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Med-e-Tel 2009 – opening session, part 2 April 1, 2009

Posted by peterjmurray in conference, Europe, health informatics.
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The second part of the opening morning featured a series of seven short presentations. The first speaker, Gerard Comyn, from the European Commission, spoke about European Commission policy initiatives on telemedicine, under the title ‘Telemedicine for the benefit of patients, healthcare systems and society’. He mentioned a joint initiative between his directorate and DG SANCO. he sees telemedicine as part of medicine and believes it should be part of normal medical training – he sees separating medicine and telemedicine a a trap we should not fall into. he says many people, especially doctors, are not convinced by the benefits of telemedicine – one of the objectives of the Commission will be to provide the scientific evidence for benefits. He sees potential for growth in telemedicine market of 19% per annum, from 4.7 to 11.2 billion Euro between 2007 and 2012.

Telemedicine in Europe has, so far, been mainly regional pilots, but there is no real national deployment anywhere in Europe. There are currently legal barriers (national regulations), which are the main barriers to telemedicine use, and often attitudinal barriers due to perceived lack of scientific evidence of benefit. There is not, though a single ‘telemedicine’, and different people mean different things, so there are many ‘telemedicines’ – can we have one legal environment to cover many different delivery/interaction methods? Specific services may have specific issues/problems, eg comparison of telemonitoring of patients at home, versus teleophthalmology services involving remote interpretation of health tests (the latter a ‘telecommerce’ transaction between two partners, which is different from telemonitoring). There is now a Telemedicine Communication aimed at supporting integration of services enabling patients to get benefits, and to provide a consistent approach across Europe for the benefit of the mobile patent. There are principles of trust (building confidence and acceptance of telemedicine services, through collection of good practice examples, and aimed at providing evidence from large scale pilots); developing legal clarity, encouraging national legal frameworks to support telemedicine use, as well as developing consensus among Member States; and facilitating market development, through encouraging international interoperability for functionality of telemedicine systems.

Marco Obiso, from the International Telecommunication Union (ITU), spoke on ‘Implementing eHealth in developing countries: principles and strategies’. He spoke about ITU focus in eHealth activities, and has developed a strategy to assist developing countries at national levels, including providing tools for development of eHealth strategies, promoting co-operation among stakeholders, and facilitating information exchange, sharing knowledge on best practices, etc. An ITU-WHO scoping study report has been produced, and guidelines have been developed for identifying needs, and developing local strategies. Another initiative has been the mHealth initiative, seen by many as potential ‘killer application’ in many areas, to promote co-ordinated introduction of effective mHealth in developing countries.

Michael Nerlich began his talk by discussing global inequities in health, which are killing people on a grand scale, through social injustice combined with health inequity, resulting in a toxic combination of effects. National health does not equate to national wealth. While evidence and standard guidelines for medicine are good and can save money and patients’ lives, they can takes at least 10-15 years to be implemented on a wide scale. We currently have ‘industrialisation’ of healthcare and medicine, and assembly-line type treatment, and often do not have individualised care. Currently the doctor-patient relationship is under strain; there is growing need to take account of better informed patients, through ‘pHealth’ or personalised health.

Claudia Bartz, from the International Council of Nurses (ICN), spoke on ‘Telenursing and global health’. She described ICN as a federation of 133 national nursing organisations, which aims to bring nursing together worldwide, with an ICN Code of Ethics and programmes in leader development through the ‘Global Nursing Leadership Network’. ICN Telenursing network will be launched at the ICN Congress in Durban, South Africa in JUne 2009, and several other specialist networks exist. She says that telenursing may test traditional licensure boundaries, due to many nurses currently being licensed in their own countries or areas within countries.

Yunkap Kwankam, previously with WHO and now ISfTeH Executive Director, spoke on ‘The Rockefeller Foundation eHealth Initiative for the Global South’. He spoke about the Bellagio conferences of 2008 on eHealth connections, which focused on existing collaborations and looking to develop new collaborations. Among the major challenges are capacity building to deliver telehealth programmes; there is a shortage of 4M health workers worldwide, which does not take account of shortages in ICT capabilities. Interoperable eHealth systems are needed, as well as supporting development of educational tools and programmes. Rockefeller is looking at development of networks of networks, and collaborations.

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