Trieste 1/4/2011 Alessandro Taddei 1 ICT for collaborative health care in the Mediterranean area...
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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
Trieste 1/4/2011 Alessandro Taddei 2
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
Trieste 1/4/2011 Alessandro Taddei 3
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/
Trieste 1/4/2011 Alessandro Taddei 4
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
Trieste 1/4/2011 Alessandro Taddei 5
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
Trieste 1/4/2011 Alessandro Taddei 6
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 …)
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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
Trieste 1/4/2011 Alessandro Taddei 8
Live Tele-consultingLive Tele-consulting
Upload Internet bandwidth > 512 Kbps
Videoconference equipment(25 fps, criptography)
audio
Video
INTERNET
Echo equipmentTele-consulting
Video
-
Trieste 1/4/2011 Alessandro Taddei 9
Tele-echocardiography Tele-echocardiography in neonates from Clinical Center in neonates from Clinical Center
Banja Luka (BIH)Banja Luka (BIH)
t
Trieste 1/4/2011 Alessandro Taddei 10
Tele-ecocardiographyTele-ecocardiographyfrom Pediatric Clinical Centerfrom Pediatric Clinical Center
Rijeka (KR)Rijeka (KR)
Trieste 1/4/2011 Alessandro Taddei 11
Fetal tele-echocardiography Fetal tele-echocardiography from Gynecology Hospitalfrom Gynecology Hospital
Tirana (AL)Tirana (AL)
Trieste 1/4/2011 Alessandro Taddei 12
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
Trieste 1/4/2011 Alessandro Taddei 13
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)
Trieste 1/4/2011 Alessandro Taddei 14
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
Trieste 1/4/2011 Alessandro Taddei 15
• 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