Borderless HEALTHCARE COMMUNICATION Collaboration IT-service Collaboration in telemedicine between Danish and German health services South Jutland County Region Schleswig County of Funen Technologie-Region K.E.R.N. 2 Odense Aabenraa Flensburg Kiel Healthy COMMUNICATION at the international level t the national level, expanded electronic communication fer the patient, this is to be backed up by flexible and re- A between the parties in the health service has long liable communication of patient data. shown its value. This applies for instance to the area of telemedicine, where a large number of projects have In the ciTTis project, hospitals in four regions on either demonstrated the opportunities that direct exchange of side of the Danish-German border have joined forces to images, text and sound provides for on-line healthcare gain experience from international telemedicine. A service cooperation. which makes it clear which expert resources are Some of the most important available at any given time benefits consist in a rise in is being developed and the quality of treatment and tested under the project. better utilisation of resour- In addition, a cooperation ces. At the same time, the platform, a Collaboration new communication tech- IT-Service, is being estab- nology helps remove the lished for use in flexible barriers that geography can telemedicine collaboration. put in the way of patient An important element in treatment. The healthcare the project is the organisa- expert is no longer any further away than the nearest PC tional development, which is to ensure that the project with a network connection. The necessary specialist know- partners are all able to benefit from the new opportunities ledge is available where it is needed – without the patient for cooperation. having to be moved to receive the best treatment. The project focuses on both technological and organisa- The idea behind the ciTTis project is to make use of posi- tional development. The greatest challenge is purely tive national experience at the international level. Health- organisational, while the communication solutions from a care professionals in one country are to be able to draw purely technical point of view primarily necessitate adap- easily and quickly on the knowledge that other experts in tation to current conditions. the network possess. The patient is to be given the best possible treatment provided in the most efficient way At the same time, the project intends to promote commer- possible, regardless of whether the situation necessitates cial IT development within the four regions. crossing national borders. If it becomes necessary to trans- Patients: Healthcare professionals: Equal access to the best and Quality and development fastest treatment through cooperation The health service is becoming increasingly specialised. Highly Healthcare experts acquire their continuing training to a great extent specialised knowledge is possessed by a relatively small number of through collaboration in their daily work with colleagues in the same people, and in many ways technological developments also support or related specialities. Previously, this continuing training in practice the centralisation of treatment facilities. At the same time there is a was almost synonymous with collaboration with colleagues in the great need to achieve effective utilisation of resources in the health same department and the same hospital. For the same reason, there service. These trends have to harmonise with the wish to give all has been a clear trend towards specialists looking for special units patients equal access to the quickest and best treatment. Part of the with a high scientific level. The new information technology provides solution, in popular terms, is to move knowledge, so that there is ex- an opportunity, in popular terms, to break down the barriers in health- pert knowledge where is needed, or to move the patient and patient care cooperation. As a healthcare professional it is possible to look data to the place where the treatment is to take place. Whatever the for sparring partners regardless of distance and national boundaries. circumstances, this involves communication, and in this context, This strengthens individual development of qualifications and raises advanced information technology offers excellent opportunities. the quality of the work done. Denmark 3 Four parties, one project Six project participants from four regions are involved in ciTTis. These are South Jutland County and Region Schleswig, represented by the hospitals DIAKO and Malteser Krankenhaus St. Franziskus-Hospital in Flensburg, as well as County of Funen, represented by the Danish Centre for Health Telematics and Odense University Hospital and the Technologie-Region K.E.R.N, represented by Klinik für Diagnostische Radiologie am Universitätsklinikum Schleswig-Holstein in Kiel. The project has received assistance under the EU’s Interreg Germany IIIA, both for the regional cooperation between County of Funen and the Technologie-Region K.E.R.N. and for the cooperation between South Jutland County and Region Schleswig. The Interreg assistance finances 50 per cent of the project budget. The remaining 50 per cent is funded by the participants. ciTTis timetable Project 2002 2003 2004 2005 1. Project management 2. Analysis of technical conditions 3. Recommendations, guidelines and support 4. Procedural analysis 5. Development of new procedures 6. Software development 7. Pilot implementation of IT collaboration service 8. Dissemination of project results 1. Effective project manage- 3. Preparation of guidelines and 5. Based on the results of the 6. Development of software for ment and quality assurance recommendations on the analyses referred to above, collaboration service and the of all major results through- basis of an analysis of tech- from a workshop for clini- communication standards to out the project. nical conditions. Support for cians on their procedures and be used. 2. Analysis of technical stan- regional implementation. best practice from other tele- 7. Installation of collaboration IT dards, interoperability, laws 4. Identification of relevant pro- medicine projects, the new service in the various organi- and regulations, equipment cedures, including problems procedures where the new sations. and applications with respect and delays in these proce- technology supports and 8. Dissemination of project to harmonisation and the dures. contributes to a more appro- knowledge and experience preparation of guidelines. priate flow are described. the healthcare sector and in- dustry through printed matter, Start of project in the spring of 2002, end in the spring of 2005. website and conferences. Politicians: Effective utilisation of resources, satisfied patients, regional development The general public wants the best possible treatment of diseases and illnesses and at the same wants the lowest possible costs for the health service. It is the task of the politicians to accomplish this complex task, and in this context information technology is a useful tool. In many ways, health service trends are leading to an increased concentration of knowledge and resour- ces. This is a situation that may be difficult to handle in reality, where the patients also regard the proximity of treatment facilities as an important quality in itself. Information technology makes it possible to utilise knowledge and resources regardless of distance. The result is higher quality, better utilisation of resources and more satisfied patients. At the same time, the development work on IT solutions in itself helps support regional business develop- ment – all the participating regions attach great importance to business development in the area of IT. 4 Knowledge Patients BLAZES CROSS trails borders n many situations there an available neurosurgeon surgery at Odense I may be a shortage of through the IT Collabora- University Hospital. expert assistance when a tion Service and is told that G Odense University patient needs treatment. a neurosurgeon at Odense Hospital initially responds The local place of treatment Universitetshospital will be to the referral by asking may, perhaps, lack experts available in 30 minutes. Haderslev Hospital to carry in a particular area, or the G A request for assistance out several tests before experts at the place of and a reservation for this surgery can be carried out. treatment may need a assistance is sent to Odense G The tests are performed, second opinion. University Hospital from and the results are for- An example: the local hospital. warded. G CT/MRI scans and a G The patient is trans- G After a road-traffic acci- referral describing the ferred to Odense and dent, a male motorist is patient’s clinical situation undergoes surgery. She is hospitalised with a severe are sent to Odense Univer- t is not always sufficient transferred back to Hader- head injury. The patient is sity Hospital. I to exchange knowledge slev and data on the treat- unconscious. G The neurosurgeon ana- between experts for treat- ment process and post- G The local hospital takes lyses the images and other ment to progress. treatment are sent from a CT/MRI scan, but wants a information concerning the Diagnosis, surgery and Odense University Hospital second opinion on the situ- patient. The surgeon follow-up treatment may in to Haderslev Hospital. ation. The hospital looks for returns his neurological/ many cases involve several G The patient chooses radiological report. hospitals, and it is vital