well as the lack of confidence into using these technologies.
Lack of awareness, however, is a real difficulty further constrained by lack of sufficient training and time by clinical staff.
That is why a multidisciplinary group of enthusiastic and technically aware users was set-up and also to share knowledge and expertise.
| MARI Computer Services Limited Old Town Hall N/A Gateshead Tyne and Wear NE2 4RX, U.K. | EORTC Avenue Mounier 63 B-1200 Brussels, Belgium |
| The Children's Foundation Lambton Road 1 Newcastle Upon Tyne Tyne and Wear NE2 4RX, U.K. | CAOS/CAMM Center Toernooiveld NL-6500 GL Nijmegen, The Netherlands |
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