June 1998

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ITIS98logo Visit the website of he first International Conference on the Telemedical Information Society (ITIS '98)

Generate your own personal medical home page
At the University of Belgrade a research team led by Professor Zoran Jovanovic has developed an experimental medical data system for remote access via the Web. The team is partnering with Euromed project workers to establish a standardised system for generating unique personal medical home page sites. At the ITIS'98 Conference, Professor Jovanovic and his colleague presented a first demo-version of the working prototype to show the audience that all basic concepts work.. As a next step, clinical practice will be needed to optimise the system.

New software helps EEG data analysis and transmission
During the HPCN Europe 1998/ITIS Conference, Domenico Conforti, researcher at the Department of Electronics, Informatics and Systems (DEIS) at the University of Calabria, presented two telemedical software packages for computer aided diagnosis. Both Computer Aided Medical Diagnosis (CAMD) for breast cancer and TeleEEG to support the EEG data analysis and transmission are being realised in the overall framework of the Euromed project. Here is a closer look at the purpose, features, strategies and results of the TeleEEG initiative with relationship to the quality improvement of health care.

How the Web brings patient data puzzle together
In his introductory talk, ITIS'98 chairman Andy Marsh defined the scope of the Euromed project and outlined the framework for a future Telemedical Information Society (TIS) to try and trigger off plenty of fertile discussion among the conference participants during this three-day gathering on telemedicine . He introduced the World Wide Web as the common glue between the different multi-media medical information systems, using the power of Java and the variety of local servers. The central focus in the system is the patient health care homepage as a unique URL address on the Web. This collective point of medical patient data constitutes the core of the organisational TIS structure, formed by Euromed's twenty building blocks.

The use of Trusted Third Parties for secure telemedical traffic over the Web
The Internet is an open network. If you want to establish a telemedical information society (TIS) by using the World Wide Web as the common and global communication protocol, you have to integrate the necessary security components and measures to avoid unauthorised access and malicious manipulation of the local or remote medical data. In order to safeguard the patient's privacy, the EUROMED-ETS initiative, supported by the European Commission within the INFOSEC programme, has tackled the multiple security issues through the special installation of Trusted Third Parties services (TTPs) over a secure Web. At the ITIS'98 Conference, Dr. Despina Polemi of the National Technical University of Athens (NTUA) described the different EUROMED-ETS activities, which are complementary to the Euromed project, in a physical, human and theoretical context.

Wavelet lossless coding is a breakthrough in medical imaging
Mr. Adrian Munteanu is a colleague of Euromed-partner, Dr. Paul Cristea from the University of Bucharest. At the Free University of Brussels, he is involved in research projects on data compression. Before the ITIS audience, he presented an advanced method of wavelet lossless compression, which outperforms the classical zero-tree coding. The procedure includes the calculation of lossless compression algorithms in order to obtain compression schemes which are ideal for remote browsing through large image data sets and for real time archiving of medical images.

Internet gives access to patient records
A freshly graduated German doctor claims never to have used the Internet and leaves an enthusiastic Web addict like Dr. Tuomo Kauranne from the University of Joensuu in Finland stunned. If this young physician doesn't have any experience with the Web, then how should mature and older generation of general practitioners)? This anecdote shows that we cannot take the medical advantages of the Internet for granted.

The Holy Grail of Virtual Reality and Medical Imaging
Professor Richard Robb, director of the Biomedical Imaging Resource (BIR) at Mayo Clinic in Rochester, Minnesota, was a noticeable guest at the first ITIS Conference. Virtual Reality, medical imaging, and their applications constitute no less than a religion to this man, who confesses to be a die hard "Star Trek" fan, absolutely devoted to the skills of "Bones McCoy", the surgeon of the Star Trek Enterprise. Nevertheless, his medical experiences are cloaked in the every day practice of fascinating and innovative visualisation techniques.

Telemedical and 3D medical imaging projects or the future at your doorstep
Dr. Georgios Sakas is Head of the Cognitive and Medical Imaging Department at the Fraunhofer Institute for Computer Graphics. At ITIS'98, he presented four exciting projects in which the institute is actively involved together with other partners to try and bring together HPCN, 3D modelling and telemedicine. A few of these initiatives are supported by the European Commission. This spirited speaker proved that the advanced (tele)medical technologies we often talk about, are not hidden away in some misty vision but are constantly being optimised, refined, tested and applied here and now. Seems as if we were travelling "back to the future..."

Diagnostic image processing on high performance architectures
The Italian Inter-University Consortium CINECA is a large supercomputer centre, specialised in vector and parallel optimisation of algorithms and code development in all kinds of scientific fields. Diagnostic medical image processing is one of them. During the ITIS Conference, Dr. Sanzio Bassini and his colleague, Mrs. Cinzia Zannoni presented some of the European Commission medical projects in which CINECA has been involved. This interesting contribution showed how High Performance Computer Networking (HPCN) can offer extremely useful support in the pre- and post-processing of medical images, like it did in the ESPRIT based project, referred to as PROMISE.

The essentials of global telemedicine
Good medical practice starts with diagnosis, treatment, and possibly prevention of human diseases of the body as well as the mind. Professor Jean-François Moreau, who is chairman of the Department of Radiology in the Hospital Necker of Paris, warned the ITIS'98 participants that these principles still keep their content and value, especially in the telecommunication era. He held an ardent plea for the "use of the five senses" in the contact between physician and patient.

The National Health Service plans networked GPs
As the Managing Director of the National Health Service (NHS) Telecommunications Branch in the United Kingdom (UK), Tony King was offered the opportunity at ITIS'98 to present the recent evolution of the network facility tender, issued by the NHS. The overall idea is to build a system network, connecting the general practitioner's (GP) offices to the hospital sites to allow direct access to essential patient related information as well as to book immediate hospital consultant appointments. By the end of 1998, several demonstration sites will be set up for testing. A year later, it should be possible to transmit the hospital test results to the GPs' surgeries. Finally, in 2002, the network services will be made available across the country.

Rude awakening in UK telemedical practice
People considering telemedicine as an unrealisable dream, were suddenly rudely awakend by Dr. Paul Garner who confronted them, during his ITIS-conference talk, with impressive video images of daily telemedical practices developed at the British Telecommunications (BT) Laboratories, in the fields of teleconsultation, education, lifestyle monitoring and telecare. This UK experience shows the commercial and technical potential of relatively simple and inexpensive solutions, covering a wide range of useful home and hospital services, accessible for ordinary people like you and me.

Drug discovery through large-scale data management
European pharmaceutical and agrochemical companies such as Bayer, Hoechst, Merck, and Lion Bioscience are using Silicon Graphics Origin2000 servers to isolate the causes of disease and produce drugs to combat them. Large-scale databases of genomic information requiring high-performance, scalable computing systems are the foundation for the compute-intensive search and analysis algorithms and applications used to make bioinformatics a valuable tool in drug discovery.

New member Capsule Technologie supports Andover Working Group in plug-and-play health care computing
Capsule Technologie recently joined the Andover Working Group (AWG) to support their activities in the fast growing field of interoperable health care applications. As a new member, this innovative software development company already displays a solid background in system integration, considering the fact it was only created in 1997. AWG will rely on their expertise in medical device connectivity to optimise their plug-and-play health care computing implementation.

Philips Medical Systems reseller in Benelux of Sysware's PowerLAB
PowerLAB, a fully integrated Laboratory Information Management System (LIMS), developed by Sysware Healthcare Systems, will be marketed in the Benelux under the tradename LABOSYS by Philips Medical Systems. The product supports all scientific specialities and is able to meet the future requirements of virtually every type of end-user laboratory. Philips will translate the system to Dutch and customise the screen layouts and reports without any programming.

How can Europe compete with Internet II ?
Europe urgently needs a decent high-performance network infrastructure for research and education as the existing one is completely saturated. Various initiatives and projects within the European Commission (EC) are being undertaken to find our own original European answer to the huge telecommunication challenge. Unfortunately, the EC projects are limited in time, complex in administration and far too slow. The idea of involving industry has not quite matured yet in Europe because of the possible conflicting business interests. Meanwhile, time is running out on us, Mr. Hans-Peter Axmann of the Federal Ministry of Science and Transport in Austria anxiously warns the ITIS'98 audience, so "please, to join forces and keep up the pressure."

Health care technology from Fourth to Fifth Framework
As a representative of the European Commission (EC), Dr. Massimo Luciolli highlighted the projects related to health care technology in the Fourth Framework Programme and tried to indicate the future direction of the telemedical share within the Fifth Framework Programme in his ITIS'98 lecture. The upcoming European R&D programmes show a general trend towards enhanced flexibility and increased integration, and are characterised by revised management procedures. Join us for a quick tour through the organisation of the Information Society Programme.

How to judge a healthy medical Web site
Internet provides access to large amounts of uncontrolled medical information. As a health consumer, you can roam for hours on the Web without finding the right solution to your problem and even get mislead by commercial propaganda or pseudo-scientific news. At the Central University Hospital in Rouen, Dr. Stefan Darmoni is coordinator of an international research partnership between Europe and the USA in order to establish a methodology for the scoring and evaluation of the quality displayed by medical sites on the Web. At the ITIS'98 Conference, Dr. Denis Mrejen, member of the board of the French National Health Information Technology Industrial Association, presented seven categories of criteria, used by the international co-operation, to assess the value and validity of the numerous Internet health resources.

Sonification gives clearer picture of brain activity
At the Institute "Mihajlo Pupin" in Belgrade, a research team has developed a visualisation and sonification method in order to introduce this software into a temporal electro-encephalography (EEG) mapping programme, referred to as TEMPO . Professor Emil Jovanov explained and demonstrated the system at the ITIS'98 Conference. A standard browser which supports Java and Virtual Reality Modelling Language (VRML), suffices to create the synaesthetic effects, enabling the physician to simultaneously view the spatial distribution of the patient's brain activity as well as perceive the symmetry between the left and right hemisphere.

French Healthcare tests electronic networking
The health care organisation in France is supported by both the public and the private system. In order to guarantee an optimal service for the patient, the two parties should work closely together. At ITIS'98, Dr. Régis Beuscart of the University of Lille, was offered a chance to illustrate the growing potential for medical collaboration through electronic networking, but also to mark the human factors which sometimes hinder a smooth follow-up of the patient's data between the hospital, the specialist, the general practitioner (GP), the social security, and the nurses. He made an engaged plea for the strong involvement of the user in the health care network, resulting in the creed: "The Virtual World is for Humans".

ISIS sums up standardisation issues
A meeting which discusses the establishment of a telemedical information society, sooner or later faces the concept of standardisation. Before an attentive ITIS'98-audience, Dr. Simon Smith, a European Commission representative from DG III Industry, gave a short introduction to the Information Society Initiatives in the Standardisation programme, referred to as ISIS. He invited possible project candidates to urgently submit their proposal for the recent call of this European programme. For the current year, the European Commission has assigned a funding capital of 3 million ecu to the ISIS sponsoring activities.

Satellite turns telemedicine into a self-supportive service
Dr. Roberto Viola was invited to kick off the HPCN Europe '98 Conference, giving evidence of the European Space Agency (ESA) experience in the building up of a telemedical information society. He briefly outlined the future potential and the current limitations of innovative communication technologies, such as satellites, Internet and digital video. Economic factors clearly play a larger role than technical issues in the dissemination of high speed networking. People are interested in content rather than in bits and bytes. Today, telemedicine constitutes one of the most popular frontline applications in dynamic network operation. In this regard, ESA's major concern is to create a synergetic relationship between telemedicine as a humanitarian mission on the one side, and as a commercially sustainable service on the other.

Workshops for coordinators of European R&D projects
The Institute of European Trade and Technology (IETT) is organizing four one-day project management workshops, designed specifically for coordinators of European research and technological development projects. The IETT is a non-profit organization whose main role is to promote European RTD collaboration and to assist UK organizations to participate in the EU's Framework Programmes for research and technological development.

NewStar Asian carrier will bring telemedicine services
Transcom International Ltd., a technology development and communication systems company, will enter the long distance telecommunications arena in a joint venture with Xinhua News Telecommunications Pty Ltd., which is fully owned by Xinhua News Agency. Together, they will commercialise a long distance telecommunications carrier in Australia and the Asia-Pacific region, referred to as NewStar. The project has been submitted for approval to the Australian government. Future applications of the NewStar programme will also include telemedicine services.

See you in Hong Kong at EMBS'98
On behalf of the IEEE Engineering in Medicine and Biology Society (EMBS), Professor Zhang Yuan Ting invited ITIS'98 attendees to join in the celebration of the 20th anniversary of their annual international conference, taking place in Hong Kong for the first time during the week of 29 October - 1 November 1998. As the official programme chair, he properly defined the telemedical items which will be highlighted during this event.

Creating a Virtual Medical Worlds Community
The organisation of a Telemedical Information Society (TIS) implies the idea of cooperation through communication. In this regard, setting up a Virtual Medical Worlds Community (VMWC) could make this happen. At the ITIS'98 Conference, VMWC-project manager Ad Emmen introduced the concept and indicated the steps which already have been taken. The general purpose is to bring together telemedicine workers and advanced Information Technology (IT) suppliers to accelerate TIS developments on a European scale.

PHP Healthcare Corporation installs forty NCs
Medical management is a rapidly evolving business with urgent needs at the level of information technology architecture. PHP Healthcare Corporation handles medical risks and provides a great variety of management services to groups of health care providers and hospitals. To meet the growing challenges of customised services, the company has opted for a Java computing solution.

Germany takes broad view of telemedicine applications
Dr. Gudrun Zahlmann works at the National Research Centre for Environment and Health in Germany. At the ITIS Conference, she presented a short survey of the current telemedical applications, technical tools, global projects and patient related services. Telemedicine as a concept includes remote health care services, patient data management, and medical expertise. General patient care is supported by the transfer of patient specific data, knowledge exchange, and overall improvement in communications. Telemedicine involves items such as teleconsultation, diagnosis, education, management, and therapy. Throughout this vast definition, one major priority has to be kept in mind : the physician has a responsibility to explain to the patient what is going to happen.

What's the future of the Euro-Mediterranean Information Society ?
As a follow-up of the Ministerial Conference in Rome in May 1996 on the "Construction of the Euro-Mediterranean Information Society", the Government and University of Cyprus organised the EuroMed Net Conference, in collaboration with the European Commission. Professor George Papadopoulos was invited at ITIS'98 to report on this event and talk about the people who will constitute the future Euro-Mediterranean society; its inherent potential that has to be generated through successful interaction; the cultural, educational, financial, and organisational issues; and the various pilots projects that will be set up.

Privacy is still a sensitive issue for telemedical society
As a member of the European Parliament, Mrs. Renata Heimisch represents the voice of the political world at the ITIS Conference, and its ideas for the establishment of a Telemedical Information Society (TIS). She firmly expressed her belief in international cooperation for the development of useful telemedical applications. On the other hand, she pointed out that the concept still remains controversial with regard to the patient's privacy. As a result, politicians have to pave the way to enable standardisation.

Ambitious Electronic Biomedical Library Image Service planned for Europe
Within the European fourth framework programme, an operational infrastructure for networked image information is being developed under the project name ELISE II, referring to the Electronic Library Image Service for Europe. Coordinator of the initiative is Michael Adeyinka, director of the Laboratory for Biomedical Informatics (LBMI) in the Netherlands. At the ITIS Conference, he gave a short but stimulating account on the activities displayed in this three-year project, which are offering him a chance to delve into some new and fascinating research.

Cosmo Software streams interactive VRML with audio
SGI's Cosmo Software started an initiative aimed at enabling the streaming of interactive 3D animation in VRML (Virtual Reality Modeling Language) format, synchronised with audio, via RealNetworks' RealSystem G2 architecture. Cosmo demonstrated the technique for the first time at the RealNetworks Conference 98, showcasing online advertising in the streaming of an interactive 3D ad banner over a consumer modem.

Telemedical testbed applied in remote areas in North-West USA
The building and assessing of a regional telemedicine testbed at the University of Washington has proven that the American experience is not so far apart from the European situation as we might imagine. In her talk at the ITIS Conference, Professor Sherrilynne Fuller gave a vivid account on what telemedicine involves in geographically separated and isolated areas, in order to define the regional needs and testbed components. She briefly but explicitly mentioned the policy and technical hurdles before entering into the interesting details of the research and evaluation of a project, which is trying to reconcile the perpetual fog and traditional way of living in Alaska with the wonders of telemedicine.

Medical students explore the body with virtual reality
The potential of Virtual Reality for educational purposes is fully being discovered at the University of California, San Diego (UCSD). After seven million dollars of research lasting four years , Professor Helene Hoffman came up with the Anatomic VisualiseR, a revolutionary means to create new procedures of learning for medical students within a Virtual Environment. She offered the ITIS'98 audience a vivid account on the tremendous advantages but also on the enormous technical challenges brought up by this training approach.

Chinese telemedicine project puts chips in patients stomachs
In 1997, Hong Kong spent 107 million dollars on wireless communication facilities and at the Chinese University of Hong Kong (CUHK), a telemedicine network has been set up, through which a link can be established between Beijing and Shangai. Dr. Zhang Yuan Ting confronted the ITIS attendants with the amazing development of telemedical implementation in Asia. In fact, telemedicine could be described as telecommunications applied in medicine. He speaks of electronic technology in a way that does not scare politicians off. In Hong Kong as much as elsewhere, the acquisition of the necessary funding is a delicate issue.