Professional Documents
Culture Documents
available in Romania.
This paper presents the concept, structure of a pilot model
for a regional medical telecenters network, based on TELMES
platform, for the implementation of complex medical
teleservices applications for GPs and patients. This TELMES
network also includes the capability for transmission and
acquisition of medical records and remotely updating the
medical regional database developed within the project.
II. CONCEPT
The TELMES project proposes to develop a pilot
multimedia network, with integrated teleservices for the
medical area, using the most recent IT&C technologies.
These teleservices should help optimize the medical
decisions to increasing of quality, with the decreasing of
costs for the medical act, and also the expanding of the
services range in the healthcare, by introducing medical
teleservices.
A telemedicine system can be divided into three
different components:
People - Telehealth Users & Providers at remote
and main location(s): health care providers, patients,
communities, researchers and health administrators.
Telehealth Application Technology at remote and
main location(s): hardware, software and peripheral devices.
Telecommunications and Network Links between
remote and main location(s): plain old telephone systems,
dial-up digital telephone lines, asynchronous transfer
modes, Internet and virtual private networks.
The proposed project enables to design a secure
multimedia transmission (medical telemetry, digital images,
video, and text) and a secure medical records acquisition
system in order to enhance the telemedical consultancy
services. The main objective of this project is to enable
personalized teleservices delivery and patient safety
enhancement based on an earlier diagnosis with medical
telemetry using and images, video, text transmissions, and also
applying the suitable treatment according to the remote
medical experts recommendations.
The TELMES project
intends to enable a diverse medical staff to provide complex
medical teleservices; this could be done due to a regional
telecenters network.
Therefore the complex medical
teleservices could enroll for the positive trend in Romania, for
using the ITC technologies in the field of the public services
(e-commerce, e-government, e-health, etc.).
I. INTRODUCTION
A. Main Objectives
The TELMES project has the following main objectives:
To develop a scalable medical telecenters network, in
order to provide the complex telemedicine services;
23
a) Medical telecenters
A medical telecenter there is an entity with the following
functions:
Hosting a local server to assure the users access to the
network;
Hosting the medical regional database;
Hosting software applications used for telemedical
services;
Hosting
software
applications
used
for
information/training services;
Has implemented applications to ensure the security of
personal user information;
Ensures the connectivity with other regional telecenters,
within the TELMES network.
3) Teleconsulting
A family doctor that will perform a teleconsult will be able
to register all information inside patient records. Also a
diagnostic or treatment can be established so that the patient
will be sent to other medical institutions that will have access
24
5) Medical procedures
TELMES database contains the standard set of medical
procedures as stated in International Classification of
Diseases and Health Problems CIM-10-MA) used both in
public and private health institutions.
Beside data
management, a regional and national database has the
responsibility of defining and managing:
Access rights. Users of the system have restricted access
in order to assure data confidentiality of the patient.
Data integrity and security. Health services provided
contains several confidential information.
IV. APPLICATIONS
From user point of view, TELMES project is addressing
especially to the segment of generalist medicines in order to
allow:
Access to the qualified information, by direct cooperation
with specialized medicines;
Efficient management of the chronic ills;
Covering the rural and remote areas.
We are considering that making of such tool available for
the GP or for a doctor placed in a rural environment covering
a large area, allowing him to call for a group of experts by
means of a telecenter, and without need to move the patients,
sometimes on hundreds of kilometers away, is a real gain for
the medical practice in this field.
Further, we present applications that were experienced still
now:
B. Telemonitoring Services
Telemonitoring service represents a set of activities
necessary for planning and deployment of medical
telemonitoring
applications.
Medical
telemonitoring
application represents the transposition of distance medical
monitoring activities, through a dedicated communication
network. Telemonitoring system must comply with the
interoperability principle: anytime, anywhere, by anyone
which is authorized and in any manner.
Within a TELMES platform we develop two telemonitoring
models.
A. Teleconsultation Services
Teleconsultation - remote discussion of the concrete
clinical case for the answer to precisely formulated questions
for the help in acceptance of the clinical decision.
We want to introduce two types teleconsultation: off-line
and on-line.
Off-line teleconsultation comprise a type of remote
consultations not involving real time network
communication (video, chat etc.). Consulting and
inquiring physicians exchange information via email,
FTP-servers, Internet forums. This type of
teleconsultation is used for routine medical practice.
25
ACKNOWLEDGEMENT
This work is supported by a grant from the Romanian
Ministry of Education and Research, within CEEX
programmer
(www.mct-excelenta.ro),
contract
No.
26/10.10.2005.
REFERENCES
[1]
[2]
[3]
[4]
[5]
26
[6]
[7]
[8]
[9]
[10]
[11]
[12]
[13]
27