November 1999

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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Towards the Millennium of Cybermedicine

Read VMW's coverage of MedNet'99: an anthology of the most fascinating telemedicine presentations held at the Fourth World Congress on the Internet and Medicine

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.

The next issue is planned in November during IST 1999 in Helsinki.
When you want your project results in this issue, 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.
Forum discussions freshly available as of 01-08-99!

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EC to announce programme for IST'99 Conference and Exhibition in Helsinki
This year's Information Society Technologies Conference and Exhibition will take place from November 22nd to 24th at the Helsinki Fair Centre in Finland. A special session on "Health in the Information Society" has been scheduled on Wednesday from 2.15pm till 3.45pm. Health telematics topics will equally be discussed in Tuesday's session "Inclusive Information Society" starting at 1.15pm to 2.45pm. More details on past and future IST calls are offered in the last IST session on Wednesday, "Information Society technologies programme", from 4pm till 5.45pm. IST Participants can visit the exhibition permanently during conference hours.

EC's activity in health telematics research summarised in European Telemedicine Glossary
The European Commission's Directorate General XIII has recently published a 171-page Telemedicine Glossary of concepts, standards, users, and technologies. The working document covers a decade of support by the European Commission for research in telemedicine. As such, it identifies the previously funded projects in health telematics while it also aims to facilitate a common understanding of terminologies in this area. The glossary has to serve as a basic document to future developments in the IST or Information Society Technologies domain which will have a large impact on all aspects of health care, and medical education and training.

Lack of innovative inspiration kills over one third of first call IST proposals
EuroInfo Tech, the fortnightly newsletter on European Union policy in telecommunications, information technology and consumer electronics, has reported that over one third of project proposals in the first call for the EU's Information Society Technologies R&D programme failed to meet European Commission demands on their scientific, technological and innovative content. One of the member state officials in the sector stated that the quality of projects was particularly weak in the area of applications, where firms proposed Internet ideas that were not very original and which failed to capture the imagination of the expert evaluators. Since the proposal thread needs to be clear from research down to the consumer and has to be credible, the commission will consider looking at documentation provided to proposers to make sure the requirement on quality is made clearer in future calls.

ISPO to launch call for Euro-Mediterranean Information Society Projects' proposals
The Information Society Project Office (ISPO) of the European Commission will shortly publish an open call in the Official Journal, which invites Euro-Mediterranean consortia to submit proposals for Euro-Mediterranean Information Society Projects (Eumedis). This call will cover the fields of regional health care networks, pilot projects in the areas of electronic commerce, tourism and cultural heritage, IT research in applied industry and innovation, and education. The Euro-Med Information Society call is organised to deploy the ICT potential within the Euro-Mediterranean region.

Impact to produce assistive technology courseware for disabled and elderly people
Currently available assistive technology and ICT enables disabled and elderly people to more fully participate in daily life. The Impact project, funded by the European Union's Telematics Applications programme, has produced a courseware package aimed at increasing the take-up of assistive technologies as well as at avoiding their misuse amongst the professionals in health and social services. The educational material applies both traditional paper-based teaching methods and multimedia. It consists of a student's and a teacher's manual, case studies, software and sample data. The project leaders hope to establish a European network to disseminate and enlarge the results by exchanging information and experiences.

Web-based continuing medical education for doctors provokes positive but also mixed feelings
General practitioners who visited the poster sessions at the recent MedNet'99 Conference, could find out everything about a continuing medical education (CME) initiative via the Internet. The two-year Post-Doc project has been set up in January 1998 by a team of universities and network providers to develop and validate a Web-based learning environment for post graduate training in favour of European doctors. The consortium has received funding support from the Telematics Application Programme, Esprit, and TenTelekom as part of the Educational Multimedia Taskforce, as well as from sponsoring industrial partners. At the RWTH Aachen, the Rheinisch-Westfälische Technische Hochschule, a research team has tested the level of participation by general practitioners in the generation and the assessment of high-quality contents for this Post-Doc Web service but co-operation between doctors and developers was not as good as expected.

Martini Hospital dermatologists provide Dutch general practitioners with telediagnosis
Four general practitioners, who are situated in the Dutch province of Friesland, are the first physicians in the Netherlands to transmit images of patients with skin diseases over the Internet. The medical images are sent to dermatologists at the Martini Hospital in Groningen to receive telediagnostic consultation. Dr. Theo van den Akker, as one of the involved dermatologists, estimates that this innovative technology is able to replace over one third of the traditional consultation sessions. References in medical literature have stated that the application of teleconsultation for dermatology in most cases leads to similar results as conventional patient examination.

Hospitals in Trento region impatient to benefit from real time tele-oncology facility
At the Italian research institute ITC-irst in Povo in the Province of Trento, an inter-hospital network has been developed for teleconsultation in oncology. The system allows two or more physicians to simultaneously share digital clinical records with multimedia patient data in real time. The Wide Area Network (WAN) infrastructure will interconnect one central hospital and four district clinics. The teleconsultation service will be made accessible from different hospital departments, enabling oncologists to advice on treatment plans, to conduct follow-up sessions, and remotely support clinical research within the peripheral cancer units in the region of Trento.

European Union soon to have its Forum for Health Telematics Solutions
On September 10th and 11th 1999, a two-day kick-off workshop was organised in Germany by the members of the EHTEL consortium to discuss and validate the proposal for the creation of a neutral, permanent Forum to support the development of Health Telematics Solutions in Europe. EHTEL started in December 1998 as a feasibility study to assess the interest in generating such a forum to offer the three different categories of actors, namely administrations, industries and users, a platform to exchange ideas. In the first six months, the project staff met with over 100 actors of various backgrounds, including representatives of 16 different national health care authorities. The positive feedback from the discussions has encouraged the EHTEL partners to begin the long administrative process necessary to create a viable Forum which can be responsive to its members needs.

Computerised nose imitates ancient Chinese sense for scents to diagnose infections
Scientists at the British Cranfield University have developed a new medical test based on ancient Chinese methods for diagnosing disease. The sensor named "Diag-Nose", uses olfactory-emulating technology to "sniff out" illness. A number of medical conditions produce a characteristic odour, and their identification is a difficult process due to the subjective nature of human smell. To solve this problem, Dr. Selly Saini and Jan Leiferkus of the Cranfield Postgraduate Medical School in Bedfordshire, have developed an artificial nose that electronically identifies odours. It uses the same process as human noses except odours are classified electronically, thereby avoiding human bias. The technology will dramatically reduce the diagnosis time for Urinary Tract Infections (UTIs).

ZEUS robot system reverses sterilization to enable birth of baby boy
The ZEUS robotic surgical system, developed by Computer Motion Inc., has assisted a team of surgeons at the Cleveland Clinic in performing a fully endoscopic fallopian tube reconnection procedure. The intervention was carried out in July, last year. As a result, the world's first child, born ever after this kind of reversal operation, has been successfully delivered ten days ago.

Windows-PC management threatens university hospital like the sword of Damocles
Incidents with jammed PCs and extensive software maintenance sessions are threatening the work flow efficiency in university hospitals with several operating theatres and intensive care units. Hans van der Kolk, ICT Services manager in the Academic Medical Centre (AMC) in Amsterdam, is growing increasingly worried about the tremendous management costs of PC hospital networks, running on Windows platforms. But how to cut down expenses with regard to business-critical processes in hospitals which have to keep functioning? The AMC is urgently in search of an alternative solution in the form of central software distribution management.

Heart failure study programme integrates HP Interactive Health care Services for patient monitoring
The New England Medical Center (NEMC) in Boston, a Lifespan Hospital, has expanded its Specialized Primary and Networked Care in Heart Failure Study (SPAN-CHF) programme to include the Interactive Health care Services of Hewlett-Packard Company. HP Interactive Health care Services, pending with United States Food and Drug Administration 510(k) clearance, is designed to establish and support a framework for the daily patient measurement and clinician review of weight, ECG rhythm, blood pressure and pulse. All these are vital signs recognised as important to observe in the ongoing management of congestive heart failure (CHF).

Memorial Health Services' remote patient record access "piloted" to secure Virtual Private Network
Nowhere else do security issues raise more alarms than in the sensitive area of patient care. As health care organisations work at improving services, while reducing costs, physicians' remote access to patient data is one compelling option, but one that is fraught with serious legal and ethical issues on how to protect the data. Now, with the assistance of Pilot Network Services Inc., the Security Utility pioneer, Memorial Health Services, which includes Anaheim Memorial, Long Beach Memorial, Miller Children's at Long Beach Memorial, Orange Coast Memorial and Saddleback Memorial Medical Centers in Southern California, is offering physicians the cost-saving, better business practice of remote access to patient data. Doctors can review lab reports, medications, x-rays and other critical patient information on-line, while Pilot ensures that the confidentiality and security of the health records remain intact.

Senographe 2000D offers new dimension in early detection of breast tumours
Computers will play an increasing role in the early detection of breast cancer. Until recently, computer technology was unable to compete against the diagnostic potential of conventional x-ray. Since then, digital radiology has rapidly conquered the hospital departments but in spite of this evolution, the introduction of digital mammography was lagging behind. The technology was not available to provide the required level of high resolution for a correct diagnosis of breast cancer. The novel Senographe 2000D full-field digital mammography system, developed by General Electrics Medical, featuring the company's exclusive flat panel Revolution detector, now offers the possibility for significant improvements in breast cancer detection.

Breath-smelling computers trace bacterial lung diseases in no time
At the Imperial College in London, the Breathalyzer is currently being developed, a device to detect the bacterial odour of diseases. The patient has to breathe through a tube, connected to a reaction chamber with an integrated sensor to measure very low molecular concentrations. Traces of certain chemicals may indicate the presence of infectious bacteria. Doctors are able to use the method to distinguish between diseases which can be caused by bacterial as well as viral infection. If the bacterial odour is missing, the patient's complaints are due to a viral infection. In that case, the prescription of antibiotics is unneeded. The Imperial College however is not the first to discover the possibilities of this type of electronic nose. The Pennsylvanian team of Dr. Hanson already used a similar tool earlier on, to detect pneumonia in hospitalised patients.

Medical imaging service providers forced to adapt business to hospitals' one-stop shopping demand
Hospitals are increasingly requiring medical imaging service providers to assist them in areas that go beyond traditional maintenance and imaging system repair. As a result, service providers are broadening their portfolio to also include asset management, technology assessment, training, and consultation services. Winning service providers will be those who are willing to expand their geographical base to cover entire hospital chains. Providing this type of one-stop shopping is expected to remain a key to winning customers.

Virtual Reality helps diabetic patients control their blood circulation
In scientific studies starting this autumn at the Strelitz Diabetes Research Institute, the research team of Dr. Aaron I. Vinik is aiming to teach diabetic patients techniques based on Virtual Reality for increasing their own blood flow. Poor circulation, especially in the fingers and toes, is a dangerous symptom of diabetes which might lead to amputation in some patients. The experimental system uses the patients' skin surface pulse and temperature measurements to create computer-generated images of the nature and state of the blood vessels beneath the skin. Virtual reality headsets will display the data, allowing patients to "observe" the inside of their bodies.

Australian public health IT outsourced to IBM Global Services in million dollar contract
The Australian Federal Government has selected IBM Global Services Australia to provide Information Technology services to the Federal Government Health Group Agencies in a contract worth about $US230 million ($AU350m) over five years. The agreement covers a wide range of IT infrastructure and services currently delivered "in house" and represents a strategic decision by the Health Group Agencies which will allow them to gain faster access to advances in technology, focus on their core function of improving health services to all Australians and assist in developing efficiencies and improved client services through e-business.

First eHealth management programme for diabetes offers patients remote assistance
DiabetesWell, a division of Advanced Care Technologies Inc., has introduced the first Internet treatment and management programme ever for diabetes in the United States. Health care is entering the new millennium with the most significant event in diabetes treatment and management since the discovery of insulin in 1921. For the first time in history, patients with diabetes and Internet access will be able to receive on demand, expert care regardless of their geographic location. The eHealth management programme combines the breakthrough treatment methods developed at the renowned Endocrine Metabolic Medical Center in Atherton, California, with the latest Internet and mobile monitoring technology.

Shared-user solution delivers diagnostic power of mobile PET to hospitals
CPS Inc., which is a Siemens Medical Systems CTI Inc. joint venture company, recently signed an agreement to provide Alliance Imaging Inc. with positron emission tomography (PET) technology for its mobile, shared-user PET imaging operations. Alliance Imaging is a leading provider of hospital and clinical fixed and mobile, shared-user diagnostic imaging services. Through this agreement, CPS will provide ECAT EXACT scanners, the only PET imaging technology currently available for mobile applications.

UroCor and Mallinckrodt sign agreement to sell prostate cancer radiotherapy
UroCor Inc., a leading disease management company in urology, and Mallinckrodt Inc., a global manufacturer and marketer of speciality health care products have signed an agreement, allowing Mallinckrodt to sell and distribute UroCor's new radiation treatment for prostate cancer through Mallinckrodt's 35 nuclear medicine pharmacies and more than 80 independent pharmacies. Mallinckrodt also will add the product to its group-purchasing contracts with hospital groups such as Premier.

Sun Microsystems teams with Health Network Ventures to create Web portals for health care
Sun Microsystems Inc. and Health Network Ventures Inc. (HNV) have closed a strategic partnership to offer health care providers practical solutions for sharing clinical and administrative information. As part of their alliance, the companies will help customers deploy intranet and Internet portals to deliver increased access and flexibility.

ChannelHealth teams with HealthStream and MD Consult to strengthen medical content Web offerings
ChannelHealth, a subsidiary of IDX Systems Corporation, has expanded its Internet offerings through partnerships with HealthStream Inc. and MD Consult. These newly established alliances will allow physicians to access continuing medical education courses and peer-reviewed medical information as well as practice management and clinical tools directly from their desktops on ChannelHealth's Physician Channel. ChannelHealth was organised this year to provide Internet services to physicians and patients which focus on the local and personal nature of health care.

MedPlus' ChartMaxx patient record system to enter British health care market
MedPlus Inc. has signed an Original Equipment Manufacturer reseller agreement with Summit Document Management Limited (SDM), an operating company of The Summit Group Limited of the United Kingdom. The relationship will enable SDM to sublicense and sell MedPlus' ChartMaxx enterprise-wide patient record system as Virtual CaseNotes Plus throughout the United Kingdom health care market. As part of the OEM agreement, ChartMaxx will be modified to reflect all the terms and working practices, as applied in the UK. Virtual CaseNotes Plus will form an integral part of SDM's medical records outsourcing service Virtual CaseNotes.

HPC has become truly a tool for scientific investigation
Want to get an overview of the processors currently in use in HPC machines? Interested in knowing the types of computer architectures available and how they are used in Europe? The report Whither HPC in Europe? provides a nice overview. The report, written by Dr. Rob Baxter for the Direct Initiative of European supercomputer centres, equally lists the results of a survey amongst academic HPC centre users. Several of the HPC processing technologies and capabilities have become mainstream in particular disciplines, such as prototyping procedures in the automotive and aerospace industries, and 3D imaging, rendering, and data storage in the medical sector.

Second call IST closes in January
The second call for IST proposals under the Fifth Framework programme has been issued by the European Commission on October 1st 1999. Closing date for Research and Development proposals is January 17th 2000. However, the current places emphasis on proposals for take-up measures, for which a number of specific topics are mentioned. A structure of take-up support nodes, similar to the HPCN Technology Transfer nodes in the previous programme, will be put in place. The budget available for this call is 400 million euro.

Cognitive science offers new keys to build expert systems for medical diagnosis
Expert systems might play a crucial role in assisting the physician in his medical decision making and diagnostic analysis if only they were able to function more accurately. Today's cognitive science provides a totally new insight to optimize the performance of knowledge systems, according to Dr. Niels Taatgen, who received his doctor's degree at Groningen University on the subject of ACT-R, a powerful architecture for cognition. Three factors are important in learning newly designed knowledge systems to match the skills of a human expert: the building of experience through implicit learning; the use of examples to construct reasoning; and the development of strategies through explicit learning.

Latest DataCaptor software version to provide support for Windows 98 and NT platforms
Capsule Technologie has released version 3 of DataCaptor, a medical device data acquisition software for medical information systems. DataCaptor uses ActiveX and MS Distributed Component Object Module ([D]COM) to recuperate data in real time from medical devices and integrate it seamlessly into Windows 98 and NT compatible applications.

Advanced American and European research and education networks linked by Internet2 and Dante
Dante and Internet2 have connected high-performance research and education backbone networks across the Atlantic Ocean. Peering between Abilene, an Internet2 backbone network, and TEN-155, the pan-European research network, will enable collaboration among researchers and educators in the United States and in Europe in ways not possible on today's commercial Internet. The interconnection will operate at 45 megabits per second, or nearly 1000 times faster than a typical modem.