In VMW's recent June issue, we have reported about a congress that was held from May 22nd to 23th on the island of Tilos in the presence of the Ministers of Greek Government and Territory, all the mayors of Greek islands, as well as physicians and managers of health care facilities. During this meeting, at which more than 500 participants arrived by ship, the results of the TimTem telemedicine project were discussed in the light of the future health care organization on the islands in the Aegean region. The project team from the Post-graduate School of Emergency Surgery operating at the University of Pisa under the lead of Professor Cavina, will try and give TimTem true European wings in the new Archipelago project. This initiative aims at building a real European model able to address health care problems of people in rural and isolated areas.
The TimTem methodology will serve as a basis for the Archipelago project proposal to be submitted to the DGXIII Department of the European Commission for funding. The TimTem Telemedicine Station model for South Europe has its counterpart experiences in the centre and north of Europe, in the areas of the Capraia Island and the Tuscany Archipelago in Italy, and the Western islands of Scotland. Although the TimTem staff has encountered a host of implementation and logical issues due to the occurrence of what can be referred to as "human factors", the project leaders have been able to contribute to the local Greek ambition of pursuing a policy to support the health care of people who live on dispersed islands in the Mediterranean Sea. The Archipelago initiative will continue to meet the requirements of the new Greek health care line.
Initially, the TimTem project started from the idea to experiment a small but efficient telemedicine system on a little island with respect to the habits and organization of the local health care system. During the two-day Tilos event, it occurred that some attendants considered the promotion of TimTem by a foreign university as well as the activity of the Italian team on this island as a disturbing element causing opposition. This attitude of refusal might have negatively influenced the selection of TimTem to serve as an export model to other islands in the region. However, the mayor of Tilos and the project team succeeded in convincing the audience of the European interest of TimTem's scientific methodology.
In fact, the Tilos experience never was meant to become a deliberate action of intrusiveness. On the contrary, the Greek Ministers have been kindly invited to freely execute their own health care programme in full autonomy of power, according to the laws and political choices defined by the Health Ministry, as it is centralized in the Greek Minister of Health. Thus, the TimTem team was most successful in safeguarding the rational objectivity of both analysis and technical options for an alternative health care approach in the Aegean area. A survey, involving 500.000 Aegean island inhabitants, indicates indeed care as a priority issue. In this regard, the on-field results of the TimTem project also seem to meet the guidelines in a 1998 draft provided by WONCA, or the World Organization of Family Doctors. The draft was titled: "Policy on using information technology to improve rural health care".
The Congress participants received the opportunity to witness the potential of the Telemedicine Station, installed in the new rooms of Livadia ambulatory which have been equipped with ISDN lines. A video-conference session via Internet with Pisa and a video-phone consultation with Rhodos were set up. The Nokia 9110 GSM was used to conduct ultrasound examinations as well as electrocardiogram analysis in co-operation with the Centro Diagnostico in Milano. The team performed dermatology and laboratory tele-consultations by means of old radiograms. From the new ambulance on the field in Tilos, vital parameters, acquired with a monitoring device, were transmitted live by GSM in a wireless way. Compared to the tens to hundred cases on the other islands, Tilos only had two heli-rescues in a whole year.
All devices and equipment to implement the permanent Telemedicine Station in Tilos were funded by the Aegean Minister, as was reported in our previous article. In turn, the National Telecommunication Company (OTE) installed the ISDN lines to enhance the GSM covering, provided the video-phone, and also prepared the ground for a technological support to the permanent video-conference. Currently, the most urgent issue consists in having trained the local youth by resident informatics experts in order to operate the permanent Telemedicine Station. The engagement of the TimTem team might be affected by some negative attitudes of local habits. In this regard, a positive response of the DGXIII with regard to the Archipelago project can solve a great deal of these "human factor" problems.
For more details on the current status of the project, you can consult the TimTem home page. For further background information, we also kindly invite you to read the VMW article Aegean Ministry willing to plan and implement permanent Telemedicine Station in Tilos in the June 1999 issue.