May 2000

VMW is a monthly Virtual Magazine on Telemedicine and High Performance Computing and Networking for readers interested in computer applications in medical environments. It is produced by an editorial team composed of professionals in publishing and an advisory board with professionals in telemedicine, provides the embedding into the everyday practice and research. You can put the editorial team to work as well. Read about our services and find out about the friendly rates.

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Future perspectives of e-health and telemedicine

Curious about the commercial and technological evolution of Internet health care and remote medical applications? Virtual Medical Worlds Magazine presents a cross-section of ten viewpoints from different expert consultants in the health care business with regard to the development of medical information technology beyond 2000.

Special issue with an update on results from European R&D projects, 1999 !

Each year hundreds of European R&D projects produce important results. In this special issue, co-published by the magazines Primeur and VMW, we give an update from a number of projects in the HPCN and medical sectors that were supported within the Esprit or Telematics programmes from the European Commission.

Please, check in at the telemedicine project below:

TeleInViVo, the building of an economically viable telemedical workstation for 3D ultrasound

This special issue is published in conjunction with the ITIS-ITAB 99 event in Amsterdam.

When you want your project results published in one of our next special issues, please contact the editors of Primeur magazine or Virtual Medical Worlds magazine.

ITIS99logof Visit the website of the second International Conference on the Telemedical Information Society.
Combined ITIS'99-ITAB'99 Conference, April 12-13 1999, Amsterdam.
Also featuring all forum discussions!

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Past, present, and future perspectives for medical data integration in European health care policy
Closing speaker of the MediMedia workshop on medical imaging was Dr. Luciano Beolchi from the European Commission, DG Information Society, who presented an overview of the past perspectives and also drew a comparison with the present and future European policy regarding the field of medical imaging. In the past twelve years, the European Commission has devoted almost one fifth to one fourth of its available budget and effort to the medical imaging area. From 1991 to 1994, this capital has been invested in general projects whereas from 1994 to 1998 more specific applications were targeted. For the present 1999-2002 period, nine out of 28 medical imaging proposals have been approved.

IT acceptance in health care can only succeed via magically balanced developer-decision maker-user triangle
At the occasion of the MediMedia workshop on medical imaging, DG13 Officer at the European Commission, Dr. Ilias Iakovidis, shared his vigorous viewpoints on the indispensable need for user acceptance to create a market for IT in health care. On the other hand, the dynamic speaker drew a vivid picture of the future e-health scene in Europe where policy makers try to cuddle the citizen with general Internet access to personal health data by the end of 2000 in exchange for a vote at the elections. In the meanwhile, health experts are panicking with the thought that such tremendous speed of implementation will simply be impossible to realise. Dr. Iakovidis strongly insisted on careful manoeuvring between the Scylla and Charibdis of these two extreme scenarios and urgently pleaded for a tight collaboration between users, decision makers and developers within health care IT projects.

Risk management strategies and quality control for medical databases
Closing speaker of the second session in the MediMedia workshop, Dr. Jürgen Stettin from Olympus Software Europe, treated the delicate topic of risk management and quality control issues in the design of medical imaging databases and devices. In the future, deployment of risk strategies for medical equipment will become compulsory by law. Risk management is comprised of risk analysis, risk control, and risk evaluation. Risk analysis in turn consists of two different elements, namely hazard identification and risk estimation. Each possible risk should be defined in the correlation between severity and likelihood of occurrence.

Increasing and validating the contents of medical image databases at a European level
Co-ordinator of the MediMedia initiative, Dr. Michel Delvaux from the Hôpitaux de Toulouse, described the past efforts of the MediMedia consortium as an attempt and an ongoing challenge to increase and validate the contents of medical image databases in Europe. Today, the search engine technology is in place, as Dr. Delvaux stated in his talk during the workshop on medical imaging, but the user is now asking for valuable content. The fact that we are able to access in a "one-step" query medical images which are scattered over the Internet, using the search engine is not enough. We also need to implement services which can provide specific content to the user according to a set of quality criteria.

DANTE and Infonet sign contract for interconnectivity between TEN-155 and European commercial Internet
Infonet Services Corporation and DANTE, the company organising advanced data networking services for the European research community, have signed a contract that awards the provision of connectivity between the TEN-155 network and the European commercial Internet to Infonet. The first interconnection between TEN-155 and the European commercial Internet under this new contract was made in Amsterdam in September 1999. The interconnections in Geneva, London and Stockholm were made in October, November and January respectively.

Medpearl solution helps implement correctional managed Cyb-R-Care programme in Texas
Recognising the challenge to deliver quality patient care supported by stringent compliance reporting, UTMB-CMHCP, the University of Texas Medical Branch Correctional Managed Health care Plan has contracted with Inc., which is a leading e-health company providing HIPAA-compliant, clinical/financial work flow solutions for the health care industry. The terms of the contract cover more than 135.000 patient lives in Texas correctional facilities.

American TeleCare selected to assist in best funded diabetes home telemedicine project ever
American TeleCare Inc. has been chosen to supply telemedicine equipment and services for a $28 million federally funded diabetes home telemedicine initiative, the largest telemedicine grant ever awarded by the federal government. The project, led by Steven Shea, MD, is a collaborative effort of the Joslin Diabetes Center of SUNY Health Science Center, the American Diabetes Association, the United States Health Care Financing Administration (HCFA), Arnot Olean General Hospitals in Olean, New York, and Good Samaritan Hospital in Watertown, New York.

Two Siemens health care solutions nominated for prestigious Computerworld Smithsonian Award
Two Siemens health care solutions, namely a smart card project for dispersing benefits to those on government health and food assistance programmes, and a digital imaging technology which has helped a regional hospital in Southern California go filmless, have both been nominated and named laureates in the Computerworld Smithsonian awards programme. Both technologies have been demonstrated at the Health care Information and Management Systems Society (HIMSS) trade show in Siemens' booth.

National Library of Medicine project to create largest-ever digital medical image library
Storage and visualisation technologies, designed by the San Diego Supercomputing Center (SDSC), will be integrated into a National Library of Medicine project to create one of the largest-ever medical image databases. The project will demonstrate how leading-edge information technologies in computation, visualisation, collaboration, and networking can expand the capabilities of medical science in developmental studies, clinical work, and teaching.

U.S. federal agencies awarded by GE for groundbreaking role in digital imaging technology
United States lawmakers, Administration officials, and the leading health organisations have previewed on Capitol Hill new breakthrough digital mammography imaging technology which is ushering in a new era in breast cancer detection. GE Medical Systems, which has developed the innovative technology in partnership with numerous federal agencies, recognised the contributions of the U.S. Department of Defense, the U.S. Department of Health and Human Services and the U.S. Department of Commerce for their pioneering contributions to digital imaging technology, presenting each with the GE Partner's in Vision Award.

New approach of hospital work flow modelling urgently requires standards for middleware
Professor Heinz U. Lemke from the Technical University of Berlin addressed the subject of middleware in the MediMedia workshop on medical imaging. Within the hospital environment, middleware relates to work flow management. This modelling of clinical services constitutes a new paradigm in comparison with the more traditional data driven approach. Middleware can be defined as a set of IT tools to bridge the gap between lowerware, being the hardware on which everything is running in the health care setting, and the upperware consisting of the various application software modules.

North Kansas City Hospital selects Marconi solution to support outpatient services in new facility
North Kansas City Hospital in Missouri has expanded its network by implementing Marconi's industry-leading ASX-4000 and ASX-1000 multi-service backbone switches, as well as ES-3810 and ESX-2400 edge switches. Marconi is a leading global supplier of advanced communications solutions. The Marconi solution will support high-bandwidth applications in the novel Health Services Pavilion, a six-story, 323.000-square-foot outpatient facility scheduled to open in June 2000. North Kansas City Hospital selected the Marconi solution because of its reliability, its ability to support additional network users and more advanced services as need arises, and because of the success of the Marconi equipment used in the main hospital since 1998.

Xpressions 470 allows hospitals to save money with promising unified messaging features
Siemens Information and Communication Networks Inc. recently demonstrated how unified messaging applications allow to improve patient services in a hospital or clinic by providing physicians instant notification of, and telephone access to voice, e-mail and fax messages. This demonstration was showcased in Siemens' exhibit booth at the Health care Information and Management Systems Society (HIMSS) trade show, which was being held last April at the Dallas Convention Center.

Jini technology to empower creation of electronic medical records in high acuity care
Sun Microsystems Inc. and eko systems inc. have presented at the 2000 Health care Information and Management Systems Society's (HIMSS) Annual Conference and Exhibition, a new solution that leverages Sun's Jini technology to automate the creation of patient medical records in high acuity environments, such as operating rooms, intensive care units, and emergency rooms. The novel system called Frontiers was designed to enable physicians and nurses to reduce charting errors, eliminate both wasteful and inefficient manual work, and ultimately improve patient care.

Yipes to provide "speed of light" optical IP network to Palo Alto Medical Foundation
Yipes Communications Inc., the leading provider of fully scalable bandwidth for business applications, will build light-speed links between the campus of Palo Alto Medical Foundation (PAMF), its satellite clinics, and the Internet, in order to facilitate a wide range of advanced medical imaging and telemedicine applications. Yipes is a major managed optical Internet Protocol network provider. Its high-speed LAN-to-LAN and LAN-to-Internet services will enable the transmission of high-bandwidth applications such as medical records and diagnostic images, between PAMF's offices and the Internet at unprecedented speeds.

Manchester Visualisation Centre installs 1 million euro VR facility
The Manchester Visualisation Centre ordered a 1 million euro VR facility with Virtual Presence, a subsidiary of MUSE Technologies. The order includes setting up high-performance visual computing platforms for researchers, students and commercial users to project real time graphics in a three-screen theatre. The presentation of data in a theatre setting using extremely high-resolution graphics improves interaction with the data so that large groups of users from different disciplines can collaborate and reach conclusions as a team. Virtual Presence has previously collaborated with the University of Manchester on other projects, including the development of MIST (Minimally Invasive Surgical Trainer), an advanced computer-based system designed to teach and assess minimally invasive surgical skills. More than 125 MIST systems are in use at 70 medical institutions worldwide.

From source diversity to flexible medical data presentation and user interaction in MediMedia
Dr. Thomas Berlage from the German National Institut für Angewandte Informationstechnik talked about the concept of integration in the MediMedia search engine during the workshop on medical imaging. The project partners introduced two solutions to present the diversity of medical images in a functional and flexible way to the user. The application of the XML data format and the Visual Integrator software module have considerably facilitated both the query and manipulation of medical images within the framework of the MediMedia architecture.

Three new Artificial Intelligence approaches for pattern recognition in medical imaging
One of the MediMedia workshop presentations dealt with Artificial Intelligence (AI), as applied for pattern classification in medical images. Mr. Arnaldo Maccarone, image analysis algorithm developer at Nergàl, an Italian specialist in high-performance system architectures and advanced IT solutions, described three current AI methods, in order to recognise specific features in a medical image. The different approaches use artificial neural networks (ANN), fuzzy logic systems, and genetic algorithms to perform the classification task. Mr. Maccarone also indicated new ways of combining the three technologies to achieve even more accurate recognition results.

Identifying users' scenarios in Web-based medical image services to create Virtual Health care Organisations
In the first session of the MediMedia workshop on medical imaging Professor Alessandro d'Atri from LUISS University in Rome explained how a variety of medical activities is supported by the project search engine. These diverse user scenarios will eventually lead to intensively co-operating virtual medical organisations with a high degree of integrated support. MediMedia's main merit in this regard forms its contribution to a telemedical information society in terms of a facilitation for medical data delivery and communication standardisation to achieve a true information and knowledge sharing beyond the physical walls of European health care institutes.

The world of medical imaging standards and compliance certification by conformity assessment bodies
Implementation was the central theme in the fourth session of the MediMedia workshop on medical imaging. Joël Chabriais, M.D. at the Hôpital Necker in Paris, addressed the issue of standardisation which covers an extensive field. There are various actors, divided into international, European, and national organisations, responsible for general, specific, and telecommunication standards. In his presentation, Dr. Chabriais exclusively dealt with standards that are applicable in the Health Informatics area, such as ISO TC 215, CEN TC 251, AFNOR, DICOM, and HL7.

Dragon Systems to constitute L&H's second mega-acquisition in one month's time
Lernout & Hauspie has signed a definitive agreement to acquire Dragon Systems Inc. of Newton, Massachusetts, a privately held leader in speech and language technology. Combined, the two companies' existing resources create a "brain trust" that is expected to use the best of the technologies developed in both companies to work on projects designed to accelerate the use of speech and language in emerging and mainstream consumer markets. Dragon Systems will help L&H meet the growing demand for speech and language applications in key markets such as telephony and health care.

CardioComm partners with Sierra Systems to launch Internet Cardiology Portal
Stephen R. Martin, President and CEO of CardioComm Solutions Inc., has appointed Sierra Systems Group Inc. as the company's iBuilder partner. Specifically, Sierra Systems Group has been contracted to develop CardioComm's Internet Cardiology Portal Project which is the first phase of the company's comprehensive Web-based product and marketing strategy. CardioComm's strategy is based upon securing a significant position for its cardiology applications within the telemedicine field and the evolving impact of the Internet in health care.

HBSI's Executive Information System helps health care executives identify cost reduction and clinical improvement opportunities
HBS International Inc. (HBSI), a recognised leader in aggregating, warehousing and analysing health care process and outcomes information and in providing outcomes-management systems to the health care industry, has issued the HBSI Executive Information System (EIS), an Internet-based application, as a subset of HBSI EXPLORE, one of the most comprehensive, dynamic clinical analysis and resource utilisation databases in the United States.

Integrated triad of HealthSphere 2000 tools delivers e-Business to the hospital
At the Health care Information and Management Systems Society (HIMSS) Show, New Era of Networks Inc. (NEON) launched a new product suite which provides a complete set of e-Business integration solutions for the health care industry. The HealthSphere 2000 solution suite enables health care organisations to harness the benefits of the novel health care economy by providing a broad range of medical e-Business applications, layered above NEON's industry-leading e-Business application integration solutions. The applications include Web portal, single sign-on, and EMPI, the Enterprise Master Person Index solutions.

MAGNET selects Toshiba to provide ultrasound technology
Toshiba America Medical Systems signed a three-year, sole-source agreement to provide cardiovascular and diagnostic ultrasound systems to MAGNET Inc., a not-for-profit group purchasing organisation (GPO), which is comprised of 12.000 members in 20 states. Under the contract, MAGNET's GPO members may purchase scanners at negotiated group discount prices from Toshiba's full line of ultrasound products, which include the all-digital PowerVision 8000 and 6000edp systems, and the Eccocee and JustVision scanners.

Collaboration between French research organisation CNRS and InforMax on bioinformatics
InforMax,a United States developer of bioinformatics software for accelerated drug discovery, entered a strategic collaboration with The French National Centre for Scientific Research (CNRS) in the field of computational genomics. With support from InforMax, CNRS will establish a European Center of Excellence as part of the CNRS Research Unit on Molecular Genetics and Developmental Biology in Villejuif, France.

Next gen graphics for SGI Onyx2
SGI launched the InfiniteReality (IR3) graphics engine for the Silicon Graphics Onyx2 visualisation workstation. Extending the industry-leading InfiniteReality graphics architecture, InfiniteReality3 provides the most advanced capabilities for image quality and realism. IR3 is suited for applications in the modelling and simulation, oil and gas, manufacturing and entertainment markets. For scientific visualisation, researchers can now interact with medical and seismic data sets with greater visual accuracy due to performance increase on volumetric data sets up to 512x512x512 in size.

EHFG demands to establish health as a basic right for European citizens
The right to health for all must be embodied into the European Charter of Fundamental Rights, according to a demand of Dr. Günther Leiner, president of the European Health Forum Gastein (EHFG), based on the Gastein Health Declaration, the outcome of a meeting between more than 300 health experts from all over Europe during the 1999 EHFG. Dr. Leiner presented this demand to the chairman of the convention, Mr. Roman Herzog and the convention, responsible for the preparation of a draft Charter of Fundamental Human Rights of the citizens of the European Union.

First favourable clinical trial results available for the Automated OsteoGram
CompuMed Inc. has issued favourable results of the clinical trials to evaluate its phalangeal bone mineral density software, which is called the Automated OsteoGram. The company has recently concluded the preliminary analysis phase of the clinical trials that have been conducted in January and February of 2000 by means of the Automated OsteoGram.

Web site for strategic and institutional health care investors hires industry veteran has appointed Robert W. Brown, CPA, as chief financial officer. Mr. R. Brown is the first CFO hired by the company, which launched its new Web site only last month. The site delivers original and objective content on the emerging telemedicine industry for corporate decision makers and both professional and individual investors. The reports, articles and interviews are produced by a team of analysts with extensive IT, health care, and investment expertise.