Updated: Feb 1, 97
TANIT

Project Code:   A2036 Project value:   7031 KECU EC contribution:   3748 KECU No of partners:   8 No of countries:   5 Duration:   36 months

Contact: Dr. Claire Bowes Kontron Instruments Ltd. International Marketing Div. Blackmore Lane Croxley Centre Watford WD1 8XQ, U.K. Tel.: +44-923-24.59.91 Fax: +44-923-22.06.66

Overview

Purpose and objectives

The goal of TANIT is to develop, implement, demonstrate and evaluate generic computer systems for Anaesthesia and Intensive Care, i.e. two major component parts of Critical Care (CC).

The project aims to produce a demonstrable reference for Critical Care departmental computer systems in the mid-nineties, transferable in time and space throughout Europe, and open to the hospital information space and to the health communities. The core of TANIT is the development and evaluation of Anaesthesia and Intensive Care pilot systems.

Results

The core of TANIT has been the development, implementation and evaluation of pilot systems for two example environments: the Anaesthesia Department and the Intensive Care Unit (lCU). The TANIT pilot systems are demonstrating an increase in the effectiveness of departments by supporting all their activities in an integrated way. From the clinical perspective, the pilots have the capability to improve patient care by increasing diagnostic and therapeutic capacities and by facilitating the work of nurses and other healthcare professionals. The pilots also have significant impact on the application domain by addressing two major issues in healthcare: (i) the audit of care delivered to patients and the outcome of that care; (ii) the assessment of the costs of treatment delivered to patients and the provision of tools for the management of the environment.

Pilot systems have been installed in European hospital sites and are being incorporated in the daily routine of users (e.g. doctors, nurses, unit managers, hospital managers). A detailed methodology for the evaluation of the pilots has been developed within TANIT. Pilot evaluation has been an on-going process throughout the project, and the systems are undergoing formal evaluation at clinical sites.

The pilot developments have been supported by the results / recommendations of supporting strategic and telematic R&D work packages. These include:

• monitoring of current and emerging data transfer standards;
• recommendations for data protection and security (legal and technological perspectives);
• recommendations for transferable CCE medical record;
• specifications for healthcare evaluation and clinical audit in CCE;
• specifications for resource management and patient costing in CCE;
• guidelines for Human Computer Interaction of CCE systems, and evaluation of pilots;
• proposals and prototypes to support co-operative work in CCE;
• recommendations for transferability of CCE computer systems, and their interoperability with other hospital computer systems and patient we devices;
• implementation of prototype portable preoperative data collection system;
• implementation of three prototype Clinical Decision Support modules;
• methodologies for validation of signals from bedside devices.

The project has actively contributed to medical informatics standards development, e.g. to CEN TC251 WG5 (open-system for communication between patient care devices and information systems).

TANIT provides:

• improved overall effectiveness of departments by providing integrated systems that are the basis of state-of-the-art products for world-wide markets;
• comprehensive, integrated support for both clinical and departmental management functions;
• solutions that fulfil the needs of healthcare professionals, hospital managers and healthcare authorities;
• openness to the healthcare information space and adherence to data transfer and security standards;
• configurability to meet current and developing practice;
• solutions that are transferable to other acute healthcare environments;
• methods for measuring quality of care delivered and its effectiveness:
• methods for monitoring effectiveness of resource usage;
• contribution to healthcare harmonisation in Europe and to medical informatics standards development;
• platforms to test both emerging standards and results from European Community programmes.

The results of TANIT can be exploited with the focus on real and functional integration in the healthcare community. There are a number of possible avenues for exploitation:

• demonstration and validation of TANIT pilots integrated within hospitals and the community, thereby supporting harmonisation of healthcare practice in Europe;
• integration of TANIT pilots with other pilot systems from within the current AIM Programme;
• use TANIT pilots as evaluation platform for novel telematics / multimedia developments, i.e. further integrate results / recommendations from the support work packages of TANIT and from other AIM projects;
• use TANIT pilots as a testbed for European standardisation;
• further contribute to European Medical Informatics standards development;
• investigate the transferability of pilots to other hospital environments;
• further evaluation of the preliminary implementations;
• complete the pilot implementations, and prepare them as marketable products.

List of Deliverables

Year 1

• Data transfer standards for CCE computer systems (first proposal) (4/R/P)
• Interim report on co-operative work support in CCE (methodology (7/R/L)
• Interim technical recommendations for data protection CC computer systems (8/R/L)
• Preliminary clinical models, and specification of clinical module user interface (9/R/I)
• Demonstrable human - computer interaction testbed (with basic functionalities) (9/P/I)
• Design requirements and evaluation criteria for the development of user interfaces in CC departments (9/R/L)
• Data requirements for medical audit in the Critical Care Environment (12/R/L)
• Interim report on transferability factors for CCE computer systems (12/R/L)
• Interim recommendations for data protections in CC computer systems: medical and legal issues (8/R/P)

Year 2

• Medical recommendations and specifications for a security model (1/R/P)
• Overall methodologies for evaluation of prototype / pilot implementations (1/R/P)
• Interim report on, and recommendations for, transferable CCE medical record (2/R/P)
• Prototype software and hardware security systems for the TANIT Critical Care Environment
• Specification of auditing functions for Critical Care Department (4/R/L)
• Preliminary report on unit management and patient costing in the Critical Care Environment
• User requirements of signal processing and methodologies for signal validation (4/R/P)
• Second Interim report on co-operative work support in CCE (results) (7/R/L)
• Example clinical module installed in pilot site (9/P/I)
• Demonstrable human - Computer Interaction testbed (with enhanced functionalities) (9/P/I)
• Recommendations and guidelines for transferable CCE computer systems (9/R/L)
• Remote data collection and integration in the CCE computer system: the case of pre and post operative data (demonstration) (9/P/L)
• Prototype Clinical Decision Support modules (9/P/L)
• Pilot system for OR and recovery, including networking (9/P/I)
• Interim synthesis of the TANIT project (12/R/L)

Year 3

• Unit management and patient costing in the Critical Care Environment (1/R/L)
• Final description of the design guidelines for the development of user interfaces in CC departments (4/R/L)
• Data protection in CC computer systems : final recommendations (5/R/P)
• Preliminary prototype management support system (6/P/I)
• Proposal for transferable CCE medical record (7/R/P)
• Proposal for co-operative work support in CC departments (7/R/L)
• Demonstrable integrated Anaesthesia Pilot (9/P/I)
• Health care evaluation and medical audit in critical care telematics, including networking of audit (9/R/L)
• Final report on clinical decision support (9/R/L)
• Results of overall evaluation of pilot implementation (11/R/I)
• Update on data transfer standards for CCE computer systems (11/R/P)
• Evaluation results of Anaesthesia pilot (12/R/I)
• Synthesis and conclusions of the TANIT Project (12/R/P)

List of Participants

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