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Framework for European Services in Telemedicine


Telemedicine has the potential to enable the provision of improved health care no matter where the individual is located. However, the implementation of telemedicine services will significantly alter current health care practices and may encounter a range of different problems and difficulties.

The overall objective of this project is to develop a Framework of common understanding which will assist those wishing to set up a telemedicine service by providing the information required for such an endeavour.
A Framework of common understanding has been developed which will assi wishing to set up a telemedicine service by providing the information required f endeavour.

So far 12 input related deliverables have been developed giving up t the various topics influencing the design and operation of telemedicine services the Framework has been started.

The framework has been built from 3 interconnec parts:
descriptive model (terminology, definitions and structuring by viewpoints aspects);
prescriptive model (provision of information, guidance of rules and pa proposals);
user model (guidance to telemedicine framework model and question se experimental demonstrator has been chosen to provide a testbed for the ideas; th Telecardiology as a support of European mobility.
The full design and a first li of the demonstrator Barcelona-Berlin has been executed.
In order to achieve this, the project aims to:

- Study the various factors which affect such a service, taking into account the commonalities and differences encountered in European health care systems and assembling the results from investigation of technical, political and social factors relevant to the development, installation and justification of European telemedicine services.
- Develop a Framework for European telemedicine services, which comprises a systematic description of the relevant requirements, constraints, rules and cause and effect relationships which will influence the realisation of telemedicine services on regional, national and international scales within Europe.
- Validate this Framework through the installation of an experimental de-monstrator for particular telemedicine services in Cardiology.
- Extract from the Framework a set of recommendation for standards, specifications of services and statements of requirements for applications.
- Propose a project and action plan for the installation of European telemedicine services based on the Framework experience from the experimental demonstrator and the results from research and development arising out of AIM.

Key Issues

FEST is the kind of work that European medical industry will not undertake by itself. This background work will help this dynamic but fragmented industry to avoid producing equipment and applications that will either not be used as it will work only in stand alone modus or will be produced but not serve the broader purpose that Telematics is starting to put into perspective.

FEST is also well a horizontal framework project with respect to various national research projects.

FEST finally is a work that can be used as a general framework module in other areas of the Telematics Systems programme like ENS, ORA, etc.

In this way this project will provide the assistance and guidance to ensure that the implementation of the new technology is brought about in a safe and optimal way.

Relationship to Previous Work

Most of the partners in this project were deeply involved in the preparation of the EC Operation 1992 "Supplement, Application of Telecommunications for Health Care, Telemedicine" (from July 1990). In that document the complete background as well as the State of Art is described in detail. Beyond that concrete experiences and results from previous Telemedicine projects both national (i.e. SIP, Deutsche Bundespost Telekom funded) and European (i.e. RACE Telemed) are well known within the FEST consortium and can be included.

Relationship to Other Projects and Actions

Cooperation with new AIM projects, ENS and RACE projects, have been performed from the beginning.

Contacts to R1086 TELEMED in order to use existing concepts and tools is agreed upon. A close cooperation to the AIM projects A2009 EPIC, A2025 NUCLEUS, A2033 SEISMED, A2035 SHINE has been established in order to interchange information concerning user demands, requirements, tools and their results and experience made in getting up their pilots. (i.e. Agreements on FEST/SHINE Consortium dated May 1992).

Relationships with ENS projects have been established according to application oriented issues E2006 TECN and E2005 CARE.

Due to the involvement and access of different partners of the FEST consortium to national program and project initiatives, it can be stated that the Framework can also be validated against existing services and pilots in other European countries both in Telemedicine as well as in other Telematic Systems. Considerable work for CEN TC 251 has been started.

Expected Impact L
A workshop in December 1992 on Telemedicine Application Framework organised by the projects of the TAF Project Line of AIM COM has demonstrated the impact of FEST both in the methodology of its Framework and in the gathering of relevant inputs following a systematic descriptive approach (ODP-Model). FEST will influence AIM projects consensus process and be platform for further business planning in European Telemedicine Services.

Testbed Sites and Verification

The FEST demonstrator interconnecting both sites at Barcelona with Berlin is a good example of the Framework verification as well as service for improved mobility of European citizens. Verification will also be executed in Standards and Telemedicine and Telematic Health Care Services design.

An AIM TAF Project Line Workshop on Telematic Health Care Services Framework in December 1992 including ESPRIT, ENS, RACE and AIM Projects has largely been supported by FEST.

Contribution to the objectives of the Community in general by:
%lL - specification and publishing guidelines and strategies to set up telemedicine and Telematic Health Care services with technology and systems based on common standards, thus enabling a transfer to other programmes,
- identification of generic applications in order to guarantee the transfer of principles and basic applications to other sectors,
- investigation and integration of Europe's multi-cultural Health Care domain,
- design, development, test and evaluation of advanced technologies aiming to improve the quality level and the availability of Health Care independent from where the patient is located and may have access to (primary care, secondary care). From the home level up to nation-wide and international operations,
- involving users and medical instances from the beginning in the design of these services, thus avoiding a pure theoretical approach.


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DeTeBerkom GmbH
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Voltastraße 5
13355 Berlin

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Participants (14)