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The ICMCC Event June 1-3, 2005 NCC, The Hague. Telemedicine segment of the Croatian e-Health system Klapan I, Pavelin A, Stevanović R, Katić M.

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The icmcc event june 1 3 2005 ncc the hague

The ICMCC Event

June 1-3, 2005NCC, The Hague

Telemedicine segment of the Croatian e-Health system Klapan I, Pavelin A, Stevanović R, Katić M.


  • ‘eHealth refers to the use of modern information and communication technologies to meet needs of citizens, patients, healthcare professionals, healthcare providers, as well as policy makers.’

  • excerpt from e-Health Ministerial Declaration 22 May 2003.


The usual workplace

Shift plan

Documentation

Lassie

Magazine

Notes

Communication

Records

Literature


... and another one.

List of cost centers

Physical stock

Telephone

Mail and archive

Literature

Postcards

Calculator

Patient records

Shift plan

Lists of capacity load

PC(4372)

Telephone directory


Michael Hammer, Philadelphia1999.

“If you create Web pages in front of unsubstantial business processes you will only show the world how unsubstantial your processes really are.”

“Before you start perfecting the common external processes it is necessary to efficiently manage the integration of internal businesses.”


INTEGRATED information system...

... means a complete integration of ALL business processes and transactions in a way that ensures absolute consistency of data and their up to dateness.

FORMS OF INTEGRATION:

  • integrated data, processes,

    and organizational elements,

    • application and

      • technical integration.


as well as all other healthcare subjects.

Physician

Employees

Home care

Drugs

Patients

e-HEALTH

Cities

Media

Insurance companies

Ministry of Health

Visitors

Vendors


Health care systems today why ict should be applied
Health Care systems today...Why ICT should be applied?

20% Health Care budget goes for inadequate curing!

40% of time spent on patient is of information nature!Source: Večernji list, Poslovna srijeda


Areas to be addressed
Areas to be Addressed

  • Primary Care Patient Management

  • Community Care

  • Chronic Disease Register

  • Call and Recall Systems

  • Population Registers National Clearing Service

  • Performance Monitoring

  • Financial Management

  • Critical Care and Emergency

  • Admissions, Discharges and Transfers

  • Appointments and Resource Scheduling

  • Medical Records Tracking and Coding Systems

  • Clinical Laboratory and Diagnostic Support


Working environment of healthcare employees

To access your workplace any place, any time !?

IMPOSSIBLE!


Pizza-Service

O/I

To access your workplace any place, any time?

My Web Information Source

My Mail

My Tasks

POSSIBLE!

My

Calculator

My Patients

My Pizza-to-Order

My Reports


Ict makes difference health care services anywhere anytime
ICT makes difference:health care services - anywhere, - anytime.

Answer:

Take a pill,

lay down!

Question:

It hurts...

Please, help!


3x1 billion subscribers users

1000

Fixed

900

800

700

Cellular

600

500

Subscribers (millions)

400

Internet

300

200

Mobile

Internet

100

0

1996

1997

1998

1999

2000

2001

2002

2003

2004

3x1 billion subscribers/users … + …

Telecommunication Trends

Connected Globe


e-Health ...

e-Health ...

is a global reform approach with a purpose of promoting the usage of INTERNET by healthcare providers and all other individuals and institutions working with them on a daily basis.

e-Health ...

IS A SET OF INTEGRATED SOLUTIONS AND SERVICES THAT ENABLE PHYSICIANS, PATIENTS, PHARMACISTS AND VENDORS TO WORK TOGETHER ANY PLACE, ANY TIME WITH THE HELP OF ICT.



European information society concept eeurope
European information society concept eEurope eHealth ?

  • eEurope landscape

    • New EU Regulatory Framework (EU NRF)

    • ICT sector is a key driver

    • investments and innovations

    • ‘broadband everywhere’ strategy

    • eGovernment, eHealth, eLearning and eBusiness segments


It is the building block of the ecroatia

Croatian eLearning eHealth ?

Croatian eGovernment

Croatian eBusiness

Croatian eHealth

it is the building-block of the eCroatia

eCroatia


Guidelines for creation of the croatian ehealth
guidelines for creation of the Croatian eHealth eHealth ?

  • Croatian eHealth

    • building-block of the Croatian integrated IS -

    • eCroatia

    • interactive establishment with soft borders, but well-defined interfaces

    • seamless associations with related international IS

    • nationwide ICT infrastructure

    • technical and legislative framework definition



It is one of the functional segments of the croatian ehealth

Croatian eHealth eHealth ?

it is one of the functional segments of the Croatian eHealth

PatientcareSegment

Public Information Segment

Administration Segment

Telemedicine Segment


Users perspective
Users' perspective eHealth ?

  • End user’s (patient’s) perspective

  • mobile patient

  • no papers around

  • no worry about health history

  • tax money well invested

  • Doctor’s perspective

  • less paper work

  • quicker process around patient

  • less bureaurocracy towards insurance and public health

  • Politician’s perspective

  • tax money well invested (elections)

  • good basis for undeveloped regions

  • good basis for foreign tourists

  • Health administration

  • perspective

  • better control over the process

  • quicker statistical research

  • financial control in real time

Common

pers-

pective


Clinical hospital - informatization layers eHealth ?

Special medical devices

Radiology

Endoscopy

Surgery

Urology

CTd

MRId

RNGd

CTa

MRIa

RNGa

UZVa

Anga

"Digitalization"(analog-to digital picture conversion)

"DICOMization" (DICOM - medical standard for digital images)

DICOM

HL7

CIMS (Clinical Image Mngm System) = PACS (Picture Archiving and Communication System) (+ RIS)

special servers and SAN equipment (capacity cca 2-10 TB)

IHIS (Integrated Hospital Information System)

standard ERP and HR SW, clinical SW, specialist hospital SW (pharmacy, radiology (RIS), labs...)

HL7

Standard SW

SOE(Standard Operating Environment);Office(text, spreadsheets, presentation, e-mail, web browser);Anti-virus

PC clients

Pentium IV 533 MHz, RAM 256 MB, HD 20 GB, graphics 256-bit; COE (Client Operating Environment)

Servers and SAN (Storage Area Network) equipment

IBIS (DB server 146 GB, appl. serveri); Office (mail, file/print, web); infrastruktura (AD/DNS/DHCP, backup)

LAN (Local Area Network)

1 Gb/s optical backbone, 100 Mb/s to the desk


Clinical hospital - Value of informatization eHealth ?

Special medical devices

Radiology

Endoscopy

Surgery

Urology

CTd

MRId

RNGd

CTa

MRIa

RNGa

UZVa

Anga

"Digitalization"(analog-to digital picture conversion)

10%

"DICOMization" (DICOM - medical standard for digital images)

DICOM

CIMS (Clinical Image Mngm System) = PACS (Picture Archiving and Communication System) (+ RIS)

special servers and SAN equipment (capacity cca 2-10 TB)

HL7

20%

IHIS (Integrated Hospital Information System)

standard ERP and HR SW, clinical SW, specialist hospital SW (pharmacy, radiology (RIS), labs...)

HL7

40%

Standard SW

SOE(Standard Operating Environment);Office(text, spreadsheets, presentation, e-mail, web browser);Anti-virus

5%

PC clients

Pentium IV 533 MHz, RAM 256 MB, HD 20 GB, graphics 256-bit; COE (Client Operating Environment)

10%

Servers and SAN (Storage Area Network) equipment

IBIS (DB server 146 GB, appl. serveri); Office (mail, file/print, web); infrastruktura (AD/DNS/DHCP, backup)

5%

LAN (Local Area Network)

1 Gb/s optical backbone, 100 Mb/s to the desk

10%


Key characteristics and benefits
key characteristics and benefits eHealth ?

  • Telemedicine Segment

    • videoconference as the key service

    • intreractive real-time communication

    • diagnostic, consulting, practice, education

    • direct patient welfare


We have tested videoconferencing over multiple isdn lines and ip
we have tested videoconferencing over multiple ISDN lines and IP

  • Test Cases

    • Polycom (ex. PictureTel) videoconferencing equipment

    • H.321 and H.323 protocol suite

    • 4 ISDN BRA lines (512 Kbps) within Croatia and with medical institutions in Germany, USA and Japan

    • IP over Frame Relay/ATM network (768 Kbps) within Croatia

    • exchange of video, ECG (color doppler) and other medical data in the form of files containing pictures and/or documents




Diverse applications are supported
diverse Applications are supported and IP

  • ICT Platform – Applications and Quality of Service

    • medical and business (specific medic apps, videoconference, IP telephony, SAP)

    • advanced network resource management


Business continuity must be ensured

Data Center and IP

Disaster Recovery Site

HQ + DRC

Service Provider

Regional Medical Centers, Service Provider

Small Medical Offices, Mobile Units, LANs

business continuity must be ensured

Distribution

Core

Distribution

Access


Modular network architecture

Internet and IP

WAN

modular network architecture

  • ICT Platform – Network Architecture and Technologies

    • LAN (Ethernet-based, 10/100/1000, VLANs, WLANs)

    • WAN (Frame Relay, ATM, IP/MPLS VPN - leased from SP)

    • Remote Access (dedicated or Internet, PSTN/ISDN, ADSL, GPRS, UMTS future)

LAN



Security is an ever evolving proccess
SECURITY IS AN EVER EVOLVING PROCCESS !!! and IP

  • Security

    • NOT an ICT segment !!!

    • NO single-point, single-layer security

    • comprehensive, proactive proccess

    • spread accross all ICT layers

    • BS 7799 standard

    • HIPAA


Standardization and legislative should be generators and not obstacles
standardization and legislative should be and IPgenerators and not obstacles

  • Standards and Legislative Aspects

    • equipment, applications

    • business process standardization

    • increased efficiency,

    • decreased costs,

    • legislative as a strategic stronghold


Attention must be payed to
attention must be payed to ... and IP

  • Key Issues

    • well-defined framework

    • converged ICT platform

    • standardization, legislative

    • joined efforts and coordinated activities with internal and international subjects


Vision of croatian ehealth network platform
Vision of Croatian eHealth and IPnetwork platform


With a complete ict solution
. . . with a complete ICT Solution and IP

  • T-Com in Croatia has

    • telemedicine experience

    • internal and DT Group expertise

    • partnership biosphere

    • broad range of implemented technologies and services

    • nationwide network coverage


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