Health Telematics (AIM) Final Report
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METROPOLIS

Telecommunications Services for Health Care Added Value: Strategies for telematics systems in metropolitan areas to improve health care delivery

Project Code:  A76252
Project value:  192 KECU
EC contribution:  192 KECU
Duration:  9 months
Contact:
Mr. Antonio Mena
Arthur Andersen, src
Raimundo Fernandez Villaverde, 65
E-28003 Madrid, Spain
Tel.: +34-1-597.00.00 ext. 545
Fax: +34-1-556.95.69

Overview

This study focus on problems like the lack of co-ordination between health care and social services, the growing demand for people aged 65 or over, the insufficient monitoring of population "risk groups", the inefficient primary and secondary care co-ordination, all major problems identified in metropolitan areas that could be improved by the implementation of telematics systems.

Purpose and objectives

Strategies design for telematics systems to address these problems, represent the direction that current applications and future developments should follow. Defining, as a starting point, strategic lines with a wide approach in their scope, such as; services multiprovider focus, systems integration programs, meet user-specific requirements, etc. the design of concrete programmes and action plans is the tool chosen to translate theoretical schemes for technology development promotion "real life" implementation.

The effective management of resources for health care delivery in major urban areas in Europe is becoming increasingly difficult. Decision makers and providers are confronted with the task of providing quality and efficient health services in cities via a multiplicity of scattered facilities originally designed to function autonomously, while at the same time keeping abreast of and harnessing emergent technologies.

The Metropolis study aimed at providing an overview of the key problems and needs experienced by health care and social services providers in a metropolitan environment and how these could be resolved by the implementation of telematic systems. The experiences of Madrid, Paris and Copenhage were taken as main case studies. The study concluded with well-defined programmes, to help in a more efficient investment of the limited financial resources available.

Study main findings and conclusions

From an operational standpoint, the key problems and needs identified by health care and social services providers in European metropolitan areas are insufficient co-ordination for existing resources management, and inefficiency in processes/activities.

The problems with most impact and specifically to be addressed in metropolitan areas were prioritised as follows:

Problems Areas:

  1. Health care/Social services co-ordination.
  2. Demand for services by an ageing population.
  3. Insufficient control of "population risk groups"
  4. Time consuming, non-value added activities
  5. Lack of access to information by system users.

To address these problems, European countries are developing and implementing a broad range of thematic initiatives. In each case, the technology focus, as well as the development and implementation process is different, as in evidenced by the undernoted chart showing how experts in Copenhagen, Paris and Madrid defined "mature", "advanced" and "emergent" technology initiatives in their respective cities.

Mature:

Copenhagen - Electronic Interchange of Laboratory Data
Paris - Inter-Hospital Teleradiology System
Madrid - Home Health Tele-assistance System

Advanced:

Copenhagen - Electronic Transmission of Prescriptions
Paris - Home health care services (Minitel)
Madrid - Emergency Transportation Communication Trunking System

Emergent:

Copenhagen - Co-ordination between hospitals in Copenhagen County
Paris - "Vital Card", patient medical card
Madrid - Multi-media applications for interpersonal communication

Concluding the study, and based on the previous definition of the Strategic Lines and the Target Model for technology implementation, an action plan for research and technology development was defined. These action plan included a list of programmes and initiatives to be undertaken within the Commissions' overall strategy.

As a summary, an overview of some of the most representative programmes proposed.

There is a need for an IT&T based Framework to Co-ordinate Communication of Health Care and Social Services Organisations. Health care and social services in large metropolitan areas are frequently characterised by the coexistence of a multiplicity of interrelated organisations (national, regional and local) responsible for services provision and/or management.

There is a clear need for "information transfer" between all parties, (government administration-organisations-private, etc.), involved in the health care and/or social services delivery system.

Primary and Secondary Care Data Interchange should be improved. In most metropolitan scenarios, primary and secondary care are not electronically interconnected; rather, communication mechanisms and procedures in use (paper based, telephone, person-person,...) are time-consuming, inaccurate and non-cost efficient. The objective of implementing EDI systems to link primary and secondary care is to promote communication and service integration.

Multiple Access by Patients to Information on Health Care & Social Services should be enabled. Multiple access system interface to most frequently-requested information (fax, telephone, minitel, octel, etc.). Centralisation of interfaces, maintenance, data security and confidentiality.

Telematic Home Assistance Systems need to be reinforced. Home health tele-assistance systems could provide a large range of services that would permit the user/patient to remain in his or her normal environment: emergency alarm systems (tele-alarm), post-hospital treatment monitoring, social assistance (24 hour tele-assistance), etc. These applications potentially represent an increase in service quality by enhancing quality of life and providing cost reductions over traditional services.

For each of the above, the study defined the technical approach and the expected key results to guarantee the attainment of its objectives.

List of Deliverables

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