Dr. Dirk Peek, ISfTeH member from The Netherlands, was recently rewarded as one of the "Care Heroes 2019" by the Dutch Ministry of Health. He received the award for his Ambulance-Based Telemedicine System which was developed in collaboration with DXC-Technology.

 

In this project a voice-communication system, a tablet and a high-definition digital camera were installed in the ambulances. Real-time vital data such as blood pressure, ECG, pulse, saturation, capnogram were transmitted to the hospital physicians who supervised the transport of the patient. The data were directly captured from the vital signs monitor present in the ambulance and sent in one batch together with live video images to the hospital.  With this direct live transmission, advise could be given to the paramedic at the scene. This enabled  remote and preliminary diagnosis and informed the emergency room to which the patient was transported. Medical experts were virtually on board and supervised the patient remotely. Because the patient had been observed in the ambulance, the ER was informed about the clinical status of the patient and received advice about the need for a surgeon, anesthesiologist or cardiologist to be present or for the need to prepare the OR, or the Intensive Care Unit. The system has already passed the stages of  Technical Proof of Concept and Medical Proof of Concept.

 

Dr. Peek is looking for partners for implementation of this telemedicine system in practice. He can offer a complete roadmap, including a positive business case on neurology and cardiology, a technical roadmap for the ICT infrastructure, training of personnel, and more. Opportunities are scalability on either a national or on an international platform. The  scope can be extended to include a  connection with an electronic patient record system to store the collected vital data and video-images. The system is mobile enabled, cloud based, secure and GDPR compliant.

 

For further information, contact Dirk Peek at info@teso-telemedicine.com or telemedicinesolutions01@gmail.com or see www.teso-telemedicine.com.

The Millennia2025 Foundation (ISfTeH member) develops a new Foresight Exercice 2020-2025: Millennia2025 digintelles, "Collective intelligence and digital skills as drivers for empowerment."

As we are more and more solicited or surrounded by Artificial Intelligence, we must learn to master its technologies in order to enjoy them freely. In this environment that helps or overwhelms us, what about Collective Intelligence? How to re-value the human being and transmit skills with digital tools in solidarity? These concerns are the objective of digintelles, the new foresight exercise of the Millennia2025 Women and Innovation Foundation.

The Millennia2025 digintelles statement is now valued by the UN Secretary General, published, translated and circulated by UN ECOSOC for the UN Women CSW54 in March 2020: undocs.org/pdf?symbol=fr/E/CN.6/2020/NGO/199.

To participate in digintelles, we ask you to answer 7 + 1 questions online: it takes just a few minutes, and your testimony will be included in our analysis and we will make recommendations to decision makers.
 
The objectives of digintelles are available at millennia2025-foundation.org/objectifs_en.html. The response form is at millennia2025-foundation.org/votre-contribution_en.html.
 
Share this call, present digintelles to your colleagues, your students, your associations, your networks and mobilize them for this survey: we must collect a maximum of answers at all levels. To help you explain digintelles, you can use this short video presentation (FR+EN): millennia2025-foundation.org/video_digintelles_en.html.
 
We are now in direct and active international contact with the United Nations Economic and Social Council (ECOSOC), UN Women, Commission on the Status of Women (CSW64) and therefore the "Beijing+25" celebrations including the "Equality Forum" in July 2020 in Paris: our resolutions will be integrated into those works.

 

The event takes place on 19-20 March 2020 in Lisbon (the Portugal eHealth Summit itself runs already from March 18th till March 20th). The Global Digital Health Partnership (a collaboration of governments and territories, government agencies and the World Health Organization, formed to support the effective implementation of digital health services) is also meeting in the margin of the Portugal eHealth Summit, making it truly an international meeting of the minds not to be missed.

 

Participate in this event to share your own digital health activities with ISfTeH members and a wider range of stakeholders, and to discuss possibilities for collaboration. The event will of course also be an excellent opportunity to witness firsthand what the Centro Nacional TeleSaude and SITT are doing in Portugal and which telemedicine and eHealth initiatives they are implementing. Program details will be announced soon and will be integrated into the Portugal eHealth Summit website. 

 

If you have any questions about the event, contact us at info@isfteh.org.

The 25th ISfTeH International Conference is scheduled to take place on October 8-10, 2020 in Takasaki, Japan. The meeting will be hosted and organized by the Japanese Telemedicine and Telecare Association - JTTA (national member for Japan in the ISfTeH) and held in conjunction with JTTA's 24th Annual Academic Conference.

 

Abstract submissions (for presentation at the conference) can be done via the submission system, to which you can find a link here. Deadline for submission is June 30, 2020. 

 

If you have any questions about the event, contact us at info@isfteh.org. There are sponsorship opportunities available. If this is of interest, also contact us at info@isfteh.org for more details.

ISfTeH Board Member and Coordinator of the ISfTeH Francophonie Working Group, Philippe De Lorme, recently attended the SFSD annual conference in Paris, along with 400 other participants. The SFSD is the French Society of Digital Health (formerly SFT, French Society of Telemedicine). The event saw the launch of the Digital Medical University ( UMD - Université Médicale Digitale) with its international masters degree. The event also featured an international benchmark session involving Morocco, Tunisia, Ivory Coast, Senegal, and the Caribbean Island of Saint Martin, dealing with "digital health apps".

 

Philippe De Lorme was also present at the 1st congress of SITELEMED (the Ivory Coast Telemedicine Society), gathering 200 people in Bouake and Yamoussoukro, which has allowed to WG to stengthen its links and collaboration with African countries.

 

And last December, under the auspices of the National Medical Academy in Paris, the Francophone Telemedicine Academy has awarded the Global Telemedicine Prize to a medical concierge app. The Academy was set up in 2018 by Ghislaine Alajouanine (President) and aims to reinforce the Francophone presence in digital health.

 

The ISfTeH Francophonie WG is now working towards the next meeting of the International Organization of the Francophonie in Tunisia in December 2020 and proposes a focus on "digital health training and skills."

The editorial of Vol. 8 (2020) of the Journal of the International Society for Telemedicine & eHealth is now available. Editors Richard Scott and Maurice Mars reflect on how " eHealth - influencing behaviour change more, and more, ... and more." 

 

A large number of papers are under review for publication in Vol. 8 of the Journal in the coming weeks and months. Your paper submissions are continuously welcome here.

PlatformUptake.eu, an EU-funded project that started earlier this month, seeks to deliver an inventory of the state of the art and analyse the use of open service platforms in the active and healthy ageing (AHA) domain, covering both open platforms - such as UniversAAL, FIWARE, and partly-open/proprietary platforms developed by industry.

 

If you are a provider or developer of such open service platforms, or of active, healthy and assisted living (AHA/AAL) solutions and applications that are built on such platforms, and if you would like to know more or get involved in the project's activities and events, get in touch with office@platformuptake.eu or find out more at www.platformuptake.eu (website will be online in the next week).

Last November, Prof. Louis Lareng passed away at the age of 96. Prof. Lareng was at the origin of the ISfTeH and of telemedicine developments in France and worldwide.

 

As pioneer of the emergency departments in France, he was the creator of the Emergency Medical Service "SAMU" in 1967 and continued to advocate for the legal recognition of this organization by law, which finally happened in 1992. Prof. Lareng was also founder of the University Paul Sabatier in Toulouse, and recognized as Professor Emeritus from 1992. It is at that time that he takes up the cause for telemedicine, a virtually unknown discipline in France in those days, which he will bring to the highest political levels.

 

In his region of Midi-Pyrénées, at first with the Public Interest Group 'Telemedicine Network' (Groupement d'Intérêt Public (GIP) Réseau de Télémédecine) in 2003 and then through various responsibilities up until the administration of the Health Cooperation Group 'Telehealth Midi-Pyrénées' (Groupement de Coopération Sanitaire (GCS) Télésanté Midi-Pyrénées) since March 2011, Louis Lareng implemented telemedicine and telehealth, and ensured the best possible applications.

 

The creation of the European Institute of Telemedicine, of which he was the Director, and of the European Society of Telemedicine and eHealth, of which he was the President, allowed him to make his work and realizations known throughout France and beyond the French borders. He was one of the founding members in 1997 of the International Society for Telemedicine (ISfT) and a member of the board of this same society - which in the meantime had become the International Society for Telemedicine & eHealth (ISfTeH) - from 2007 till 2009.

 

The ISfTeH honoured him in 2012 with a special award for his entire lifetime achievements. This 'ISfTeH Lifetime Achievement Award' now carries his name and has, in the meantime, already been bestowed upon other telemedicine pioneers and visionaries, and will continue to be awarded to others in the future, carrying forward the legacy of Louis Lareng!

 

Read the full tribute to Prof. Lareng in the current issue of the JISfTeH. 

Modern. Technology. Global. Innovation. These words describe today's deeply interconnected world. The technology allowing us to easily connect to one another is developing so rapidly, the value of empathy and understanding one another is sometimes overlooked. Cultivating this understanding of others whether its cultures, personalities, and beliefs is becoming an essential element of everyday life. What happens then, when you place the combination of future-oriented attitudes, modern technology, and intercultural diversity into a traditional, rural environment?

 

We are pleased to invite you for research submission in preparation for publishing a special edition of the Bavarian Journal of Applied Sciences (JAS) organized by the Deggendorf Institute of Technology (DIT). This call for papers is inviting research works from various fields of applied sciences which must include an intercultural component. In this special edition, the journal is highlighting the European Campus Rottal-Inn - ECRI (ISfTeH member), one of the most interculturally diverse college campuses hosting 750 students hailing from almost 80 countries. This new academic institution is bringing an internationally diverse and globally inclined community into a rural Bavarian environment.

 

The journal's theme is "Inserting Modern Thoughts in Traditional Environments" and submissions from all over the world will be accepted, but they must feature an intercultural component to their research and should come from one of the five categories that are listed below.

 

The deadline for research manuscript submission is March 15, 2020. Use this link to submit. Refer to the submission guidelines on the Bavarian Journal of Applied Sciences page (JAS).

 

Submitted research will undergo a double-blind peer review process. Accepted research will be published in the special edition of the JAS in both printed and electronic form. 

 

The topics of this journal edition include:

• Tourism
• Health/Medical
• Informatics
• Engineering
• Sustainable Buildings

ISfTeH Executive Director, Yunkap Kwankam, was a guest speaker at the recent Asia Telemedicine Symposium held in Manila, Philippines. The Asia Telemedicine Symposium is an annual meeting organized since 2007 by the Telemedicine Development Center of Asia (TEMDEC) that aims to establish effective and consistent medical communications among Asian countries using super-fast internet and advanced technology.

 

Notwithstanding a typhoon, Yunkap Kwankam was able to deliver updates on international initiatives in telemedicine and digital health in general and about the ISfTeH network in particular to an audience composed of participants from several countries in the region and in the presence of Prof. Shuji Shimizu, Director of TEMDEC and Alvin Marcelo from the Asia eHealth Information Network and the Philippine Medical Informatics Society (the national member for the Philippines in the ISfTeH).

 

The event also served as inaugural international symposium of the Telemedicine Network of the Philippines led by Dr. Jeff Domino.

 

The program of the event is available here. If you'd like to establish contacts in the region, contact us at info@isfteh.org. 

 

The ISfTeH Telenursing Working Group currently has 165 active members worldwide. The goal of the group is to provide a forum for exchange of knowledge and experiences of nurses and others who are working with or supporting nurses using eHealth applications. More specifically:

• Technology:
• Advocate for increased use and evaluation of telehealth services by nurses.
• Stimulate innovative ideas and promote initiatives for further development of eHealth.
• Business:
• Support interdisciplinary telehealth collaboration for improved healthcare delivery and outcomes.
• Professional:
• Advance nurses' knowledge and skills in telehealth through dissemination of research findings, education programs, and practice guidelines.
• Advocate ethical use of telehealth services.

In 2019 the working group organized a webinar on the topic of "Telenursing in Advanced Practice Nursing" with presentations on "Hot Spots: Using Telehealth to Partner with Patients and Educate Students" (by Dr. Rebecca A. Bates) and on "Advanced Practice Telehealth Nursing: Practical Strategies and Remaining Questions" (by Dr. Patricia Camillo).

 

The group also was involved in the preparation of the Special Issue for Nurses and Midwives of the Journal of the International Society for Telemedicine and eHealth, in collaboration with the ISfTeH Working Group on Women (WoW) and with guest editors Claudia Bartz and Pirkko Kouri (ISfTeH Board Members, and Vice-Chairs of the Telenursing WG) and Veronique Thouvenot (Chair of the WG on Women). This special issue will mark the celebration of the year 2020 as the International Year of the Nurse and the Midwife. In 2020, WHO has decided to mark the important role of nurses and midwives in the past and the future, and it is also the celebration of 200 years since the birth of Florence Nightingale, the founder of modern nursing.

 

Claudia Bartz also participated in the World Health Assembly in May, the official event of the WHO, and is working towards strengthening our collaboration with the International Council of Nurses, the most important international organisation for nurses.

 

Our plans for 2020, include the celebration of the International Year for the Nurse and the Midwife, with the publication of the Special Issue of the JISfTeH, a spring and an autumn webinar, and other activities that will highlight the important role of nurses in telemedicine and eHealth.

Telemed Austria is the leading interest group for applied Telemedicine and eHealth solutions in Austria. Its focus is on implementation, distribution and funding of evidence-based innovations in the field. Telemed Austria combines academic knowledge and skills with practical support for the medical industry and associated stakeholders.

 

Telemed Austria was founded in 2014 as an independent organisation with the goal to improve the networking among stakeholders in the field of telemedicine especially between start-up companies and healthcare professionals. Therefore, the main contribution is knowledge generation and transfer about medical and health economy solution approaches of telemedicine and eHealth among stakeholders in healthcare, economy, science and politics.

 

Telemed Austria is a practice-oriented community of interests for all stakeholders in the Austrian healthcare system (health service providers, academic research, medical industry, system managers, patients) who want to improve the Austrian healthcare system so it is able to face the challenges of the 21st century through innovation in telemedicine.

 

The use of information and communication technologies is a fundamental part of healthcare and holds great potential in a wide variety of medical and therapeutic areas of applications. Health policy and health economics in Austria cope with demographic challenges. One of them is an upcoming retirement wave of physicians in 2025, when 55% of registered active physicians will leave the system. Additionally, the chances of telemedicine to handle other effects of demographic changes like the increasing number of chronic diseases and geriatric patients in the coming years, combined with rising health expenditure will make telemedicine solutions a vital part to ensure a stable healthcare provision. Especially geographically disadvantaged parts of the population can be better served via telemedicine. However, there are a multitude of challenges for the optimal development of the benefits and opportunities of telemedicine for health care, such as the reimbursement of telemedical services, the lack of uniform technical standards and user acceptance.

 

The increased needs-oriented and appropriate use of information and communication technologies in the Austrian healthcare system to improve the quality, affordability and accessibility of medical care for the Austrian population hence needs an independent structure to serve the needs of the population to ensure long-term medical care with regards to the challenges of demographic development and foreseeable personnel bottlenecks in the healthcare system.

 

Telemed Austria's activities for 2020 are:

• an annual national congress, starting with the 1st Telemedicine Congress at the Medical University of Innsbruck on 28th May 2020
• development of a telemedicine certificate for medical assistants and healthcare professionals
• an University course for medicine students in telemedicine
• publication of annual reports on the development status of telemedicine in Austria
• networking on a national and international level (incl. cooperation with partners in the DACH region).

More Information about Telemed Austria at www.telemedaustria.at (in German) or via info@telemedaustria.at.

The same will hold for clinical information on drugs patients have taken. Electronic Health Records (EHRs), eOrdering/ePrescribing or Clinical Decision Support Systems - all will become enabled such that the medicinal products taken by a patient or to be ordered for dispensation can be fully identified in any health situation and in any country which has adopted the IDMP standards and the codes, term lists etc. specified for their various data elements and attributes.

 

For more information, contact ISfTeH member Karl Stroetmann. 

More information at www.ndcentrum.cz.

The Congress " Health of Poles 2019" organized by the Institute of Physiology and Pathology of Hearing (ISfTeH member) took place in November '19 in Warsaw, Poland. Ministers, scientists, physicians, medical equipment manufacturers, representatives of science and business, as well as representatives of non-governmental organizations took up discussions on topics important for the health of Poles, incl. a panel on "Current possibilities of telemedicine and the level of its implementation in Poland." Problems related to the development of telemedicine in Poland were discussed. The session was chaired by Prof. Piotr Henryk Skarzynski (ISfTeH Board Member) and Prof. Ryszard Piotrowicz. The panel participants tried to answer the question whether telemedicine is a cure for health care problems.

 

The first issue raised was the lack of awareness among doctors and patients about the benefits of telemedicine. This concerns both the understanding of telemedicine and its role in the healthcare system. The talks also focused on the possibility of increasing the availability of telemedicine services in Poland. One should aim at overcoming digital barriers, which for some people, especially the elderly and the disabled, still constitute an obstacle or make it impossible to connect remotely with a medical professional.

The ISfTeH Teledermatology Working Group has compiled an initial list of dermoscopy websites. Dermoscopy images can easily be sent, along with clinical photos of patients' conditions, through the internet to experts to help members evaluate and manage their patients.

• dermoscopy.org
• dermoscopy-ids.org
• dermnetnz.org/topics/dermoscopy
• www.uptodate.com/contents/overview-of-dermoscopy
• dermlite.com
• www.pcds.org.uk/p/dermoscopy-purpose-of-dermoscopy-in-primary-care
• dermoscopedia.org/Glossary:Dermoscopy
• ncbi.nlm.nih.gov/pmc/articles/PMC5038095
• en.wikipedia.org/wiki/Dermatoscopy

Members of the ISfTeH community who have additional websites or links to articles on dermoscopy are encouraged to contact the ISfTeH Teledermatology Working Group at info@isfteh.org.

ISfTeH Telecardiology Working Group coordinator, Dr. Alexandru Mischie, reports on some of the highlights of his participation at the ESC Digital Summit. This was an initiative of the European Society of Cardiology, and took place in Tallin in October '19. The location was not chosen by accident, as Estonia has 99% of health data digitized and 99% of prescriptions are digital. Prof. Viigimaa exposed the architecture of the Estonian Electronic health system in a comprehensive presentation. Current organization of digital healthcare was reviewed by Prof. Martin Cowie in an excellentpresentation, where he highlighted that we need to identify barriers and find appropriate solutions for this emerging sector. We will always find at the center of our care the patient and his family, and this aspect should not be overlooked or forgotten, especially in this rapidly digitalized era.

 

Cybersecurity was a hot topic. Dr. Avi Fischer resumed some of the important cautions to take in reducing cybersecurity risks, such as:

• sharing responsibility between stakeholders-healthcare facilities, patients, providers, and manufacturers of medical devise;
• cybersecurity should be a priority during the design and development phase of the medical device and the issue should be addressed in a "Bolt-On to Integrated" fashion;
• if a vulnerability is found, communication and coordinated actions between stakeholders and healthcare facilities are vital. Development and involvement of government structures to assure security is very important.

The participants also expressed the urgent need for developing secured protocols to transmit data.

 

A special session dedicated to electronic medical records (EMR) can be accessed here . The consensus was that even though EMR are an efficient data base that can help health professionals in decision making, they is also time consuming. A new concept that consists on "less keyboard, more patient contact" should be adopted, because according to one study , for every hour physicians provide direct clinical face time to patients, nearly 2 additional hours is spent on EHR and desk work within the clinic day, and outside office hours, physicians spend another one to two hours of personal time each night doing additional computer and other clerical work. Dr. Nico Bruining highlighted an important limitation of EMR used in Europe (vs. US), notably in Europe we use more than 30 languages that makes data collection difficult, and that should probably be addressed by a future Horizon 2020 project.

 

Augmented, mixed and virtual reality debates were really interesting. The 3 terms are intercorrelated and should not be confused one with another:

• Virtual reality (VR) immerses users in a fully artificial digital environment.
• Augmented reality (AR) overlays virtual objects on the real-world environment.
• Mixed reality (MR) not just overlays but anchors virtual objects to the real world.

 

The 2 main applications in medicine target the patients and of course the doctors. For patients, one of the presenters suggested that VR will do for patient education what Google Maps has done for navigation, thus it "will transform learning experiences by better retention and recall, it will improve patient journey and will determine behavioral change by challenging health beliefs through impactful experiences". For doctors, Dr. Dariusz Dudek explained how a pioneer program of mixed reality that is currently used in Poland helps cardiologists choose a better punction site for TAVI, with expectancy in the very near future to have VR mask that will allow cardiologists to have echo, CT and eventually other 3D reconstructions in the corner of their eyes, while a cardiac intervention is taking place. Other important applications are stroke recovery and cardiac rehabilitation.

 

Over-utilization of medical devices. One of the worries highlighted was that this new technology could cause anxiety in healthy fit subjects, translating into unnecessary consultations either by their general practitioner either by their cardiologist, as presented by Prof. Martin Cowie . 57% of subjects from the "Apple heart" study thought to seek medical attention after having an alarm from a smart device.

 

 

Even though wearables and connected devices impact sometimes positively our daily lives (sleep apnea analysis app, selfie to quantify oedema app, accelerometers incorporated into devices that quantify daily effort, smartphone-based blood pressure measurement by transdermal optimal imaging , etc), Dr. Klaus Witte highlighted that there is increased concern that wearables and connected devices impact negatively the society by increased (but unnecessary) cost to the consumer, and increased (but unnecessary) cost to the medical system (by over-investigating a healthy person thus launching a battery of tests like holter ECG, echocardiography, stress test). With this in mind, there was a unanimous consensus that medical wearables and connected devices should target special groups of populations if we want to avoid death, strokes or hospitalizations and the clinical benefit of these kind of devices should be carefully thought and evaluated.

 

Conclusions

 

Digital technology can help healthcare by providing new tools for diagnosis and therapy delivery, redesigning clinical pathways, individualized risk stratification and individualized care, patient empowerment and education, support to precision medicine (thus fewer medical errors), and telemonitoring. Digital technology and connected devices (tablets, wearables, apps) could enhance decision making of health professionals only if there is a direct link towards a clinical benefit, and maybe they would have a huge impact if they could be directly linked also to EMR. In real life, adoption of digital technology in healthcare depends on validation, easy integration of workflow & prescription pathways and ability to reduce work.

 

Consumers could think that by using digital technology and connected devices, they take control over their health; this is partially false because alarms issued by devices could translate into unnecessary consultations and increased cost to overall health system by doing unnecessary tests in otherwise healthy subjects. Narrowing the indications and the target population for the use of this devices should be a priority.

 

And finally, some punctual issues need rapid and clear solutions: stricter security protocols should be incorporated in data transmission, regulations should be adopted for all digital technology (there are too many devices and few regulations), the huge amount of data (that is collected from all digital technology) needs to be transformed into information.