Euromednet

Competitiveness & Growth

Status

Completed
Status date

2014-12-09

Objectives

Project Objectives	Major Item	Status of completion
To upgrade the existing SHARED telemedicine network toward an operational network by introducing a Telemedicine Operation Centre (TOC) and by upgrading the stations in order to have them remotely controllable together with the introduction of the necessary tools to allow services information access, booking, automatic scheduling and communications set-up and confidentiality of data.	Telemedicine Operation Center	100%
Implementation of a business plan and service provider strategy for telemedicine services.	Incorporation of TelBios S.p.A. a telemedicine service provider operational since September 2001.	100%
To perform pilot operations in order to qualitatively and quantitatively prove the validity of telemedicine via satellite and to propose a methodology to use the telemedicine network, and to evaluate the quality of service.	Extension of the network; inclusion of new sites	100%

Challenges

The principal issues which the project addressed were:

Standards and Security Data
Development and Integration of telemedicine platforms (WiFEN, WUP)
Common Evaluation Procedure for Tools (i.e. Medweb, ipACS, e-Ceptionist, Carolin)
Service Provider strategy in telemedicine
Quality Certification (i.e. ISO and CE)

Benefits

The main benefits expected were:

The rationale of these telemedicine pilot operations is to perform new experimental activities in Mediterranean regions where the Health infrastructure need to be strengthened, and where the role of the satellite as communication platform is a key element for the on-line access.

As service provider of telemedicine services, the main benefit will be the set up of operational procedures, marketing strategy and business solutions to potential customers in the Italian healthcare market and at the international level as solutions provider .

Features

EuroMedNet takes advantage of the interoperability between the satellite network and terrestrial networks. The satellite network, developed within the DESNET project, has a defined interface towards the telemedicine services, which are carried out by the Telemedicine Operation Centre.

The Tele-medicine Operational Centre (TOC) is the EuroMedNet network entity that co-ordinates all tele-medicine services provided through the EuroMedNet integrated satellite and terrestrial system.

The EuroMedNet System integrates the DESNET satellite network with the terrestrial one. It enhances the capabilities of the SHARED Tele-medicine Network, also based upon the DESNET, aimed to serve only remote Tele-medicine Clients (TC) accessing the system through the DES Data Earth Terminals (TCsat platforms). The EuroMedNet users population includes remote TCsat, corporate TC (TClan) platforms accessing the system through the TOC LAN, remote TCs accessing the system resources through Internet or dedicated ISDN lines named TCint and TCisdn respectively. All communication links between TCs are permitted.

The overall system operation is managed by the Tele-medicine Operations Centre (TOC). The TOC performs centralised service session reservation and permits access to the Central Medical Database (CDB). When the DESNET communication links establishment is necessary, the TOC interfaces with the DESNET Control Centre (DCC) to provide satellite channel bandwidth reservation for the requested service. This procedure follows the DESNET operational rules.

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The development of EuroMedNet then aimed to create:

A Telemedicine Operations Center;
The physical facilities used to collect, distribute, store, process, and display

Plan

The tables below show the sites currently part of EuroMedNet Network and the services exploited during the Pilot Operations.

Code	Satellite Station	Present status
Site A	Policlinico Celio Roma	Operational
Site B	Scientific Institute H San Raffaele, Milan	Not - Operational
Site C	Clinical Center Univ. of Sarajevo, BiH	Operational
Site D	Poliambultario IDI, Tirana	Operational
Site E	TOC, Rome	Operational
Site F	V. Babes Hospital, Bucharest	Operational
Site H	Hosp. Pugliese-Ciaccio, Catanzaro	Operational
Site I	Italian Field Hospital,Pec	Operational
Site J	ISMETT Palermo	Operational
Site M	Hosp.Habib Thameur - Tunisia	Operational
Site N	Gemelli	Operational
Site O	Transportable	Operational
Site P	Mobile Ambulatory	Operational
Site Q	European Vision (cruise ship)	Operational
Code	ISDN Station	Present status
TTS#3	Hosp.Habib Thameur - Tunisia	Operational
TTS#4	Scientific Institute H San Raffaele, Milan	Operational
TTS#5 (Migra)

Current status

The EuroMedNet results achieved by TelBios as telemedicine service provider, represent the point of the iceberg and the first plateau of a long journey. The point of the iceberg because they are the positive end points of a lot of effort, of economical resources invested by TelBios and as income from client.

TelBios has started to provide the Italian Minister of Defence for his telemedicine activities of access to the WUP and installed a teleradiolgy system based on iPACs to the Italian Field Hospital in Pec, Kossovo. This will allow the physicians at the Policlinic Celio to perform second opinion activities on diagnostic studies DICOM 3.0 compliant. (March 2003).

TelBios S.p.a. has been certified that the quality system operated in his two operative units of Milano and Roma, is in compliance with the standard UNI EN ISO 9001: 2000 concerning the following activities: design and provision of telemedicine and e-learning services. (April 2003).

The activity of telemedicine among the San Raffaele Hospital and the site in Tirana, to support the surgical follow-up and second opinion, is still continuing this year. Bi-weekly teleconsultation involving also physicians from other hospitals in Lombardia, will continue up to the end of 2003. These activities are sponsored by the Lombardia Region and a NGO, AISPO. The clinical specialty involved is mainly orthopaedics in paediatrics. (April 2003).

Design and development and realization of a teleradiology network for emergency on trauma, using iPACs in 4 clinical sites in Siciliy, named ReSPeCT. The are 4 spokes clinical sites: Sant'Agata Militello, Taormina, Barcellona, Lipari. The Policlinic of the University of Messina is the hub. The network is operating since May 2003. Telemedicine and e-learning project in Palestine: TelBios in cooperation with an NGO, AISPO in Milano, has won a contract for the design, development and the provisioning of telemedicine and e-learning services to 6 clinical sites in Palestine, and one in Siria. (June 2003).

TelBios S.p.a. has won an open industrial bid issued by the Istituto Superiore Sanità www.iss.it for the design, development and the provisioning of a service based on the WUP and multipoint videoconference service for 6 sites simultaneous for the Italian Transplant network. The network will link more than 20 clinical sites across Italy. (July 2003).

The CARDNET network update: to the new organization of CARDNET managed by TelBios under in collaboration with the Lombardia Region, 14 hospitals has already signed the formal agreement to participate. The agreement involves three parties: the hospitals, the Lombardia Region and TelBios. Of these 14 sites, 10 are new sites. The agreement is a formal and administrative framework, where the hospital commits himself deciding to invest for the procurement of a telemedicine facility and systems designed by TelBios (ISDN telemedicine terminals). The 10 new sites are due also the commercial network that TelBios has set up mainly through local agency representatives. In this initiative TelBios is sponsored by the pharmaceutical company Amersham. (July 2003). (www.hoise.com/vmw/03/articles/vmw/LV-VM-07-03-16.html; and www.sanita.regione.lombardia.it).

TelBios has been awarded by Fondazione Istituto G. Gaslini of Genova of a contract for the provisioning of a DESNET satellite terminal to increase the operational capability of a medical and logistic mobile unit to be deploy in IRAQ. TelBios is in charge of the telemedicine services and systems. The experience done in EuroMedNet and Telemedicare have been essential for the success of the project. (July 2003).

TelBios is starting a joint project with a CRO company (Clinical Research Organization - www.opis.it) in order to set up practical guidelines in telemedicine for the application of the 'best practice' in telemedicine. The expected outcomes go well behind the scope of EuroMedNet and will strongly commit TelBios and his partner up to spring 2004. Telemedicine malpractice starts appear in the literature. TelBios has started an internal project on 'Security'. The aim is to submit for the ISO UNI 17799 by the end of 2004. The scope of the project is to assess what are the vulnerabilities within the actual infrastructure and the risks associated with the critical processes of teleconsultation. This will end in September 2003. For TelBios the issue of 'Security' together with topics like liability, ethic and law, is an important asset as the infrastructure, the organization and the clinical competences.