CALL FOR CHAPTER PROPOSALS

Proposal Submission Deadline: October 31, 2008

Grid Technologies for eHealth: Applications for Telemedicine Services and Delivery

A Manuscript edited by Dr. Ekaterina (Eka) Kldiashvili

Georgian Telemedicine Union (Association), Georgia

Introduction

“Grid” computing has emerged as an important new field, distinguished from conventional distributed computing by its focus on large-scale resource sharing, innovative applications, and, in some cases, high-performance orientation. Grid computing is increasingly being viewed as the next phase of distributed computing. Built on pervasive Internet standards, Grid computing enables organizations to share computing and information resources across department and organizational boundaries in a secure, highly efficient manner. Organizations around the world are utilizing Grid computing today for a whole host of different applications such as collaborative scientific research, drug discovery, financial risk analysis, product design, etc. Grid computing enables, for example, research-oriented organizations to solve problems that were infeasible to solve due to computing and data-integration constraints. Grids also reduce costs through automation and improved IT resource utilization. Finally, Grid computing can increase an organization's agility enabling more efficient business processes and greater responsiveness to change. Over time Grid computing will enable a more flexible, efficient and utility-like global computing infrastructure. From its inception, the goal of telemedicine has been to overcome the time and distance barriers that separate the caregiver from the patient. Widespread adoption of the technology has been hampered by a number of technological, regulatory and other barriers. Innovations such as computer-based patient records, remote consultations, clinical information systems, computer-based decision support tools, mobile and wireless terminals, community health information networks, and new ways of distributing health information to professionals and consumers are supported by, and in some cases reliant on, the widespread use of networked telemedicine technologies. Grid technology acquires more importance today. The main advantage of application of Grid technology for eHealth is the new and effective opportunities for establishment and creation of eHealth networks as well as of implementation of clinical information systems and databases.

Objective of the Manuscript

The proposed publication will present a new model of Advanced Grid Technologies, Systems and Services to implement a new model of Virtual Organization for healthcare support. eHealth faces a growing need for large computations, pre-operative planning, medical interventions simulation, the building of anatomical and physiological models, surgery support in real time, etc., all of which could be successfully implemented through Grid technology. This publication aims to describe completed and ongoing research eHealth projects and activities in this field. It is planned to present Data/Information/Knowledge Grids as well as Collaborative Grids. Special emphasis will be placed on the following topics: clinical information system; distribution of computational resources; ensuring image processing algorithm's accessibility; combining image data with other medical data, facilitating data access; bringing affordable solutions to respond to real problems in healthcare. Special attention will be paid to the following areas: ePharmacology, eImaging, eClinic and eLearning. Emphasis will be placed on presentation of: organization of clinical information system; timely and secure access of patient data; interoperability of medical databases of heterogenous content; computing intensive applications and knowledge discovery, eDiagnosis, Virtual Epidemiology.

Target Audience

The target audiences for the present publication are: healthcare professionals, eHealth and telemedicine specialists and researchers, IT specialists, healthcare authorities and managers.

Recommended topics include, but are not limited to the following:

· Clinical information system
· Clinical diagnosis
· Medical databases
· eLearning
· Simulation
· eHealth networks
· Standardization
· Virtual Epidemiology

Submission Procedure

Researcher and practitioners are invited to submit on or before October 31, 2008 a 2-3 page chapter proposal clearly explaining the mission and concerns of his or her proposed chapter. Authors of accepted proposals will be notified by November 30, 2008 about the status of their proposals and sent chapter guidelines. Full chapters are expected to be submitted by February 28, 2009 . All submitted chapters will be reviewed on a double-blind review basis. This book is scheduled to be published by IGI Global (formerly Idea Group Inc.), publisher of the “Information Science Reference” (formerly Idea Group Reference) and “Medical Information Science Reference” imprints. For additional information regarding the publisher, please visit www.igi-global.com .

Inquiries and submissions can be forwarded electronically (Word document) to:

Ekaterina (Eka) Kldiashvili, Ph.D.     (Executive Director)
Georgian Telemedicine Union (Association)
75 Kostava str., 0171 Tbilisi , Georgia

Email: grid_technologies_for_ehealth@yahoo.com
Blog: www.gridtechnologiesfore-health.blogspot.com
WEB Site : http://georgia.telepathology.org

Home Telemonitoring for Chronic Disease
A Case Study of Resurrection Home Health Services, and Conclusions

Source: TIE - Telemedicine Information Exchange    ( http://tie.telemed.org/ )
Apr 2008
By Kevin Cassin

Introduction

Congestive heart failure (CHF) and the home use of telemonitoring equipment is an area that has recently been explored in an effort to control the cost of chronic disease ( Kinsella, 1998 ; Knox and Mischke, 1999 ). The advent of modern communication and adaptation of computer equipment has now made it possible to equip almost any home with devices that will record and report a patient's daily temperature, heart rate and blood pressure ( Schneider, 2004 ). Collectively known as vital signs (VS), this information can then be transmitted automatically to a central reporting station that is attended by clinical personnel such as a registered nurse (RN). Add to this the customization possible with these devices; they can be fitted with oxygen sensors (O2 SAT), prothrombin time and international normalized ratio (PT/INR) coagulation meters or glucose monitors. The ability of a clinician to triage a patient from a distance has come into fruition ( HomMed Company Brookfield, 2005 ).

Recent studies by healthcare providers have demonstrated the effectiveness of home monitoring in controlling length of stay (LOS) and rehospitalization costs with CHF populations ( Knox and Mischke, 1999 ; Schneider, 2004 ). Yet universal acceptance or expectation of telemonitoring use has lagged behind in many home health agencies due to cost and the high tech nature of these devices ( Kinsella, 1998 ). In the case of Resurrection Home Health Services (RHHS) , deployment of a telemonitoring system was a planned initiative first researched in 2005 (R. Prosser, personal communication, March 9, 2007). Using a grant received from the Retirement Research Foundation the implementation of this program was seeded in April, 2006 ( Prosser and Watson, 2005 ).

The HomMed telemonitor , used at RHHS, is a standardized unit that records VS, O2 SATS and weight. It also allows patients to key in answers to yes and no questions specific to their diagnosis. While commonly used with CHF populations, equipment changes allow for deployment within many different diagnostic groups. Diagnostic pathways exist not only for chronic disease such as CHF but also other types of ailments like asthma, diabetes or irregular heart beat ( HomMed Company Brookfield, 2005 ). At RHHS the telemonitor has been employed when CHF is the first or second diagnostic criteria. (read more....)

EC has published the "TeleHealth2007 Conference" Report

17 Mar 2008

The European Commission's Information Society and Media Directorate General published the report of the TeleHealth2007 conference. This conference provided a first overview and introduction to all the reasons why the European Commission is beginning to explore the possibilities for a future action plan for Europe on telemedicine. It would be published in the context of a Commission Communication. Whereas it is understood that the organisation of healthcare is solely an issue for each Member State itself, telemedicine services have the potential to be used in cross-border settings. Indeed, as this conference showed, they are already being used in many cross-border contexts. The European Commission has a specific mandate to address those cross-border care issues which cannot be dealt with on a national basis alone. The overall objective of such a Communication proposal would be to support wider deployment of telemedicine services, with a particular focus on cross-border settings. Thus, the main aim would be to encourage or enable Member States, according to their specific needs, to take advantage of the potential benefits of telemedicine. A second aim of the proposed Communication would be to encourage the Member States to deal with, as a common dilemma, important challenges in cross-border care that are associated with the practice of telemedicine. The Communication would be likely to propose specific actions that meet the overall objective. A set of next steps will be facilitated by the European Commission. It will include an assessment of the prospective rationale of such a Communication, its main focus, its key messages, the extent to which it is an 'information-related' style of Communication or an 'action-oriented' Communication; and, if the latter, a coverage of its potential action points. These could, for example, be in areas such as infrastructure, interoperability, procurement of innovative services, legal issues particularly relating to liability, market issues particularly relating to certification and labelling and, last but not least, assessment, evaluation, and education challenges.

The immediate steps in the proposed calendar include:

• April 2008 : A workshop which, it is proposed will be smaller in size than the December 11, 2007 conference and will focus on the involvement and interest of European industry.
• May 2008 : Dedicated sessions to be held at the proposed eHealth 2008 high-level conference on eHealth to be held in Slovenia in May 6-8, 2008 and which will focus on discussions with policy-makers. Attendance by invitation only.
• October 2008 : The actual policy document ("Communication") on the provisionally-entitled "telemedicine and innovative solutions for chronic disease management" to be published under the umbrella of the French Presidency of the European Union.
• Winter 2008-2009 : The policy document to be discussed at a later stage in the various Councils.

Download TeleHealth2007 Conference Report (.pdf, 660 KB)

Today's advanced Teleassistance

Source:  ATTENTIANET project (eTEN)
( http://www.attentianet.eu/index.html )

Demographic changes are occurring in Europe, people are living longer, it's a process known as population ageing. A key concern of an ageing population is the welfare of the increasing numbers of elderly living alone in their homes. The Teleassistance concept had initiated as ‘home teleassistance' to provide on-demand, cost-effective, efficient and high quality health care to the home.

Governments prediction that the proportion of elder people rise from the current 16.2 per cent to 20 per cent in 2010. By 2050, if current trends continue, Europe will have a problem with old people. Nowadays, the vast majority of old people live with family or in their own home. But, as living habits change and young working couples move away from home earlier, an increasing proportion of the elderly are living alone. As a result, residential care for the elderly is growing in popularity and in more cases, this may involve the elderly having to sell their home to pay for their own care  (read more....)

A TELEHEALTH@Listserv “TeleDerm” Interview (from US to Austria)

An interview with Dr Cesare Massone, MD, of “telederm.org” , Austria.
(mail: cme.dermoscopy@meduni-graz.at )

Interviewer: Bob Pyke Jr. ( repyke@infionline.net )

Summary: Discussion about “telederm.org”, a DermOnline community and teleconsultation service

by Department of Informatics and Telemedicine of Donetsk R&D Instititue of Traumatology and Orthopedics
Donetsk, Ukraine 
March 2007

Background
The increasing of quality of treatment for traumatized and polytraumatized patients is one of the most important problems in modern medicine.  Due to telemedicine not only the doctor or the staff of the local Hospital are concerned with treatment of the patient of the patient, but also the "collective intellect" of all physicians worlwide.  

Read the related pdf document

Source: Federal Telemedicine News ( www.federaltelemedicine.com )

Date: December 4, 2006

By: Carolyn Bloch , Editor

UTMB at Galveston with a matching grant of $500,000 is installing video conferencing equipment to provide adolescent behavioral health services to the Galveston Independent School District. The grants awarded through the Robert Wood Johnston Foundation's Local Initiative Funding Partners (LIFP) program are matched in funds from six Galveston and Houston foundations. The telepsychiatry project is one of only 12 projects funded this year out of a national pool of 219 applications to the LIFP.

According to Dr. Christopher Thomas, UTMB Professor of Psychiatry and Behavioral Science and the consulting psychiatrist on the project “the project team expects the new psychiatric services to reduce rates of drug use and violent behavior in the schools by diagnosing and treating depression, anxiety, eating disorders, ADHD, and other behavioral problems.

In addition, the Center for Health and Technology (CHT) at the UC Davis Health System has a program that provides video consultations in psychiatry in rural communities. The UC Davis Health system and the Northern Sierra Rural Health Network have collaborated on a project in rural Northeastern California funded by the California Endowment. In a three year period, 10 rural sites used screening instruments to help treat multiple disorders such as depression, alcoholism, and anxiety disorders and to learn how to collect basic outcome measures for depression at regular intervals in concert with telepsychiatric consultations and on-site therapy visits.

In another CHT project, telepsychiatry was proven to be effective in treating depression and improve outcomes. In this study, a disease management module using the telephone and self reporting questionnaires was done along with repeated televideo psychiatric consultations.

The Center found out that video conferencing can be used effectively to respond to disasters and possible bioterrorism attacks. In an event of this type, help will be needed in rural areas, both from psychiatrists and other physicians and could best be delivered electronically via the internet in short courses using “just in time” training approaches.

With funding provided by the California Telemedicine & eHealth Center (CTEC), the Kings View Corporation set up six fully equipped spoke sites within the Central Valley to provide telepsychiatry services using high quality audiovisual systems. So far more than 452 telepsychiatry sessions have been provided, along with eight hours of hands-on telemedicine training.

The Medical University of South Carolina with AHRQ funding, has clinicians scheduling telephone calls to provide routine psychiatric medication management. This method is being examined as to whether this method can be effective in treating specific disorders such as PTSD, depression, panic disorders, and schizophrenia.

Two VA medical centers are participating in this study and have enrolled 346 psychiatrically stable subjects. The patients receiving routine care see their psychiatric medication provider at the recommended intervals, but the patients that are scheduled to receive telephone care are scheduled to see their provider at twice the recommended clinic visit interval. The VA is looking at the program in terms of outcomes, costs, patient satisfaction, medication compliance, and diagnosis specific outcomes.

Source: EC-IST Results
Date: October 2006

Improving awareness of e-health and telemedicine technologies in EU pre-Accession countries has forged links between the EU's Newly Associated States (NAS) and ‘older' members that remain strong today. (more)

Published by: Association of Telehealth Service Providers www.astp.org
Source: Federal Telemedicine News
Date: 5th September, 2006

Researchers at Temple University in Philadelphia with grant support from the Pennsylvania Department of Health are trying to see if telemedicine can be used to accomplish a significant decrease in cardiovascular disease (CVD) risk factors in underserved inner city and rural populations by addressing the higher prevalence and discrepancies in treatments for these underserved populations. (more)

New Japanese Study Examines Feasibility of International Fetal Telemedicine System

From: ATSP - Association of Telehealth Service Providers On-Line (www.atsp.org)   Source: Japan Corporate News,
Date: February 20, 2006

Nippon Telegraph and Telephone Corporation (NTT) and the National Center for Child Health and Development (NCCHD) in Japan will test the feasibility of transmitting digitalized fetal medical images (including 3-dimensional ultrasound as well as fetoscopic images) between the US and Japan. The purpose is to implement the telediagnosis and prospective telesurgical treatment of fetal diseases on a global scale in the hope of breaking the sharp decline in the Japanese birth rate (read more...)

Medical Records Institute’s Seventh Annual Survey of Electronic Health Record Trends and Usage for 2005

The results of the MRI Survey of EHR Trends and Usage are displayed on this web site for you to review and refer to at no cost. A total of 438 individuals responded to the survey. However, to increase relevancy and reduce bias, responses from vendors, consultants, and payers are not included in the results. Therefore, the results that follow include only provider responses with a total database size of 280. The data includes responses from April 7th through May 18th, 2005. The EHR Survey includes the results from all sixteen questions in the survey, including the first four demographic questions.
(pdf file)

2005: A Developmental Model for Rural Telepsychiatry

Telepsychiatry represents a promising means to increase access to care for rural American Indian communities. This article describes rural telepsychiatry clinics operated by the American Indian and Alaska Native Programs at the University of Colorado Health Sciences Center through a partnership with the Department of Veterans Affairs, the Indian Health Service, and local tribal health services that target American Indian veterans with posttraumatic stress disorder. A six-stage model for developing such services is presented. The model consists of needs identification, infrastructure survey, partnership organization, structure configuration, pilot implementation, and solidification. This article traces program development, presents challenges in implementing these services, and offers potential solutions. The model can guide the development of telepsychiatry services for American Indians specifically and rural populations in general.

(full Article under subscription here)

by: Dr. Jayanth G. Paraki
Source: TeleHealth (www.telehealth.net)
Date: 15 June 2001

The occurrence of natural disasters like the recent earthquake disaster at Bhuj, Gujarat, India offers an opportunity to provide health, education and rehabilitation services of a high quality to the affected victims and families. An attempt is being made to integrate holistic health services and Telemedicine to provide low cost effective services to the affected victims and their families. The project has challenges, difficulties and many unexpected problems. However networking, team effort and a co-operative spirit combined with professional expertise and management will make this project successful. (more...)