Updated: Sep 17, 97
TELMED: Case Summary

SECTION A: Description

Short Description:

Scenarios of Use	Details
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):

Technological features (infrastructure; tools; platforms)

Type	Details
Infrastructure (e.g. ISDN)
Hardware (e.g. network; PCs)
Programmes & tools (e.g. database)
Communications media (e.g. CD rom)

Organisational Structure

Type	Name	Location
1 Telecom/infrastructure provider
2 Hospital
3 Other medical practitioners
4 Other services (e.g. social)
5 Government authority
6 Regional/local authority
7 Academic establishment
8 Other (write in):

Setting: Location

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)

Geographical coverage: (areas/distances)

User Groups

User groups- group	Services used	Number involved:
1 Care receivers (patients etc.)
2 Primary care providers (GPs)
3 Secondary care providers (hospitals)
4 Other providers (write in):
5 Health authorities
6 Insurance companies etc.
7 Other (write in):

Development history

Date commenced: Currently active? Date finished:

Current status: Details

1 R&D Project
2 Commercial service
3 Government Programme
4 Regional/local initiative
5 Other (write in):

Funding Arrangements

Development cost (ECU) Current income/running costs

Economic status (subsidised/part subsidised/fully commercial)

Data sources used

Type (e.g. interview)	Source Name

Other comments:

SECTION B: Assessment

I) On the basis of the data collected, summarise in the 'assessment' box the salient points (Box C).

2) On the basis of the data collected, in Box D, rate the application for each criterion specified on a scale of 0-5, as specified in the 'criteria' box. Do not rate where there is a 'not applicable' (NA) specified in Box D.

A. Criteria	B. Indicative Questions	C. Assessment	D. Assessment Rating 0 - 5
Representative-ness	How far does the application represent a particular typology (size, user groups, partnership, funding arrangements, policy initiative)?		NA
Goodness of fit	Does the application suggest new types of scenario not yet covered in the literature?		NA
	Does it represent new organisational, funding or trans-national arrangements?		NA
Policy impacts 0 No impact 5 High impact	What is the likely impact of the application on regional/national/EC healthcare policy (i.e. does it vindicate policy)?
Structural impacts 0 No impact High impact	Effects on distribution of healthcare services nationally and regionally Integration of services? Displacement effects (does it shift the burden of care outside health services?) Additionality effects (does it introduce more service functions that were not there before? Does it generate a need for other support services like training, new administration ?) Redundancy (does it eliminate previous functions like paperwork, support services?)
Organisational impacts 0 No impact 5 High impact	Effects on distribution of healthcare services within and between organisations Integration of inter-departmental services? Displacement effects (does it shift the burden of care outside the organisation?) Additionality effects (does it introduce more service functions that were not there before? Does it generate a need for other support services like training, new administration ?) Redundancy (does it eliminate previous functions like paperwork, support services?)
Service provision effectiveness 0 No improvement 5 Big improvement	Does it create improvements in service provision (e.g. reduced in-patient times; higher patient turnover; more users covered; reduced time/staff resources?) Does it improve cost-effectiveness?

A. Criteria	B. Indicative Questions	C. Assessment	D. Assessment Rating 0 - 5
User acceptance 0 No satisfaction 5 High satisfaction	Are users satisfied with how the applications performs? Does it create any problems for users? Does it enhance user quality of life?
Technical effectiveness 0 Very unreliable 5 Very reliable 0 No problems 5 Many problems	Is the technology used reliable? What problems do users have using the technology? Are there problems of interoperability?
as above	Why is the application more or less effective/acceptable? What factors contribute to effectiveness/lack of effectiveness?
Scenario development	What organisational changes need to be made to make the application more effective and/or acceptable? What technological improvements are necessary? Is the application transferable to other healthcare domains? What adaptations would be necessary? What is the likely future demand for this application?		NA
Policy relevance	What can we learn from this application that can inform future policy?		NA
Conceptual coherence	Is the scenario used consistent with state of the art? Is it outdated or innovative? Is the technological configuration chosen consistent with the aims and objectives of the application? Does it meet user needs?		NA
Symbolic complexity 0 Not contextualised 5 Highly contextualised	Is the application consonant or dissonant with the environment in which users live and work (is it appropriately contextualised?)
Action contingency 0 Not engaged 5 Highly engaged	Are users engaged properly in how the application is developed and implemented? Is there appropriate interactivity between different types of actors (e.g. providers/users)?

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