eHealth & Telemedicine project archive

Realising that financing is potentially a powerful inhibitor to effective eHealth diffusion, the EC’s Directorate General Information Society and Media commissioned a study on "assessment of financing opportunities to support and boost investment in eHealth." The approach is to uncover opportunities for financing eHealth in the context of overall investment in healthcare development and to identify the range of financing models available for eHealth. This results in support for decision-makers of organisations investing in eHealth. The preferred financing models differ according to types of eHealth solutions and the socio-economic and regulatory environment. The different impacts and affordability issues for the short term and the medium term are highlighted.
eHealth can be financed in different ways, including as part of general healthcare development financing, public private partnership, leasing, research funds, and venture capital. Also, public funds are available on local, regional, national, EU, and international level. The best option for financing a particular endeavour can be determined by the type of eHealth investment that is envisaged. Different financing opportunities can be used in different phases of an eHealth investment life-cycle. For example, a pilot of a Hospital Information System can start with initial support from government funds on ICT development, but once operational, the system may yield enough return of financial and other resources that it can move towards internal financing from re-allocating existing expenditure budgets.

Based on the vision of patient-centred European healthcare systems, empirica will develop scenarios of ICT enabled new models of healthcare and assess their potential economic impact. This policy oriented project allows empirica to make full use of its expertise in the evaluation of ICT solutions in healthcare and combine it with an innovative scenario building methodology. Two focused, by invitation only workshops will guarantee expert input from the Health Systems Research and eHealth communities and assure the project’s impact with European health policy and healthcare decision makers. In addition, new insights into future eHealth research needs are expected.

In this study for the European Commission DG INFSO and Media a survey of almost 6,000 primary care physicians on their use of ICT and internet for communication with patients and between primary and secondary care and other health agencies will be carried out in all 27 Member States of the European Union and in Norway and Iceland. The fieldwork will start in the third quarter of 2007. The purpose of the present study is to: measure the use of ICT by primary care physicians in the EU and EEA countries, which is to be achieved by means of a survey of primary care physicians and their use of ICT and Internet for communicating with patients and between primary and secondary care and other eHealth agencies. Through this survey up-to-date information and data on eHealth developments will be obtained and an appropriate benchmarking framework and procedure for eHealth defined, thereby - and through the 29 Country Briefs for each of the 27 Member States, Norway and Iceland - enabling member states to monitor their performance to improve public services. The study is a continuation of the earlier benchmarking exercise for eEurope 2002 and was carried out as a Eurobarometer survey.

The EHR has evolved to become centre-stage in the national health informatics strategies in Europe. There is a need for interoperability standards that can permit clinical computer systems to share health record data whilst preserving faithfully the clinical meaning of the individual authored contributions.
Q-REC’S main objective is therefore to create an efficient, credible and sustainable mechanism for the certification of Electronic Health Record (EHR) systems in Europe by addressing

• EHR Systems Quality Labelling and Certification Development
• Resources for EHR interoperability
• Benchmarking Services

The core objectives of Q-REC will be to define a Model with harmonised guidelines and procedures for EHR systems certification and to incorporate the formal test plans into a Benchmarking Process Manual for quality labelling and certification of EHR systems across Europe.
The main kinds of outputs that will be accumulated through the Q-REC work packages are as follows.

• A State of the Art Report on existing EHRs Certification Schemata;
• A Labelling Terminology and Functional Profiles for classification of EHRs to be certified;
• Model Certification Guidelines and Procedures;
• A Benchmarking Services Manual for EHRs Quality Labelling and Certification;
• An Inventory of Resources for HER Interoperability, with registers of Quality
• Conformance Criteria, EHR-Archetypes, XML schemes, Health Coding Systems and relevant EHR Standards;
• A fully worked out Business Plan.

empirica is involved in Q-REC  as a subcontractor.

The recent emergence of Grid technology opens new perspectives to enable interdisciplinary research and technology development at the cross roads of medical informatics, bioinformatics and system biology impacting healthcare. The HealthGrid roadmap, to be developed by the SHARE project, will provide a comprehensive coverage of the RTD domain and the uptake of Grid applications in healthcare, including inter alia infrastructure, security, ethical, legal, financial and economic issues.
The roadmap will focus on identifying requirements for further research and technology development. It will also sketch a realistic picture with respect to desirable applications/ICT implementations and indicate which technologies may have the potential to make a substantial contribution in this context. This will be supported through the presentation of good practice examples.
Each section of the roadmap will detail actions to be taken in terms of objectives and possible methods or approach as well as recommended milestones for completion, stakeholders responsible, appropriate methods of coordination etc. All relevant stakeholders will be involved in a bottom up approach so as to ensure the relevancy and positive impact of the roadmap. Care will also be taken to include issues related to standards and security requirements for handling medical data. Non-European issues will be also factor in to our roadmap in order to ensure international interoperability.
empirica is involved in SHARE as a subcontractor.

The goal of the project is to coordinate planning of national innovation-oriented e-health RTD as the basis for a common road-map and joint RTD activities, thereby establishing an effective ERA in this key IST field and important European market. This Coordination Action emerged from an initiative involving 20+ Member States Health Ministries to improve RTD coordination and exploit the potential for European synergy. They wish to avoid barriers to patient and professional mobility in the Union threatening from uncoordinated IST uptake and ensure progress in line with the Commission's e-Health Action Plan. The consortium of 5 research management bodies - coordinated by empirica at the request of the German Ministry of Health - will research and structure European e-health RTD, build a suitable e-health ERA portal, identify priority topic clusters, locate cooperation opportunities, identify best practice, set consensual benchmarks, propose priorities for action and draw up a coherent Europe-wide road-map and action plan, finally proposing sustainable long-term mechanisms for European coordination. A Coordination Committee, to which over 25 Ministries have already committed, will oversee and direct work, adopt priorities and road-map, initiate engagement in joint RTD activities and adopt sustainable mechanisms.

Currently various Member States (MS) are launching initiatives to introduce e-health infrastructures and applications. They are dealing with critical issues of technical, semantic and workflow interoperability almost exclusively at the regional or national level. These developments threaten to hamper the further development of a European market in e-health applications and cross-border services.Building upon the activities in MS, the results of European RTD, and learning from international efforts, the project will initiate a process for accelerating the deployment of interoperable e-health infrastructures and applications for trans-European use. It will

• identify interoperability and connectivity issues and priorities, barriers and gaps, and solution approaches,
• focus on fundamental interoperability issues (like identification of actors, organisations, adequate measures to achieve interoperability, integration tests and certification)
• analyse similarly key topics relating to e-prescription and messaging
• develop a roadmap and concrete projects involving all relevant actors - guided by an open discussion process amongst Member State Health Authorities.

Allowing for patient mobility and cross-border medical care is a key EU policy priority and one focus of the e-Health Action Plan. Identifying needs, gaps and next steps will help to realise concrete solutions to reach these goals. Interoperability will allow more effective health services to be delivered wherever citizens are and wherever they may have come from in Europe.

Presently, despite the availability of e-Health systems and services, they are not yet widely used in real-life medical or health situations. A major reason why European and national policy goals have so far not been achieved with respect to e-health is that very little reliable evidence is available on the positive (economic and other) impacts of these innovations. The objectives of this project are:

• to develop a generic assessment and evaluation framework and method, including measurement tools for quantitative indicators, for e-health products and services, focusing on optimising economic resource allocation;
• identification of good practice examples of e-health applications across Member States which have relevance in the domain of this study (hospitals, regional networks)· integrating the experience and lessons learned from these examples into the method;
• applying the method and measurement tools developed to 10 application sites reflecting the regional and health system diversity of the Union in the fields of hospitals and regional networks;
• making the assessment method and tools generally available online.

The MobilAlarm project tested an innovative, location-independent alarm and teleassistance service which enables older people, chronically ill, and other persons at risk to initiate an alarm call whenever and wherever he or she needs or wants to do so. The project analysed the European market for such services in general, and in particular developed and tested business models in three distinct markets. This involved providing such services to selected user groups over an extended period of time. Finally, a comprehensive plan for fast market roll-out and diffusion across Europe was developed, and market deployment was initiated. To establish such an efficient, trans-European service meeting the needs of users across the European Union, various British, German and Spanish partners - representing the whole value chain - were involved in this project.

The IST Impact Study analyses and assesses the socio-economic impact of Information Society Technology research and development projects supported by the EU framework programmes (FP4 and FP5) in three domains:

• eHealth applications,
• mobile communications and systems,
• microelectronics and microsystems.

empirica is responsible for the eHealth area. Output is to be used for improving programme performance and suggesting recommendations for future strate-gies.
The study’s methodological framework builds on the basic model of causality which considers that RTD projects have downstream consequences that can be described in terms of a range of project outputs (publications, new tools and techniques etc.) and a range of resultant outcomes affecting different sets of actors.
The study will assess the performance of projects and programmes focusing on the following evaluation criteria: effectiveness, efficiency, impacts, additionality, relevance, progress factors. A key feature of the methodology is the analysis of results by type of stakeholders.
Quantitative project and programme data are collected by e-mail questionnaires. Data analysis techniques include multivariate techniques capable of identifying groups of results and type of stakeholders/projects (cluster analysis) and searching for correlations between them.
In addition, qualitative stakeholder interviews will provide information to allow for a well-grounded interpretation of the statistical data, setting these into the ‘societal’ context. Further-more, they will provide a qualitative view on those impacts downstream the impact chain which are difficult to assess using quantitative tools.

• Databank Consulting (project coordinator)
• Idate
• Teleport Sachsen Anhalt
• Wiseguys

It was the aim of the TEN-HMS-Project to enhance a modular Telemonitoring-System for the medical care of chronically ill, elderly and disabled citizens. The benefit of telematic home-care support should be methodically proved and models for market-launch be prepared and tested. Research focused on three benefit-dimensions:

• Medical outcome
• Quality of Life
• Impacts on the Health Care System (cost reduction)

The project started in January 2000. Patient recruitment started in June 2000 and continued into March 2002. Collection of patient follow-up data ended in November 2002. Data for more than cumulative 205,000 patient-days were collected. The main focus was on medical care for heart-failure patients; with a small pilot project on dialysis patients.

This was the world-wide first fully interactive (CATV-based) HomeCare and Telemonitoring service. Its objectives were to analyse the opportunities offered by modern ICT to improve the ability of older and mobility-impaired people to live independently, to demonstrate new strategies to reduce the load on social and home care service resources, to gain experience in new technologies, and to experiment with a new service organisation.
Work on this pilot started already in 1989. It became operational in early 1991. Its location is in a residential area the development of which dates back to the early 1920’s. 17 older per-sons (aged 70 to over 90) in 15 households were connected who, in most cases, had been living there for 40 years and more. They were self-selected; on average they were more iso-lated and less mobile than other people of the same age living in the same area. Service components included remote care; information and assistance; emergency, counselling, training and exercise services.