Updated: Sep 17, 97
SECTION 3: TELEMATICS FOR HEALTHCARE 'ON THE GROUND': RESULTS OF THE APPLICATIONS AUDIT

3.1 Objectives of the Applications Audit (Work Package 2) Following on from the main findings of the review of state of the art, the Applications Audit was intended to operationalise some of the key issues identified by the review, and to test out some of the underlying assumptions found in the literature and in the world views of the experts consulted, as well as mapping out the ground for a further iteration in the projects' evolving understanding of state of the art. The main objectives were therefore:

• To map the distribution of telematics for healthcare applications and initiatives in Europe, on the basis of geographical, sectoral, technological and organisational characteristics
• To analyse and cluster the distribution of applications and initiatives on the above characteristics
• To identify appropriate examples for in-depth case study analysis in WP4

3.2 Methodological Approach

• The 'Unit of Analysis' for the purposes of the Audit was defined as the 'application or intervention case'. This could be a single project, delivering one specific telematic service in a single hospital; a cluster of projects under a single initiative, or a national programme
• A multi-methodological approach to data collection was adopted, using both primary and secondary data. The data were structured to provide a 'mapping' of each application on the basis of the following key indicators:
  • geographical location
  • technological platforms and delivery systems used
  • telematics for health 'scenarios' represented
  • organisational structure and actors involved (partnership arrangements, e.g. private/public sector)
  • setting (e.g. single site; inter-site; regional setting; national/international setting)
  • type of user targeted by the application
  • type of application (e.g. pilot, commercial service)

The Applications Audit data were drawn from two main sources: interviews (face to face, telephone or by electronic mail) with respondents drawn from indicative health care sectors, and secondary source data such as publications and reports. The health care sectors represented were comprised of:

• European institutions
• National government institutions (e.g. Department of Health)
• Regional/local authorities
• Regional Health Authorities
• Health care companies (e.g. health insurers; pharmaceuticals)
• Telecoms and hardware providers (e.g. BT, France Telecom, Bull, ICL)

An aggregate summary of the respondents consulted, totalling 175 individuals across Europe and across a range of sectors, is shown in Table 2 below.

Table 2: Applications Audit: Respondents Consulted - Summary

Group	No. Consulted
Government	19
Academics	36
Clinicians	11
Hospitals	24
Commercial (PTT; healthcare etc.)	62
Other	15
USA	8
TOTAL	175

The secondary data used in the audit included the following:

i) Conference papers and special reports

• AMICE Conference, Amsterdam, 1995
• AIM Conference, Lisbon, 1994
• World Congress on Telemedicine, Toulouse, 1995
• Telemed 93, UK
• Telemed 94, UK
• Telemed 95, UK
• 7th World Congress on Medical Informatics, 1995
• SITM 96 (Salon des Solutions Informatiques, Telecoms et Multimedia pour la Sante), Paris

Bakkenist Management Consultants (1994); Stimuleringsprogramma Volksgezondheid Transparant; Voorburg, Centrale Directies Voorlichting, Documentatie en Bibliotheek van het Ministerie vws.

Ministerie van Volksgezondheid, Welzijn en Sport (1995); Informatietechnologie in de zorg: feiten en opinies; Rijswijk, Centrale Directie Bedrijfsvoering en Facilitaire Ondersteuning.

Centre de Recherche Public Henri Tudor (1996); Rapport Annuel 1995; Luxembourg.

Bureau for International Research and Technology Cooperation (1995); Telematics profile Austria; Vienna.

Standards in Healthcare Informatics and Telematics (1996); CEN.

Telematics Services in Emilio-Romagna Region (1996); SCIENTER.

Information Management and Technology Strategy for the NHS in England, (1996); NHS Executive.

Building the European Information Society for us All, First Reflections of the High Level Group of Experts, Interim Report (1996); CEC DGV.

Telematics for Health: the role of telehealth and telemedicine in homes and communities. (1995); Office for Official Publications of the European Communities.

EU Biomedicine and Health Research Programmes (1996); Medical Research Council, UK.

Telematics in Primary Care in Europe (1995); IOS.

Proceedings of the IMIA Working Conference on telematics in Medicine (1990); Amsterdam.

Informatics and telematics in Health: present and potential uses (1988); World Health Organisation.

ii) Periodicals and publications

• Archives D Anatomie et de Cytologie Pathologiques
• British Medical Journal
• EHTO Journal
• Emed News
• Hum. Pathology
• Int. Jnl Biomed Comput
• Int. Jnl. Technology Management
• Jnl. Digital Imaging
• Jnl. Telemedicine and Telecare
• Lancet
• Le Monde Informatique
• Radiol. Med. Torino
• Telektronikk
• Telematics and Informatics
• Telemedicine Journal
• Telemedicine Today

iii) On-line information

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