EHTO TELMED: The Impact of Telematics on the Healthcare Sector
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ANNEX I:
Applications Audit Methodology

TELMED, WP2: Applications Audit

Methodology

1. Objectives of WP2

2. Main activities

WP2 is comprised of four sets of activities:

  1. Identification of population sources and population frame (WAs 2.2, 2.3, 2.4 and 2.5)
  2. Collect data on individual applications and initiatives (WA 2.6)
  3. Data Analysis (WA 2.7)
  4. Reporting (WA 2.8)

3. Population sources and frame

Suggested sources from which a population frame of relevant telematics applications and interventions can be drawn are:

The division of labour for TELMED partners in relation to the above is as per the activities scheduled in WP1 (Domain Review). Source identification via European institutions and database searches will be carried out in parallel by partners on a European-wide basis. A listing of applications, projects and references identified through the 'Internet crawl' carried out by the Tavistock is attached.

For the remainder of the sources, the suggested division of labour on a country-by-country basis is as follows:

Partner
Countries Covered
TI
UK
Ireland
Denmark
France
Scandinavia
FORMIT
Italy
Spain
Portugal
Greece
ECWS
Netherlands
Belgium
Germany
Austria
Luxembourg

For the EU R&D Programmes (mainly AIM), the applications audit will be shared between partners on the above country by country distribution, on the basis of the location of the co-ordinating partner of a particular project. A list of relevant AIM projects is attached.

Applications to be included in the Audit are defined in relatively broad terms. In accordance with the brief for TELMED as indicated by the Commission officers, applications should be projects or initiatives that have been established for two years. This would exclude current projects under the IV Framework (such as Telematics Applications Programme projects), but not the precursors of such projects (e.g. projects originally funded under AIM and now continuing under TAP). In order to gain some insight into the diffusion process of telematics R&D, we should include 'dead' projects (i.e. projects funded under a Programme that has now finished but which are not currently 'live'). We are particularly interested in 'real' initiatives - such as on-going innovations in service provision introduced by national governments, or local health authorities.

4. Data Collection: National Audits (WA2.6).

The National Audits are intended to provide the data from which to map the distribution of telematics for health activity on a pan-European basis. Using the population frame derived from WAs 2.2 to 2.5, partners will conduct data gathering exercises on a country-by-country basis, as per the Table above. In order to standardise data collection and recording, applications will be documented as per the pro forma attached. The 'Unit of Analysis' for the purposes of the Audit is 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, such as EDI. Data collection should be implemented on a pragmatic basis, according to the ease of availability of information. Where possible, the pro forma should be filled in using secondary source data (such as publications), but where necessary gaps in information may need to be filled through direct interviewing (preferably by telephone, FAX or e-mail) of respondents who know about the application.

5. Data Analysis

The analysis will be in two parts: a country-by-country summary by each partner of the distribution of telematics for healthcare, for the countries for which they have 'responsibility'; and an overview of the European situation, carried out by TI. In order to facilitate cross-national comparisons and clustering of the audit on a pan-European scale, data recording should be standardised between partners using an Excel spreadsheet containing the fields (variables) shown in the attached example. A coding sheet is also attached.

Data analysis for the National Audits should focus on a summary report (mapping) of healthcare telematics for each country, using:

  1. Simple frequency counts of variables on a country-by-country basis.
  2. Cross-tabulation of key variables. These could cover:

Data Analysis for the cross-national overview will use cluster analysis to define typologies of applications/interventions, and then carry out a comparative analysis of the sectoral and geographical distribution of the clusters.

6. Reporting

On the basis of the country-by-country summary reports produced by each partner in WA2.7, together with the results of the cluster analysis, TI will produce a draft Report containing the following:

Following critical review of the draft Report from partners, TI will produce a Final Report on the Applications Audit (Deliverable 2).

TELMED, W.A. 2.1: Applications Audit Methodology

Applications Pro Forma: CODING FRAME
Name of Application/Initiative: USE IDNO

Data filled in by (name): Date filled in:

Sources of information 1 Internet (write in site address):
(circle which apply): 2 AIM Programme
3 Other Programme (write in):
4 Interview with:
5 Other (write in):

Application type 1 R&D Project (which Programme):
(circle which apply): 2 Commercial service
APPTYPE 3 Government Programme (which):
as per code opposite 4 Regional/local initiative
5 Other (write in):

Current status: STATUS (code as below) DURATION (in years e.g. 1.5)
1 R&D project Date commenced:
2 Pilot project (testing) Date ended:
3 Established service/product Scheduled end date:
4 Other (write in): Other comments:

Participants
Type
1 Telecom/infrastructure provider PART1 (0=No 1=yes)
2 Hospital PART2 (0=No 1=yes)
3 Other medical practitioners PART3 (0=No 1=yes)
4 Other services (e.g. social) PART4 (0=No 1=yes)
5 Government authority PART5 (0=No 1=yes)
6 Regional/local authority PART6 (0=No 1=yes)
7 Academic establishment PART7 (0=No 1=yes)
8 Other (write in): PART8 (0=No 1=yes)

Brief Summary of Application/initiative:
(indicate aims/objectives/user groups/technologies used etc.)

Technical features (circle which apply)
INF1 (0=No 1=Yes)
INF2 (0=No 1=Yes)
INF3 (0=No 1=Yes)
INF4 (0=No 1=Yes)
INF5 (0=No 1=Yes) 		1 PSTN (standard telephony)
2 ISDN
3 WAN
4 LAN
5 Other (write in):
HW1 (0=No 1=Yes)
HW2(0=No 1=Yes)
HW3 (0=No 1=Yes)
HW4 (0=No 1=Yes) 		1 Stand alone PC's
2 Closed-Networked (e.g. client server)
3 Open network (e.g. Internet)
4 Other (write in):
MEDIA1 (0=No 1=Yes)
MEDIA2 (0=No 1=Yes)
MEDIA3 (0=No 1=Yes)
MEDIA4 (0=No 1=Yes)
MEDIA5 (0=No 1=Yes)
MEDIA6 (0=No 1=Yes)
MEDIA7 (0=No 1=Yes) 		1 Video/audio cassette
2 CD-rom CDI
3 Videoconferencing
4 Computer conferencing
5 E-mail/bulletin board
6 VIS/voice mail
7 Other (write in):
TOOL1 (0=No 1=Yes)
TOOL2 (0=No 1=Yes)
TOOL3 (0=No 1=Yes)
TOOL4 (0=No 1=Yes)
TOOL5 (0=No 1=Yes)
TOOL6 (0=No 1=Yes)
1 Expert systems/IKBS
2 Multimedia
3 Interactive educational software
4 Distributed databases
5 Other databases (write in):
6 Other (write in):
Other technical features (write in):

Scenarios of Use
SCENE1 (0=No 1=Yes)
SCENE2 (0=No 1=Yes)
SCENE3 (0=No 1=Yes)
SCENE4 (0=No 1=Yes)
SCENE5 (0=No 1=Yes)
SCENE6 (0=No 1=Yes)
SCENE7 (0=No 1=Yes)
SCENE8 (0=No 1=Yes)
SCENE9 (0=No 1=Yes) 		1 HIS (Hospital Information Systems)
2 EPR (Electronic Patient Record)
3 Decision Support Systems
4 Medical Imaging
5 EDI/interfacing
6 Training Systems
7 Telediagnostics/telemedicine
8 Community health & info
9 Other (write in):
User groups- group
1 Care receivers (patients etc.) USER1 (0=No 1=Yes)
2 Primary care providers (GPs) USER2 (0=No 1=Yes)
3 Secondary care providers (hospitals) USER3 (0=No 1=Yes)
4 Other providers (write in): USER4 (0=No 1=Yes)
5 Health authorities USER5 (0=No 1=Yes)
6 Insurance companies etc. USER6 (0=No 1=Yes)
7 Other (write in): USER7 (0=No 1=Yes)

Spatial coverage

COVER
Code as opposite

1 Single institution (e.g. hospital)
2 Single care provider (e.g. GP)
3 Local network of institutions (e.g. several hospitals in an area)
4 Local network of GPs/GP practices
5 Regional network (e.g. hospitals and GP practices)
6 National/international network
7 Home care receiver (e.g. home alone patient)
8 Networks of care receivers (e.g. NGO; self-help)

Funding/financial base (if appropriate)
Source: WRITE IN AMOUNT IN ECU
1 Private/commercial FUND1
2 EU FUND2
3 National government FUND3
4 Local/regional government FUND4
5 Health authority FUND5
6 Other (write in): FUND6

Evaluation/dissemination of results
If evaluated
IFEVAL
Code as opposite 		1 Yes
2 No
3 Not known
Evaluation reports available
Other reports available

Contact Data
Contact Name/organisation:
Address:
Telephone:
FAX:
e-mail:

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