KPN is the largest provider of telecommunications and related products and services in the Netherlands. Since a few years, the company is trying hard to enter the health care sector. Recently, the Medical Centre Apeldoorn has been selected as the ideal partner for setting up a regional network based on Internet. The initiative constitutes a first test to generate an Electronic Patients Record (EPR) for all of the Dutch health care takers, who are working in or outside the hospital environment. In the long run, KPN therefore aims at introducing this technology also in other regions of the country. The project still leaves a lot of thought about infrastructure and practical organization but KPN Telecom seems very determined to play a leading role as major future supplier of EPR technology.
Plans for the Telecare project were born out of the collaboration between KPN and Orga-Info, a consultancy office for hospital computing. In 1996, both parties already launched the Intracare-initiative, based on the Chipper, a smartcard for unique identification of the health care provider, which however had little or no success. The new idea to build an Electronic Patients Record is based on Internet technology. The exact location of vital patient data is detected via search engines. Various levels of authorization will be integrated to define which kind of data is accessible for each type of health care giver.
Initially, the Apeldoorn Telecare project will exchange medicine prescription data but in a more advanced stage, the authorized physicians will be able to consult each other's patient information online. Doctors will be identified through smartcards, and in the future possibly also patients. In this way, Telecare will serve as an intranet for all aspects of regional health care. The participants in the project include the 650-bed facility of the Medical Centre Apeldoorn, located at two sites, as well as the regional general practitioners and dispensers. The Spittaal Hospital in Zutphen soon will join the project, which strictly deals with medical communication.
The partners have set up a combination between EDI/Edifact (Electronic Data Interchange) and Internet, in order to equally present the data in HTML or Hypertext Markup Language. The EDI/Edifact option is only a temporary solution to facilitate integration of data into local Electronic Medical Files (EMFs). Communication is established via ISDN or Integrated Services Digital Network and via Transmission Control Protocol/Internet Protocol (TCP/IP). In the future, innovative applications such as Asynchronous Transfer Mode (ATM) and Asymmetric Digital Subscriber Line (ASDL) will be envisaged, since the transfer of medical images requires large bandwidths.
It is the forwarding party who decides which data are accessible to the consulting health care provider. The latter can use his browser to get a survey of the exact medical data locations. PCs are installed in practically all of the general practitioner's offices in the region of Apeldoorn. Still, the GP's remain a bit sceptic with regard to the Telecare project because their participation involves new investments for both hardware and software. KPN and Orga-Info are not worried since the initiative will run in different phases, which means that interested parties, such as nursing homes, laboratories, and homecare organizations, can enter the project whenever they are ready for it.
In the meanwhile, the Medical Centre Apeldoorn has been nominated for the project "Hospital of the 21st century". The goal of this initiative is to substantially shorten the average patient stay in the medical facility and to intensify the collaboration between nursing homes, general practitioners, and home care organizations by means of electronic communication. For this particular purpose, the telecom infrastructure of the Telecare project could be of great use. For the news in this article, we have used the Automatisering Gids as source of information.