Research driving ICT use in health sector

Brussels 30 April 2008Doctors are increasingly using ICT to improve the quality of care they provide to patients, a sign that Euorpean Union (EU) investment into related research is yielding results. A European Commission survey of information and communication technologies (ICT) take up by the medical profession found that 87 percent of Europe's general practitioners are using a computer, and just under half are using a broadband connection. The use of electronic services in health care, known as e-Health, is also making administration more efficient and cutting down on patient waiting times, according to the survey of doctors.

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"Europe is starting to reap the benefits of broadband connections in the e-health sector", stated Viviane Reding, EU Commissioner for Information Society and Media. "This diagnosis also shows that it is now time to use these electronic services much more widely as they have the potential to bring extraordinary benefits to all patients, all over Europe."

The survey shows that about 70 percent of European doctors use the internet and 66 percent use computers for consultations. However, technology for monitoring patients remotely, called telemonitoring, is only used by doctors in Sweden, The Netherlands and Iceland and even in those countries it is only provided sparingly.

Administrative patient data is electronically stored in 80 percent of general practices, while 92 percent of these also electronically store medical data on diagnoses and medication. About 35 percent electronically store radiological images. About 40 percent of European doctors often transfer data electronically with laboratories, but only 10 percent to other health centres. Moreover, using ICT to share data among general practitioners in other member states is rare, with only 1 percent saying they exchange data across borders.

But European researchers are providing the techniques to help more doctors incorporate ICT as part of their provision of patient health care. They are developing technologies that could lead to significant advances for both doctors and the patients they treat, as can be demonstrated by several EU-funded projects. Here is a selection of some of those results.

For example, the Akogrimo project team is developing the potential of telemonitoring by developing a Grid to bring diagnostic tools out of hospitals and into the field. The results of their work will potentially give paramedics and other mobile response units access to powerful tools previously beyond their grasp. The Akogrimo project was designed to link not only organisations but also individuals, often using mobile devices. The Grid can accommodate virtual organisations that are set up in advance for day-to-day tasks and also those that are created at very short notice, such as in a crisis situation.

Along similar lines, the PalCom project focused on reducing complications associated with technology. The researchers' aim was to use so-called "palpable" computing - pervasive computer technology that is also tangible and comprehensible to its users. Such technology allows for a quick fix of communications breakdowns. The EU researchers behind the project are now applying the technology to help women through pregnancies and to improve the treatment of hip-replacement patients. Another palpable computing system they are developing is aimed at enhancing post-surgery monitoring and will allow hip patients to leave the hospital 24 hours after surgery, rather than the current three or four days.

Keeping an eye on patients after they walk out of the surgery door may seem more like science fiction, but European doctors and technicians are perfecting a medical support system that can track patients' real-time vital signs, link those to patient medical history, and, crucially, provide the latest clinical guidelines for patient care. Better yet, the system can alert doctors in case a patient suffers a set back. The system is called Saphire, after the project of the same name. Saphire offers a range of services that combine scattered information stored across different systems into a new, more powerful application.

Researchers at another EU-funded project, BIOTEX, also developed a new method of monitoring patients in real-time. The researchers tapped into the ongoing development of smart fabrics to create items of clothing that can measure a wearer's body temperature, trace their heart activity, analyse body fluids, and providing another way to continually assess of someone's health.

"It's new and health care providers are not used to it", stated Jean Luprano, a researcher at the Swiss Centre for Electronics and Microtechnology who is also the project's co-ordinator. "We are not used to the information that continuous, remote monitoring can provide - so different to the one-off laboratory tests that are usually taken. BIOTEX technology makes this remote monitoring possible, but more research into the links between these indicators and disease conditions and states will make it realistic."

Jean Luprano expects continuous monitoring, made possible with smart textiles, to make a major improvement to the way doctors approach the treatment of metabolic disorders and leisure.

Following a simpler path, researchers at the Attentianet project developed a way of using a telephone line to communicate with an assistance centre set up for providing health care at a distance. While such technology is already in use for many house-bound or elderly people, the project resulted in a system that uses broadband communications and video telephony.

A mobile system is also used to allow tracking of individuals. Such a device can easily be slipped into a pocket while everyday life continues, and the person can be safe in the knowledge that a video tele-assistance centre is permanently on call. Making the system user friendly was obviously a key concern for the researchers, and they used a special and very simple mobile phone with just two buttons.

Bringing together scattered information from around the European bloc as citizens become more mobile was addressed by the RIDE project. The research team sought to chart a road map for e-health interoperability that would eventually hook up the EU's health information systems in a seamless web. The ideal is that in the future, Europeans will be able to go to any member state and not sense any difference in the quality of health care they receive. Doctors and health bodies will be able to access information on foreign patients just as easily as they do for local ones, and patient records will be accessible at any time from anywhere not only for professionals with the necessary access right but also for the patients themselves.

General practitioners and administrators are not the only ones who could benefit from ICT. Results from the OrthoSim project look set to benefit orthopaedic surgeons by producing a platform to reduce the risk of post-operative complications. The platform uses computer software to create anatomical and implant simulations, which can reliably model the interface between an artificial implant and the living tissue, giving surgeons vital information before the operation has even begun.

"With this service, a surgeon or implant engineer can effectively call on the expertise of the best people in any field of orthopaedic surgery, where biomechanical simulation can offer new insights for patient care", stated Dr. Ing. Ruben Lafuente, technical manager of the Spanish IT consulting firm Adapting S.L. and project co-ordinator.

Improving the odds for patients is clearly a priority of ICT medical research. The CLINICIP project looked at boosting the odds for those with the odds stacked against them - patients in intensive care units (ICUs). For such patients, treating high glucose levels can be a real challenge, and so the project set about developing a new automated delivery system. Nurses still have to draw blood, which is analysed in the traditional way, but then the new system takes charge, calculating how much insulin is needed and automatically administering it.

European researchers have also turned their attention to improving the lives of the 2,5 million or so people worldwide who are wheelchair bound because of spinal injuries. About half of these people are quadriplegic, paralysed from the neck down. The MAIA project aimed to help these people regain some independence by producing a new type of non-intrusive brain-computer interface, or BCI.

Using electrical signals emitted by the brain and picked up by electrodes attached to the users scalp, the system allows people to operate devices and perform tasks that previously they could only dream of. So far, the team has carried out a series of successful trials in which users have been able to manoeuvre a wheelchair around obstacles and people using brainpower alone.

Except for OrthSim, all of the research projects mentioned above received funding from the EU's Sixth Framework Programme. OrthoSim was funded under the EU's eTEN programme for market validation and implementation.

Between the early 1990s and 2004, EU research funding has supported e-health to the tune of over 500 million euro, with total investment due to co-financing adding up to about twice that amount. All this has helped to create a new e-health industry with an estimated turnover of 11 billion euro, according to the Commission. By 2010, estimates suggest that up to 5 percent of health budgets will be invested in e-health systems and services.

Current initiatives stem from the action plan adopted by the Commission in 2004 to develop the use of ICT in the health sector. As a result, all member states put in place strategies to accelerate e-health deployment. E-health is also targeted as part of the lead market initiative for innovation launched by the Commission in 2008.

The current European Commission survey, published on 25 April, takes the pulse of e-health in Europe. The survey collected responses to questions from about 7000 general practitioners. It found that a majority of them agree that ICT improves the quality of health care services that they provide. Doctors not using ICT cite a lack of training and technical support as major barriers. To spread e-health, they ask for more ICT in medical education, more training and better electronic networking among health care practitioners wanting to share clinical information.

EU-funded research is addressing those demands. In addition to providing technologies already in use by the medical profession, ongoing EU-funded research is currently preparing technologies that doctors will be able to take advantage of in five or so years time.

This article has been reprinted from the ICT Results website.


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