Last update: September 17, 1997
EUROPEAN HEALTH TELEMATICS OBSERVATORY

Rationale, mission and activities

The European Health Telematics Observatory is a service to the

health telematics sector, offering a co-ordinated approach to the

dissemination and visibility of project results, allowing a more

efficient integration of telematics within the different health

systems in Europe. It will contribute to the deployment of health

telematics technologies, applications and standards. The key

objective is to become a bridge between supply and demand.



On the demand side it will enable decision-makers to choose

appropriate telematics solutions, and help user groups to define

their requirements. Suppliers, industry and, specifically, small and

medium enterprises (SMEs) will benefit by delivering more

appropriate products. To both, EHTO will offer well-structured and

up-to-date information acting in synergy with other support

actions, especially those at the overall telematics programme

level,e.g. CONCORD, ETHOS and ASSENT.



By adding value to the information provided, and tailoring their

messages to the specific needs of policy makers and health

professionals, EHTO will facilitate the development of usable

products in the health sector from various generic telematic

services.

Introduction

The rapid changes that have taken place in the field of telematics

have had an important knock-on effect in the health sector.

Initially, the introduction of computerisation began to have

significant effects on the management of healthcare, but gradually

the impact on clinical care began to be felt, especially in relation

to the provision of laboratory and radiology services. In parallel

with these changes we have seen the development of

telemedicine, with the appearance of new types of services such

as distant consultation, linking practitioners in remote areas to

specialist services and facilitating the process of seeking a second

opinion from a distant centre of excellence.

The Third Framework Programme, under the management of DG

XIIIC, gave a substantial boost to the interest and activity in this

area by means of co-funded projects. The resulting co-operation

and exchange of ideas created, progressively, a coherent group of

people involved in health telematics research, development and

implementation in Europe, known familiarly as the "AIM

Community." The AIM (Advanced Informatics in Medicine)

Programme marked a milestone at its final conference held in

Lisbon in December 1994, when a wide range of issues were

discussed and analysed against the backcloth of a major exhibition

of health telematics products.



In parallel with these events a number of major reports appeared

which marked the strategic importance of these developments. In

1994 two key documents were produced by the Commission, the

Delors White Book and the Bangemann Report on the Global

Information Society. Another important document in this context

was the Green Paper, which concentrated attention on issues such

as technology deployment. These three publications represented

an acknowledgement of, and a contribution to, the impact of the

new information and communication technologies.

Broadly speaking, they sketched a transition to the 21st Century

founded upon innovative information-based scenarios, where

technology deployment, dissemination and access would become

catalysts in the socio-economic development of Europe. These

three publications, and G7 meetings, have served to highlight the

need for accurate and up-to-date data, readily available and in

usable form. The international co-operation required to develop

this information infrastructure needs to focus on regulatory

framework and the consequences of the information society on

economic, employment and lifestyle issues.

Rationale and Mission

From the experience obtained under the Third Framework

Programme it has become clear that little information is available

about the overall impact of health telematics on the health care

sector in particular and more generally on society. Strategic and

specific evaluations of the products and prototypes produced

within the Health Telematics Programme, will constitute the first

important stage of the work to be accomplished. Analysis of the

results of projects, according to their impact on more transversal

issues, will be a second essential element of this work. For

example, this will involve looking at economic and social impacts,

relationship to EU Policies, quality aspects, legal, security and

ethical issues. Given the rapid evolution of the sector, a strategic

market and innovation watch represents another essential

component of any attempt to obtain a wider view of impact.



The change from the Third to the Fourth Framework Programme

is characterised by greater emphasis on dissemination and

validation activities and a move towards implementation. The

Commission is eager to promote coherence in the fragmented

health telematics market by the achievement of a "critical mass".

Harnessing regional/national energies and promoting trans-

European practices depends on easy access to information on

available prototypes and products. Knowledge regarding the wider

effects and details of the state of the art in health telematics

combined with a range of appropriate indicators should also be

available. All this information requires professional organisation,

attractive packaging and distribution using a variety of

approaches including the latest technologies.



A number of particular needs have emerged, clearly, during the

Third Framework Programme. Firstly, health professionals (the

end-users) require information permitting them to develop an

insight into what is happening in the sector and its likely impact

on their activities. Secondly, health policy-makers need to form a

broad overview of progress in health telematics to allow them to

develop a coherent approach to the integration of these

technologies within the overall context of health planning and

management. Finally, European industry needs both general and

specific information which will facilitate assessment of the

maturity and market potential of their products and how to

design strategies to optimise returns over the intermediate to long

term.



In the light of these clearly recognised needs, the European Health

Telematics Observatory will collect, analyse and make available in

coherent and user-friendly format, a wide range of information on

developments in the field of health telematics, using a variety of

methods and tools including print and electronic publications,

workshops and a range of multi-media services.

The Observatory Users and Their Requirements

There is a plethora of information available on a whole variety of

health telematics issues, but much of it is difficult to find. It is

scattered widely across different types of organisations, and may

be known only to a limited number of experts in a particular

country or health sector.



Available evidence suggests that the potential clients for this type

of information are heterogeneous. They include national and local

health authorities, health service managers and health

professionals, universities, scientific societies, professional

associations, health insurance organisations, European industry -

including hardware and software manufacturers, system

integrators, information system vendors (including SMEs), telecom

operators and Value Added Network Service providers. Various

other groups related to the European Union, including European

Commissioners and Parliamentarians, Commission staff and

participants in Commission programmes also require information

on health informatics developments. However, it is plain that for

the majority of potential users, not only is 'hard' information on

most of these subjects difficult to find, but in its raw state is

somewhat indigestible and often difficult to use. The major

objective of EHTO will be to respond to these requirements.

Health Telematics Reports

One of the activities of the Observatory will be to produce regular

reports giving a series of snapshots of the current health

telematics environment and its likely evolution. This activity will

build on work carried out already by a number of Third

Framework Programme projects.

Market Innovation and Watch Activities

This complex analytical activity has a number of key elements:



*	the emergence of new informatics technologies including

	specific multimedia solutions, technical standards and

	interoperability;

*	developments in telecommunications - the operators'

	infrastructures and the related solutions and complementary

	technologies;

*	regulation with regard to the telematics sector in the context

	of information super highways and how such regulation relates to

	public policy both at national and international level;

*	industrial strategy in the telematics sector.



The results of this market and innovation watch activity will

serve as one of the primary inputs to the information/knowledge

base.

Information/Knowledge Base

In parallel with the activities relating to the physical

establishment of the Observatory, the partners have made the

necessary arrangements to secure inputs to the knowledge base.

This involves setting up effective systems to ensure the regular

supply of information in the sectors identified as relevant.

Guidelines (for Information Providers and Navigation and Retrieval) 

have been drafted for distribution to all identified

information sources, so that the material presented will be

relatively homogeneous, and suitably packaged, e.g. using HTML

format and a predefined presentation standard, in order to reflect

the needs of the different types of potential enquirers.

Information handling will constitute an important part of the

activity of the Observatory . As far as document analysis is

concerned, a number of potentially useful analytical categories

corresponding with a number of interested parties can readily be

identified.



To ensure that the information collected and disseminated by the

European Health Telematics Observatory corresponds to the real

needs of the health care sector, three groups (health policy

makers, end users and industry) will be constituted. These will

give their views on issues concerning the organisation of the

Observatory and on the type of information which they consider

to be useful and relevant. The health policy group will consist of

representatives of national/regional health authorities and social

insurance organisations, while the end users will represent the

health professions. The third group will bring together

representatives of industry (including small and medium

enterprises and the telecom operators).



It is planned to assess EHTO users' requirements on a wider basis

by carrying out surveys of their requirements. Here the objective

is to find out directly from all types of potential EHTO users what

type of information, broken down into what categories, would be

most useful to them, so as to orientate the information collection

and analysis appropriately.

The Observatory will use Internet tools to disseminate

information to the users by means of a variety of channels, of

which WWW (World Wide Web) will be the most advanced one.

As part of the service, a health care telematics newsgroup may be

established and individuals can be automatically mailed

depending on their group profile. A system will be established to

enable users to ask questions about the Observatory and about

health care telematics in general. The questions will be logged and

used to compile a FAQ-list (frequently asked questions). Questions,

remarks and feedback mail addresses of experts appointed by

EHTO will be provided.



It is proposed to develop for each health telematics project a

forum (litserv) which will be available for end-users by

subscription and which would favour information exchange

between projects and end -users. In addition, the Observatory will

constitute a horizontal electronic forum facilitating transversal

exchanges of information between different types of end-user. In

order to avoid information overload, each electronic forum will be

moderated by the Observatory.



The following broad categories of information will constitute the

base of EHTO's information/knowledge base:



*	Information from Health Telematics Projects: it is intended

to include the most relevant Third Framework Programme results

within the Observatory's information base together with all public

deliverables from the Fourth Framework Programme Health

Telematics projects. Systematic information will be collected on

the objectives of the projects and on their development. The

information obtained will be carefully analysed against certain

identified criteria, for example in relation to medical, health

policy, technological, industrial, economic, societal, quality,

adaptability, ethical and standardisation aspects.



*	Information from Horizontal Actions: a number of health

telematics projects are in the process of developing specific

expertise in areas of key interest for health telematics users and

service providers. These include technology assessment,

developments in education, legal and ethical aspects and quality

issues. Complementary activities are taking place within the

Member States; the Observatory will establish close links with

these projects, and with teams working at national level to ensure

appropriate inputs to the Observatory, and with a view to

promoting the dissemination of their findings.



*	Information from Other Related Commission Programmes: a

number of other Directorates General of the Commission (for

example III, V and XII) or programmes (such as ESPRIT, ACTS,

ENS,IDA and BIOMED) have links with the field of health

telematics. Additional information, related for example to EUREKA

and COST, or concerning funding available under European

Structural Funds, The European Regional Development Fund or the

European Investment Bank, can be of importance both to users

and to service providers, and will form another useful aspect of

the Observatory Information service.



*	State of the Art in Health Telematics in Europe: building on

work already carried out by a number of projects under the Third

Framework Programme, quantitative and qualitative information

will be collected on health telematics development in the

countries of the European Union. A comparative assessment of the

situation at the beginning and the end of the Health Telematics

Programme will be carried out in order to evaluate progress.



*	Information on Standardisation:  information on all existing

standards and on standards in the course of development will be

deposited with the Observatory. A link will be established with

the CEN TC 251 WWW server. Through CEN, liaison will be ensured

with the United States (ANSI HISB), Japan(MEDIS-DC), Canada

and Australia.

Observatory Demonstration Site

An essential aspect of the Observatory's work will be the

demonstration of the prototypes and products developed within

the health telematics domain using appropriate technology. The

benefits of the Observatory building will be available to all

relevant sectors.



Demonstrations combined with a wide range of information in a

readily accessible and user-friendly form, should permit the user

community to obtain both factual and evaluative information. This

should assist the user community in the development of their

communications networks and, at the same time, help European

industry to assess future market potential more accurately.



The initial Demo Site architecture will be designed taking full

account of the requirements of the Health Telematics Projects.

From the outset, the Observatory will provide a technological

window where the most recent telematics equipment will be

available. It is intended to develop communication links between

the EHTO Demo Site and the national Satellite Demo Sites. This will

represent yet another way in which EHTO will offer interested

parties from outside the Consortium the opportunity of being

actively involved in promotion activities within their own regions.



The Observatory's daily activities will include the provision of an

information Help Desk, and a reception desk for visitors and

potential products and services administrators.

Summary

The European Health Telematics Observatory will have an

important impact on the deployment of Healthcare Telematics

services throughout the EU. It will represent an unrivalled source

of health telematics information, carefully analysed and classified.

Equipped with a Demonstration Site, itself the hub of a group of

satellite centres, EHTO will bring together in theme-specific

workshops and cascade conferences the entire range of actors

from all telematics sectors including top policy makers. As a result

of this central position, the Observatory will have a significant role

to play in the development of the Health Telematics Programme

and related initiatives. Health policy and Industrial strategy

groups will play a leading part in this process.

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