The initial aim within the MediMedia project was to integrate the different medical domains via a single platform with the images coming from various sources. Another aspect was to deliver a general service, not targeted at a particular kind of medical user but one which could be customised for a range of medical profiles. The consortium has identified a context of activities or scenarios for current and future users, including education, training, and research; health care support; tele-diagnosis or discussion; and the Network Patient Folder (NPF). The first two scenarios are currently implemented into the MediMedia search engine.
Health care support only constitutes a secondary support which is used in a not fully integrated way, because the primary tool is the hospital information system, the departmental workstation which is especially oriented to a direct interaction with the physician. Two future environments are tele-diagnostic co-operation and NPF, both of them scenarios with a communicative instead of a supportive function. Professor d'Atri started from the existing education scenario in MediMedia which involves an on-line self-learning service and a publishing tool. The MediMedia demonstrator provides a user-friendly image searching function for medical students, general physicians, and specialists. The images can be used in educational training activities.
The publishing tool in turn provides useful multimedia contents for teachers or researchers to be used in courseware, conference presentations, articles, and scientific books. This tool is supported by Springer-Verlag, which is one of the leading publishers in Europe. In the future, the MediMedia system will also be applied for the testing and training of smart medical equipment and learning algorithms in neural networks via the use of "certified" images. Within the health care support function, the search engine is used to retrieve and compare diagnostic images as an individual decision support tool for therapy planning or patient report writing.
Professor d'Atri continued with the description of the additional services that will be provided in the future. The discussion service will enable people who are interested in a particular medical field or a patient case, to add images or comments to the system which might also be used as a reviewing tool to offer a better certification to the images. Doctors will collaborate over the Internet using groupware facilities in tele-consulting procedures and on-line forums. The last scenario applies to the Network Patient Folder (NPF) supporting over a kind of intranet service the remote creation, updating and shared but safe access of multimedia patient folders.
It is possible to think in terms of integration in two possible ways. The first consists in moving from the support of one single person to the support of a group of users, units of persons, or even health care institutions as a whole. This is the first level of possible future expansion of the MediMedia system. The second one involves a shift in defining the common tools for interaction. This comes down to identifying common standards for working together and developing a consensus for interaction. Today, the MediMedia system is only sharing information but in the future, it will also share processes instead of being based on common data visibility. For a full account of the MediMedia project, we refer to the VMW April 2000 article MediMedia provides common gateway to multi-modal medical images in European databases.