The Greek isle of Tilos and the Department of Surgery of the University of Pisa have been respectively selected as the operative and the scientific as well as organisational seats for the "Tim-Tem" experiment. This Tilos Medicine & Tele-medicine project has been set up to create an exportable model for first aid telematic assistance during emergencies on European isles and in isolated regions with no hospital. The programme runs from October 1997 until June 1999 and consists of three phases. First, the project members will execute a clinical and ecographic mapping of the local population which will permit access to a "Dispatch System" in the second stage. Finally, a number of operative telemedicine applications are planned. As an additional purpose, the experiment aims at improving health care facilities in the tourist season.
Tilos is a rocky Mediterranean isle with a surface of 59 km≤. It has two main villages: the harbour of Livadia and Megalochorio. The nearest hospital centres are situated on Rodos, Cos and in Athens. Transport happens through ferry boats, hydrofoils in summer and by helicopter. About three hundred people are living on the island but in tourist seasons this number amounts to six hundred. Dr. Tassos Aliferis is the only physician available and he is also the Lord Mayor of Tilos. Together with a nurse, he is responsible for the islanders' health and for the drug distribution. Professor Enrico Cavina is head of the Post-graduate School of Emergency Surgery at the University of Pisa. His Department of Surgery will finance the "Tim-Tem" project during the first phase. Other partners and research programmes will have to be involved as soon as possible.
The Post-graduate School of Emergency Surgery hosts a large University Hospital providing a complete range of medical and surgical specialities as well as an Emergency Department which is operative 24h/24h. The well trained personnel is able to offer immediate 'live' consult throughout the year. Initially, the University of Pisa has sent a letter to all the inhabitants of Tilos in order to convince them to collaborate to the experiment. During the past months, Dr. Aliferis has held a campaign on the isle, encouraging the population to participate to the collection of clinical data.
In the period of March-April 1998, a team from the Department of Surgery in Pisa will come to Tilos to collect all data in a database and to perform a total-body ecographic investigation of each resident. The images will be stored on a floppy disk allowing consultation both in Tylos and in Pisa. In case of serious emergency, the intra-body images of the patient can be immediately retrieved from the database enabling a comparison with new images. Transmission of data is executed via fax, email and Internet. The team will also try to isolate the inhabitants who are more exposed to specific pathologies. All images along with the RX, CT, RNM, scintigraphy and ECG, if available, will be attached to the resident's personal file.
Dr. Aliferis and the nurse will receive appropriate training with regard to the use of ecographic probes on the body of the patient. Tele-consult with specialists from the University of Pisa and from the other hospitals on Rodos, Cos or in Athens, which might decide to take part in "Tim-Tem", will facilitate the interpretation of the exam. The scientific results will appear in The European Journal of Emergency Surgery and Intensive Care and by means of the European Association of Trauma and Emergency Surgery (EATES).
The first phase will have to be completed by June 30, 1998 and will lead to the use of a "Dispatch System". Here, the deadline is set for December 1998. On the basis of the results obtained in the first and second stages, further concrete telemedicine developments will be defined, such as the planning of air-transport on insular regions. The third phase will end by June 1999. For further information, please check the special web-page for the "Tim-Tem" project that has been set up at the University of Pisa.