trieste 1/4/2011 alessandro taddei 1 ict for collaborative health care in the mediterranean area...

Trieste 1/4/2011 Alessandro Taddei 1

ICT ICT for collaborative health care for collaborative health care

in the Mediterranean areain the Mediterranean area

Alessandro Taddei

DIT 108La, Lions Club Pescia

National Research Council of Italy

Alessandro Taddei

DIT 108La, Lions Club Pescia

National Research Council of Italy


TelemedicineTelemedicine

Information and Communication Information and Communication TechnologyTechnology

allowing collaborative health careallowing collaborative health care

“ “anywhere - anytime”anywhere - anytime”

Tele-diagnosis, Tele-monitoring, Tele-assistance, …Tele-diagnosis, Tele-monitoring, Tele-assistance, …

Developing telemedicine networks Developing telemedicine networks for international multi-center cooperation for international multi-center cooperation

in medical decision making and care planningin medical decision making and care planning


Off-line tele-consultingOff-line tele-consultingMedical Image Standard

(DICOM)

PACS technology

Exchange of multimodal diagnostic examinations

(US, XA, RX, CT, MR, …)

“STORE-and-FORWARD”• Transmitting DICOM images

through network (Internet)• 2nd opinion review from

reference specialized clinical center

RX

Angio

TAC

Ecocardio

Open-source technologyDICOM server www.dcm4che.org/ DICOM viewer/processor www.osirix-viewer.com/


Live tele-consultingLive tele-consultingNeed for real-time interaction

between operators and specialists

is often crucial during imaging examination

for scanning of anatomy

Tele-echocardiography

is the typical application


Tele-consulting for early diagnosis Tele-consulting for early diagnosis of congenital heart malformationsof congenital heart malformations• Today echography equipment allow to recognize

cardiac abnormalities, even in the foetus• Actually less than 20% of diseases are detected in the

prenatal period because often experience and training are not adequate

• Thus newborns, suffering by critical cardiac disorders, are often transferred urgently to specialized and remote cardiac units while early care planning, before delivery, would limit both risks and costs


Collaborative Diagnosis and Care of Collaborative Diagnosis and Care of Congenital Heart MalformationsCongenital Heart Malformations

Project by Heart Hospital of CNR / Tuscany Region “G. Monasterio” Project by Heart Hospital of CNR / Tuscany Region “G. Monasterio” Foundation, supported by “Un Cuore un Mondo” Association” and Tuscany Foundation, supported by “Un Cuore un Mondo” Association” and Tuscany

Region, for medical cooperation with Balkan CountriesRegion, for medical cooperation with Balkan Countries

2008-2009 “Progetto per il cuore dei bambini dei Balcani” Clinical Centre, Banja Luka, BIH - Kantrida Pediatric Hospital, Rijeka, KR

2009-2010 “Progetto cuore Balcani / Albania”

Gynaecology University Hospital "Koco Glozheni", Tirana

Next projects (Bosnia, Montenegro …)


Cooperation issuesCooperation issuesDeveloping telemedicine network for both• collaborative diagnosis and care planning of

heart malformations by tele-echocardiography• training of remote health care teams by

videoconferencing

Supporting local organizations for improving health care of congenital heart diseases

Supporting patient transfers to specialized centers for surgery intervention


Live Tele-consultingLive Tele-consulting

Upload Internet bandwidth > 512 Kbps

Videoconference equipment(25 fps, criptography)

audio

Video

INTERNET

Echo equipmentTele-consulting

Video

-


Tele-echocardiography Tele-echocardiography in neonates from Clinical Center in neonates from Clinical Center

Banja Luka (BIH)Banja Luka (BIH)

t


Tele-ecocardiographyTele-ecocardiographyfrom Pediatric Clinical Centerfrom Pediatric Clinical Center

Rijeka (KR)Rijeka (KR)


Fetal tele-echocardiography Fetal tele-echocardiography from Gynecology Hospitalfrom Gynecology Hospital

Tirana (AL)Tirana (AL)


Open-Source solutionOpen-Source solutionfor low-cost medical tele-consultingfor low-cost medical tele-consulting

Video streaming on-line teleconsulting

INTERNET

DICOM data transfer

Workstation at remote specialized center

Workstation at diagnostic examination site

PACS


Open-Source Open-Source Tele-consulting SystemTele-consulting System

•ON-LINE teleconsulting (live session)

•OFF-LINE teleconsulting (Storage/Forward)

DICOM not DICOM (archived studies)

•videoconferencing for on-line interaction

•web-based user interface over Internet (reserved access by data encryption)

•ON-LINE teleconsulting (live session)

•OFF-LINE teleconsulting (Storage/Forward)

DICOM not DICOM (archived studies)

•videoconferencing for on-line interaction

•web-based user interface over Internet (reserved access by data encryption)


ConclusionsConclusions• ICT & medical standards allow implementation of

tele-consulting systems for collaborative diagnosis and care planning of medical pathologies

• Tele-echocardiography was applied successfully in the project for clinical cooperation with Balkan Countries in heart malformations

• Low-cost technology (open-source) solutions for tele-consulting (live, off-line) are challenging for promoting diffusion anywhere, potentially in any medical field


• While technology offers affordable solutions for collaborative medical decision making, it is crucial to set up projects for collaboration between health-care institutions

• Given their international and distributed organization, the Lions have a potential rolethe Lions have a potential role in promoting and supporting important initiatives for collaborative health-care along the path to integration of Countries

ConclusionsConclusions

trieste 1/4/2011 alessandro taddei 1 ict for collaborative health care in the mediterranean area...

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