AIM: Concerted actions and accompanying measures The Community programme of RTD in telematics systems for health care, AIM, wishes to draw attention to the concerted actions and accompanying measures which are now undertaken. These may be of interest to a large number of actors in the health care and telematics fields. AIM ... The Community programme of RTD in telematics systems for health care, AIM, wishes to draw attention to the concerted actions and accompanying measures which are now undertaken. These may be of interest to a large number of actors in the health care and telematics fields. AIM (Advanced Informatics in Medicine) is Area 3 within the Community's specific programme of research and technological development in telematics systems in areas of general interest, 1990-1994. The rationale of the programme, explained in an introduction to the AIM 1993 Technical Report, is based on receiving input from different sources: industry, telecommunications service providers, academic research and health care professionals in Member States. Health care providers have accepted and introduced new technologies at a slower pace than many other domains. European health care is a very fragmented market, and an effort is needed to increase the competitiveness of European industry in this sector, by advancing the technical basis of products and services, and supporting their commercialization by European companies on a world scale. Against this background, the programme has in the past proved to be a good platform for collaborative RTD work, and current AIM projects raise high expectations. AIM concerted actions, which may be of particular interest, include: - Concerted Action on Telematics Use in Case Mix and Resource Management (CAMIREMA): The introduction of patient classification systems should among other issues lead to a possibility of better resource management and also facilitate planning. Approximately 20 partners will participate in this action, which covers the three domains of acute hospital care, primary/outpatients care, and tertiary care. The participation of the main actors (doctors, economists, nurses and administrators) gives the action a good chance to coordinate the national projects that make up the action. Likewize, the action will have an impact on standardization in this field. - Concerted Action on Education and Training in Health Care Informatics (EDUCTRA): This concerted action aims to identify gaps in the knowledge of health care workers in the Community and EFTA countries concerning the use of information technology and to propose and execute actions to ameliorate the situation. Successful existing educational programmes in health care informatics will be transferred to other countries and the possibilities and limitations of such transfer will be studied. - Concerted Action on the Medical Record (MEDIREC): The medical record is the missing link which would enable hospital information systems and primary care to communicate more effectively for the benefit of both the individual patient and the public health epidemiological structure. It is a domain where fragmentation of effort is very prevalent, even at Member State or regional level. The objective of the actions is to coordinate the numerous local initiatives in the field in order to evolve to some agreed European structure to enable transfer of individual patient data while preserving confidentiality and meaningful diversity of medical structure. - Concerted Action on Telematics in Nursing (TELENURSE): Nursing is a significant and fast growing part of health care costs. It is also a domain where information technology has had low impact. The objective of the action is to coordinate work done in Member States and to help define future European activities. - Concerted Action on Telematics in Primary Health Care (PRIMACARE): An adequate dataflow on primary health care (PHC) and between PHC and secondary care is an essential condition in the realization of a cost-effective health care system in the European Community. Moreover, an equitable access to PHC for all citizens, including socially vulnerable groups (such as refugees, homeless people, unemployed) is a challenge for the coming years. The implementation of new information and communication on technologies can contribute to the realization of these goals. A first objective of the action will be to consider both the conceptual and technical problems related to this implementation (classification of data, adequate hardware and software). The concerted action will then examine the contextual basis for the development of telematics in PHC with regard to ethical, social and organizational impact and consumer perspective. Finally, the action will identify the areas where telematics may be further developed to meet the common needs of general practitioners in Europe, which are not adequately addressed by existing programmes. As well as the five concerted actions, AIM has also established two accompanying measures: - Consensus Formation and Standardization Promotion (ACOSTA): The AIM action has generated a large quantity of work and results. In order to lead to wide-scale implementation for the benefit of European industry and service providers, there is a need to spread awareness of these results to a wider audience of health care decision-makers and telecommunications infrastructure planners. This is the prime objective of this accompanying measure. It will also help in identifying gaps and preparing for future actions. - Assessment of Information Technology in Medicine (ATIM): Sound technology assessment is necessary in order to help health care providers make the best decisions for resources use and allocation. This action will develop European consensus on a methodology and test it in the two domains of exchanges of images and the use of expert systems in medicine.