Compendium of Health Telematics Projects 94-98 (Draft)
Home Documents Compendium HT Projects 94-98 Updated: Aug 26, 1998 

This is the most recent structured information on this project. Complementary data can be found on previous documents

DIABCARE Q-NET

Diabcare quality network in Europe

Project code: HC 1011
Project value: 3830.0 KECU
EC contribution: 1500.0 KECU
Number of partners: 15
Number of countries: 9
Duration:36 months
Starting date: Feb 1, 96
              
Contact: Klaus Piwernetz
DiabCare Office
Kobellstr. 3
80336 München
Germany

Tel: 49 89 74 71 91 90
Fax: 49 89 74 71 91 80
E-mail: kpi@diabcare.de
Web Site: www.diabcare.de

Overview

DIABCARE Q-Net has three major targets: Quality Development, Network, and Telemedicine. Quality Development of diabetes care across Europe is the overall target of the project. The Network provides the means for electronic communication of data and results to enable comparison (benchmarking). Telemedicine in this project provides image or video infor-mation (retina, feet) as additional input for quality development and improvement. All elements of the development cycle (data collection, electronic transfer, aggregation, evaluation of quality indicators, comparison, feedback, and local quality improvement) were developed and feasibility tested during previous R+D activities of the EU. Now, the process is implemented stepwise into all countries of the European Union and EFTA on national, regional, and local levels. National responsibility for quality improvement was accepted by the European Council of WHO in 1991.

DIABCARE Q-Net is linked to the St. Vincent Declaration (WHO-EURO and IDF-EURO). This system of applied telematics will be further improved technically using the upcoming com-munication means such as Internet, transnational network providers and on-line services. DIABCARE Q-Net will cooperate with other projects on health care telematics applications facilitating input and controlling access to the net (DIABCARD), on quality improvement through local decision support using al-ready existing guidelines (Prestige), on the inclusion of quality of metabolic control and on the standardised link to specialists starting from selected topics like diabetic retinopathy (OPHTEL).

The result of this project will consist of a network of service centres evaluating and improving their outcome through the routine use of a telematic framework. The care providers will have access to the latest guidelines and will be able to link them to their own data. The best performers can be identified for consultation, referral, or training of the other partners.

Purpose and objectives

Quality Development: With the tools developed in the 3rd Framework and continued in the 4th Framework and the data entry modules described below more than 50.000 patient records from 160 hospitals, 150 diabetes centres and 230 General Practitioners or private Diabetologists were collected from all over Europe by the DIABCARE Q-Net project partners. The tools developed are mainly the Basic Information Sheet containing the data items necessary to monitor the quality of care of individual diabetes patients. Local and national data aggregation followed by a quality benchmarking on the first level servers were done. Quality circles are already established in France, Portugal, Germany (structuring) and Netherlands.

Others are planned. The methods and tools, described in the report, are now in use by the project partners. Depending on the specific situation in each country, different solutions are preferred: Windows software (DIABCARE Data), DOS software (EPI INFO), software solution for data export (EDIFACT/ EMEDI or export functions), fax solutions or others. The latest DIABCARE Data for Windows software, version 1.4i is part of the deliverable D11.1. The DIABCARE Fax system is implemented successfully in Italy and Bavaria, Germany. In this tool the data from the Basic Information Sheet are detected by a OCR software developed by DIABCARE Italy. The service works automatically.

The objective of the network part of the project is basically reached with the deliverable D11.1 which was developed during the last year. This deliverable is a software package for a Network Demonstrator incl. Specifications. It includes a Windows program (client software), which facilitates the input of data into the Basic Information Sheet (BIS), a basis for registering people with diabetes. This computer program is included as a version for the routine use for data entry from the participating centres.

The second part of the software package is the server software for a central computer for benchmarking of data. Furthermore communication between servers are supported in order to enable aggregation of data from regional and national level to European level.

Complete specifications as technical requirements and software specifications are also part of this deliverable. Additionally a complete manual for the client software, a detailed explanation of the used data set and technical guidelines for the implementation of a regional node for the server software is included.

The objective of the telemedicine part of the project is basically reached with the deliverable D16.1 which was developed during the last year. This deliverable represents a full demonstrator consisting of two systems: (1) one system demonstrating remote examination by medical specialists of retina images for the purpose of retinopathy screening of diabetes patients (OCULab system) (2) another system for remote examination of foot and leg ulcers through still images and video clips (DORIS). Both systems are linked to BOS, a request and report messages system for diagnostic service departments.

The main goal of BOS is to aid third-party medial applications to support message-based telemedicine, in particular the exchange of Diagnostic Service Order (DSO) and Diagnostic Service Request (DSR) messages.

BOS 2.0 is based on CEN TC251 draft standard. The integration of BOS with different applications and the electronic patient record system is described in this report. Both systems are specified on a conceptual as well as on a detail level in the deliverable of the functional demonstrator (D15.1). All the modules of the systems have been integrated, tested and demonstrated in the laboratory.

Results

During the first implementation phase DIABCARE Q-Net has enforced in setting-up a multilingual compatible monitoring and feedback network at the front-end level. Based on the Diabetes Data Set developed during the 3rd Framework, a telematic Windows software was developed in English, German, Portuguese, Spanish and Catalan.

Further versions are going to be produced on individual request from the partner countries. By addition of TCP/IP protocol layers, DIABCARE Q-Net partner countries are prepared for new network services being part of one of the most boosting markets in western economies.

Furthermore the workpackages involved in production of the software applications for the quality network have agreed on creation of the BIS in an EDIFACT message. After approval of this EDIFACT standard, the Diabetes Data Set will be interoperable with many software applications for patient data management and electronic patient records. By developing telemedicine tools for retina and foot ulcer asynchronous, DIABCARE Q-Net is heading for the integration of multimedia tools into quality development.

The products derived from the DIABCARE Q- Net methodology are currently expanded to the chronic diseases hypertension, asthma, thyroid diseases, migraine. In Germany the approach is being taken up the federal association of statutory doctors. In the Netherlands the professional and commercialised version is installed in a national Quality Management Institution (CBO) for broad application.

The Italian approach towards documentation (fax solution) is commercialised by the developing software company world-wide. The same solution is implemented in Bavaria with support from industry and the health care system.

List of deliverables

Overall Project Management
Annual Review Report 1996 (09/96/P)
Annual Review Report 1997 (09/97/P)
Annual Review Report 1998 (09/98/P)

Final Report (12/98/P)
Quality Management
Reports on Quality Management (of Project Management, Implementation, Network, and Telemedicine Work Areas) will be included in
Annual Review Report 1997 and Final Report (09/97/R)

Co-operations
(Reports will be part of Annual Review Report 1998)
Report on co-operation with Prestige (09/98/R)
Report on co-operation with Diabcard (09/98/R)
Report on co-operation with Ophtel (09/98/R)
Report on co-operation in concertation meetings (09/98/R)

Quality Development
Demonstrator of Quality Development Module incl. Specifications;(Local Q-Net Software and Network Software based on Network structure as developed) (12/96/R)
Implementation Report (1st year of Implementation of Quality Development); will be part of Annual Review Report 1997 (09/97/R)
Implementation Report (2nd year of Implementation of Quality Development); will be part of Annual Review Report 1998 (09/98/R)

Network
Network Demonstrator incl. Specifications (07/97/R)
Network: Maintenance Report (12/97/R)
Network: Service Report (05/98/R)

Telemedicine
Telemedicine Functional Demonstrator incl. Specifications (12/96/R)
Telemedicine Full Demonstrator (09/97/R)
Report on Implementation, Usage, Maintenance and Service of Telemedicine Implementation (09/98/R)

List of participants

Name: Dr. Klaus Piwernetz
Organisation: DIABCARE Office
Address: Kobellstr. 3 D-80336 Munich
Country: Germany
Tel: +49 89 747 19100
Fax: +49 89 747 19180
E-mail: kpi@diabcare.de
Website: www.diabcare.de

Name: Dr. Line Kleinebreil
Organisation: DIABCARE France
Address: Association Hôpital J. Verdier Service Pr. Attali Av. de 14 Juillet F-93142 Bondy
Country: France
Tel: +33 1 4501 5092

Name: Dr. Maria Rosa Gallego
Organisation: DIABCARE Portugal
Address: Avenida Estados Unidos da America, 77, 8° P-1700 Lisboa
Country: Portugal
Tel: 00351 1 849 9515
Fax: 00351 1 8499723
E-mail: mga@diabcare.de

Name: Mrs. Cheryl Cowley
Organisation: DIABCAREU.K.
Address: Grafton House 67 Loughborough Road GB-NG2 7LA Nottingham
Country: U.K.
Tel: +44 115 981 4461
E-mail: cco@diabcare.de

Name: Dr. Fred Storms, Dr. D. Vermeij
Organisation: DIABCARE Netherlands (CBO)
Address: CBO - Central Begeleidings Orgaan National Organization for Quality Assurance in Hospitals Churchillaan 11 NL-LB 3502 Utrecht
Country: The Netherlands
Tel: +31 30 296 06 47
Fax: +31 30 296 06 47
E-mail: fst@diabcare.de
Website: www.cbo.nl

Name: Prof. Massimo Massi Benedetti
Organisation: DIABCARE Italy
Address: Università di Perugia Dipartimento di Medicina Interna e Scienze Endocrine e Metaboliche Via Enrico dal Pozzo I-06126 Perugia
Country: Italy
Tel: +39 75 572 7627
Fax: +39 75 573 0855
E-mail: mbe@diabcare.de
Website: euliste.krenet.it/A/sidwww/sidinden.html

Name: Prof. R. Landgraf
Organisation: DIABCARE Bavaria
Address: University of Munich Med. Klinik Innenstadt Ziemssenstr. 1 D-80336 Munich
Country: Germany
Tel: +49 89 5160 2225
Fax: +49 89 5160 5355
E-mail: rla@diabcare.de
Website: www.med.uni-muenchen.de/mki/endokrin/diabetes/intro.htm

Name: Dr. Svein Skeie
Organisation: DIABCARE Norway
Address: Sentralsjukehuset Med. avd, A. Hansensvej 20 N-4011 Stavanger
Country: Norway
Tel: +47 5151 8000
Fax: +47 5151 9906
E-mail: svskeie@sn.no

Name: Dr. Rolf Engelbrecht
Organisation: GSF Research centre for health and environment
Address: Ingolstädter Landstr.1 D-85764 Oberschleißheim
Country: Germany
Tel: +49 89 3187 4182
Fax: +49 89 3187 3008
E-mail: ren@diabcare.de
Website: www-mi.gsf.de

Name: Prof. Dr. Rudolf Haggenmüller, Dr. R. Hettler
Organisation: FAST Forschungsinstitut für angewandte Software- Technologie e.V.
Address: Arabellastraße 17 D-81925 Munich
Country: Germany
Tel: +49 89 9200 4724
Fax: +49 89 9200 4718
E-mail: rhe@fast.de
Website: www.fast.de/

Name: Mrs. Monika Johansen
Organisation: UHT
Address: Department of Telemedicine University Hospital of Tromsø P.O. Box 35 N-9038 Tromsø
Country: Norway
Tel: +47 7762 8151
Fax: +47 77 62 81 57
E-mail: maj@diabcare.de
Website: www.telemed.rito.no/

Name: Prof. John Hakon Husoy
Organisation: Stavanger College
Address: Dept. of Electronics and Computer Engineering Ullandhaug P.O. Box 2557 N-4004 Stavanger
Country: Norway
Tel: +47 51 832046
Fax: +47 51 831750
E-mail: jhu@diabcare.de
Website: www.his.no/foreign/english

Name: Prof. G. Henning
Organisation: Technical University of Ilmenau
Address: Institute for Biomedical Engineering and Informatics P.O. Box 10 05 65 D98684 Ilmenau
Country: Germany
Tel: +49 3677 691308
Fax: +49 3677 691 311
E-mail: ghe@diabcare.de
Website: www-bmti.tu-ilmenau.de

Name: Dr. Kirsten Staehr Johansen
Organisation: World Health Organisation
Address: Reg. Office for Europe Quality of Care and Technologies 8 Scherfigsvej DK-2100 Copenhagen
Country: Denmark
Tel: +45 39 17 15 66
Fax: +45 39 17 18 64
E-mail: ksj@who.dk
Website: www.who.dk

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