Compendium of Health Telematics Projects 94-98 (Draft)
| Project code: | HC 1112 |
| Project value: | 500.0 KECU |
| EC contribution: | 500.0 KECU |
| Number of partners: | 5 |
| Number of countries: | 4 |
| Duration: | 36 months |
| Starting date: | Jan 7, 96 |
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| Contact: |
C. Viens-Bitker
Assistance Publique
Hopitaux de Paris-Cedit
3, Avenue Victoria
75004 Paris
France
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| Tel: | 33 1 40 27 31 07 |
| Fax: | 33 1 40 27 38 09 |
| E-mail: | Catherine.Viens-bitker@sap.ap-hop-paris.fr |
| Web Site: | |
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Overview
Health Technology Assessment (HTA) is a discipline with a set of methodological tools, originated in about 1975. It is a form of policy research that systematically examines effectiveness, cost-effectiveness, impact on public health, health expenditures, health care organisation, and legal, ethical and psychological short and long term consequences of the use of new or existing health care technologies (Banta and Luce « Health care technology and its assessment: an international perspective, Oxford University Press, 1993). The aim of HTA is to support and inform decision making processes related to the introduction or the spreading out of a health care technology.
HTA methods have been developed and applied in many countries for traditional health care technologies like drugs and medical devices. There is an agreement today to consider that HTA methods cannot be readily applied to Information Technologies, so called « diffuse « technologies by J.Keen and al (Evaluation of diffuse technologies: the case of digital imaging networks, Health Policy 1995 ;34 :153-166) for many reasons : 1/ Information Technologies have several distinct components which have distinct effects on groups of patients (and professionals) and services, 2/ the different components may interact with one another, so that the overall impact of the technology may be greater (or smaller) than the summatory of the individual effects, 3/ from the complexity of these technologies it follows that the subsequent intervention becomes, in practice, the combination of the technology and a management process. Methodological difficulties encountered to assess Information Technologies in the health care sector explain the few HTA data available in the literature (W.G.Tohme and S.Olson, Developments and Directions of technology assessment in telemedicine, SPRI tryck 274) and the low spreading of telemedicine services (Ace Allen)
In this context, the TASTE project aims to produce « guidelines and recommendations » for the HTA of Teleneuromedicine services, according to one of the « Ten Commandments » of the telematics Applications Programme . Moreover the project is based on the users’ experience in teleneuromedicine (the Irish Health Southern Board hospitals and the French Assistance Publique-Hôpitaux de Paris hospitals) and the expertise of two agencies specialised in HTA (the Dutch TNO and the Spanish Catalan Agency for Health Technology Assessment). The consortium includes also the French Conseil National de l’Ordre des Médecins, in order to cover ethical and legal issues related to telemedicine. Within the TASTE project, target decision makers are health district managers, hospital managers and physicians heads of departments. The TASTE workplan includes four main workpackages: 1/ decision makers needs for information (WP03), 2/ guidelines to set priorities in teleneuromedicine (WP04), 3/ a set of assessment methods in teleneuromedicine (WP05), 4/ guidelines to assess teleneuromedicine services (WP06). Other workpackages are 1/ project management (WP01) and 2/ dissemination and co-ordination activities (WP02)
Purpose and objectives
The acronym TASTE is used for Technology ASsessment in TEleneuromedicine.
The overall aim of the TASTE project is to deliver METHODS for Health Technology Assessment in Teleneuromedicine, in order to help decision makers (at a national, regional or local level) who have to decide implementation of Teleneuromedicine services. The choice of teleneuromedicine within telemedicine services is due to the fact that neuromedicine can be considered as a scarce resource available only in a few medical centres and that patients’ vital prognosis is often in question. In this perspective, teleneuromedicine responds to well identified medical needs.
Results
Development Activities
Workpackages 03 (decision makers needs for information) and 04 (guidelines to set priorities in teleneuromedicine) are terminated:
- The public deliverable 03 (WP03) which is the report on decision makers needs for information is annexed to the annual project review report. Even if the main issue of this deliverable is to be an input for the followings deliverables, it offers useful information to industrialists because it emphasises the aspects considered for premium interest by the decision makers (the capacity for teleneuromedicine to answer to medical needs and to improve equity of access to health care within available resources).
- The public deliverable 05 (WP04) which is the guidelines to set priorities in teleneuromedicine gives to decision makers methods to choose between the different telematics applications in teleneuromedicine This last deliverable is available in paper sheets (annexed to this annual project review report) and in a soft document in the form of an Internet website. The deliverable 05 soft document will be presented during the « hearing » in Brussels and will be available on the TNO web site with a link from EHTO website after the annual audit.
- Workpackage 05 (Assessment Methods in Teleneuromedicine) is on-going : the formalisation of the assessment methods applied at the Irish Southern Health Board and the French Assistance Publique-Hôpitaux de Paris teleneuromedicine services is done. The review and the analysis of these methods in order to generalise assessment methods are ongoing.
Project Management
A rigorous project management (under the responsibility of the Assistance Publique-Hôpitaux de Paris) oriented to quality and adapted to the size of the project is applied. The partners have an effective and efficient collaboration. All the partners have actively participated to the management meetings.
The procedure for the validation of the deliverables by our « Advisory Board », composed of representatives of the Swedish Council on technology assessment in health Care (SBU), the Finish Office of Health Technology Assessment (FinOHTA), the European Association of Radiology (EAR), the European Association of Neurosurgical Societies (EANS) and the Société Française de Neurologie (SFN), is successfully applied : three meetings of the Advisory Board have been organised with the partners and comments have been done by the Advisory Board about each deliverable.
Besides these meetings, many visits and exchange of information have been done.
Dissemination
The members of the consortium have achieved dissemination activities undertaken for each task of the dissemination and co-ordination activities: three Advisory Board meetings and one workshop during the 13th Annual meeting of the International Society of Technology Assessment in Health Care (ISTAHC). The plans for next year include: newsletters, organisation of a workshop during the next Health Care (HC) sector Concertation Meeting and organisation of a session during the Ninth World Congress on Medical Informatics (MedInfo’98), in collaboration with the European project VATAM.
The members of the consortium have also presented the project at many events (15 communications and posters at international scientific conferences); they have also organised a demonstration of the TAP-HC projects during the European Congress of Radiology in Vienna.
Details on these dissemination activities are compiled into deliverable 07 (interim report on dissemination activities).
Conclusion
In conclusion, we consider that the project is achieving its objectives from a qualitative and a quantitative points of view and no change to the initial plan is required for the future work which is ongoing.
Moreover, some other users of Health Technology Assessment methods have made their wishes to join the project (North Finland hospital, South of Italy hospitals, Czech hospitals) and this issue has been discussed between the partners. Partners are considering this issue very constructive to 1/ enlarge the demonstration of the TASTE assessment methods and guidelines usability, 2/ enlarge the scope to some other telemedicine services. The « restricted call for on-going health telematics projects » would have been a good opportunity to extend the TASTE project in these two directions. Nevertheless, the delay to answer to this restricted call has been considered to short by the partners who have finally decided to postpone this project to the next call or Programme.
List of deliverables
| ID | Title | Delivery month | Type |
Year 1 |
| Nihil |
Year 2 |
| D01 | Questionnaire on user needs | 13 | R |
| D02 | Peer review report on: Questionnaire on user needs | 15 | R |
| D03 | User needs report | 17 | P |
| D04 | Peer review report on: User needs report | 19 | R |
| D05 | Guidelines to set priorities for TNM | 17 | P |
| D06 | Peer review report on: Guidelines to set priorities for TNM | 19 | R |
| D07 | Interim report on dissemination | 19 | P |
| D08 | Assessment method applied at AP-HP and SHB | 19 | R |
| D09 | Report on analysis and review of the applied method | 21 | R |
| D10 | Generalised method | 23 | P |
Year 3 |
| D11 | Peer review report on: Generalised method | 25 | R |
| D12 | AP-HP network extension report | 30 | R |
| D13 | SHB network extension report | 31 | R |
| D14 | Assessment guidelines in TNM | 34 | P |
| D15 | Final report on dissemination | 36 | R |
| D16 | Final Assessment Report | 36 | R |
| D17 | Published Final Report | 36 | P |
| D18 | Minutes of AB meetings | per. | R |
| D19 | Minutes of CIG meetings | per. | R |
| D20 | Minutes of Workshops | per. | R |
| D21 | Newsletters | per. | P |
R = Restricted
P = Public
Per = periodic
List of participants
| Name: |
Dr. Catherine VIENS-BITKER |
| Organisation: |
Assistance Publique-Hôpitaux de Paris (AP-HP) |
| Address: |
3, Avenue Victoria
Paris, F 75004 |
| Country: |
France |
| Tel: |
+33 (1) 40 27 31 07 |
| Fax: |
+33 (1) 40 27 38 09 |
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| Name: |
Dr. Christophe DUVAUX |
| Organisation: |
Conseil National de l'Ordre des Médecins (CNOMF) |
| Address: |
180, Bld Haussman
Paris, F 75008 |
| Country: |
France |
| Tel: |
+33 (1) 53 8932 22 |
| Fax: |
+33 (1) 53 89 32 24 |
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| Name: |
Dr. Cari ALMAZAN |
| Organisation: |
Catalan Agency for Health Technology Assessment (CAHTA) |
| Address: |
Travessera de les Corts, 131-139
Barcelona, SP 08028 |
| Country: |
Spain |
| Tel: |
+34 (3) 227 29 00 |
| Fax: |
+34 (3) 227 29 98 |
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| Name: |
Dr. Taeke van BEEKUM |
| Organisation: |
TNO Prevention and Health (TNO) |
| Address: |
Zernikdreef, 9
P.O. Box 2215
Leiden, 2301 CE |
| Country: |
Netherlands |
| Tel: |
+31 (71) 518 1482 |
| Fax: |
+31 (71) 518 1906 |
| Website: |
www.tno.nl |
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| Name: |
Mr. Jacques Sommers |
| Organisation: |
Southern Health Board (SHB) |
| Address: |
Cork Farm Centre
Wilton Road
Cork |
| Country: |
Ireland |
| Tel: |
+353 (21) 54 50 11 |
| Fax: |
+353 (21) 54 57 48 |
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