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Beyond the E-health horizon

Norway’s health system is rapidly evolving, and health care ICT – telemedicine – is an integral part of this development. As one of the leading e-health countries in the world, Norway aims through technological innovation to continually improve the availability...

Norway’s health system is rapidly evolving, and health care ICT – telemedicine – is an integral part of this development. As one of the leading e-health countries in the world, Norway aims through technological innovation to continually improve the availability and quality of health services, patient safety and productivity both nationally as well as internationally.

Central in the process of developing successful health care ICT initiatives is providing environments conducive to research and development. The Norwegian Centre for Telemedicine (NST) located in the northern city of Tromsø plays a vital role in this regard. The NST gathers, produces and provides knowledge about telemedicine and e-health in Norway and internationally, functioning as a catalyst to facilitate the integration of products and services into the health care mix.
The NST is serving as the host for the Tromsø Telemedicine and eHealth international conference to be held in June 2007. With the intentionally ambiguous title “Elderly – Who Cares?”, the conference will address the intrinsic challenges we face as a growing proportion of the world’s population is elderly. The main focus of the event will be how to best provide high quality of care to senior citizens through the use of information and communications technologies.

The IMATIS Patient Terminal is a powerful tool that provides entertainment, information and communications possibilities to the patient, as well as working tools for the caretaker. © Cardiac

Hotbed of Activity
One organization that fully recognizes the importance of a positive research environment is the Norwegian University of Science and Technology (NTNU), located in the hotbed of medical activity that is the Trondheim area. NTNU success is achieved by coordinating and stimulating activities utilizing interdisciplinary means, working with health informatics research within its own organization as well as research organizations such as SINTEF, the Norwegian Centre for Informatics in Health and Social Care (KITH), as well as hospitals and the health industry in general.
Trondheim-based KITH was formed to contribute coordinated and cost-efficient application of information technology in the health and social care sector. It and other organizations within the health sector have developed Te@mwork 2007, the national ICT strategy for development in the health and social sector during the period 2004–2007. The strategy shall give direction and continuity to ICT development in the sector, and consists of a vision that patients and clients shall experience continuity of care when using health care services.
Tracking Patient History
Tracking patient history is one key to medical success, and there are a number of public and private organizations looking at this from an ICT perspective. The Research Council of Norway considers electronic patient records (EPR) to be the biggest challenge facing the health sector in the development and use of information and communications technology, and has therefore established an R&D centre covering the topic at NTNU.
Private companies such as Trondheim-based prosperityLiving are looking to the global market with innovative ideas related to patient history, recently introducing solutions permitting patients to gain control of, and have access to, their own medical records. By electronically placing their medical records in their very own, highly secured private “Health Vault” within the prosperityLiving “Health Bank”, patients and their caregivers (with the patient’s authorization) are enabled immediate on-demand online access to these records globally.
All is Well
Well Diagnostics is a spin-off from the Norwegian Centre for Telemedicine, and together NST and Well comprise one of the world’s leading environments for developing new and cost-effective e-health solutions within the areas of medical multimedia handling, systems integrations and secure communication. On the cutting edge of the ICT industry, Well is involved in activities such as the delivery of a state-of-the-art laboratory system for suburban Oslo’s Nye Ahus hospital. Nye Ahus shall provide local and central hospital services for approximately 340,000 people in the Oslo region and features other ICT suppliers such as Hewlett-Packard (HP) and the Norwegian telecommunications giant Telenor.
Well Diagnostics’ products include the provision of secure communication between the patient and the health institution (Well Arena), a communication and integrations tool for hospitals, doctor’s offices and other health institutions (Well Communicator), and a multimedia archive for health institutions which includes other features that simplify complex health care activities (Well Multimedia).

MerMAid provides excellent sea-to-land information and response when treatment and/or medication is necessary. © iMed

Paperless Hospital – Right Here, Right Now
Control of information flow in a hospital is crucial to saving lives, and the Bødo-based company DIPS improves hospital efficiency with data systems for patient administration and electronic patient journals. The company’s DIPS module system supports activities related to digital journals, patient administration, treatment plans, nursing activities, radiology, polyclinic management and laboratory systems. Over 30 separate system developers are now generating solutions that interface with the DIPS open system product. The DIPS Paperless EPR concept has now been implemented in over 30 hospitals in Norway.
Cardiac is an innovative technology company with a focus on industrial and medical ICT, developing solutions that have been awarded a number of prizes for innovation, including the IMATIS system. The open technology IMATIS Medical system enables data collection, collaboration and presentation of all kinds of data elements
At the Nye Ahus hospital, Cardiac is piloting the development of the IMATIS Integrated Hospital as part of the “the perfect environment”, a joint initiative by HP, Cisco and Cardiac. By combining Cisco’s Clinical Connection Suite, HP’s Digital Hospital Infrastructure and Cardiac’s Integrated Hospital, the vision is to create the “perfect environment for modern health care”. The goal of this alliance is to make meaningful information available anytime, anywhere in a hospital environment, in order to increase the quality of care and efficiency.
Total Solutions at Land or Sea
Focusing on total solutions, iMed combines health care products and standard ICT tools with user-friendly interfaces. Based on market requests, iMed delivers integrated user-friendly solutions in close cooperation with vendors of medical equipment and ICT tools. These solutions include such products as the merMAid telemedicine system, especially developed for use by medical officers at sea and designed to enhance medical communication. The merMAid software runs on a standard Windows PC, and with a camera, ECG and other medical sensors that can be attached, data is retrieved and sent in a secure and well-documented format.

Miniaturized biosensor technology from Alertis Medical provides early warning of serious medical conditions. © Alertis Medical

Monitoring Critical Conditions
Alertis Medical is an award-winning medical device company pioneering new and unique technology for biosensors. These miniaturized biosensors improve health and save lives by providing early information about critical changes in blood perfusion and respiration, are user-friendly and reduce health care expenses.
Miniaturized biosensor technology addresses a considerable need in modern medicine by providing early warning of serious medical conditions through the measurement of CO2 concentration in tissue. For this and other work, Alertis was the 2005 winner of the NHO (Confederation of Norwegian Enterprise) innovation award.
International Acclaim
Oslo-area company Rolltalk offers speech assistance to persons with speech disabilities, whether the disabilities are congenital or a result of a stroke or an accident. The company’s Rolltalk product also enables control of the physical environment, which means that doors may be opened, TVs turned on and remote control devices operated. The product received great praise from Bill Gates at the Microsoft IT Forum in Copenhagen: “Rolltalk is a very nice piece of software. I think it is about as good of an illustration of the magic of software as I have ever seen”.
As all Rolltalk models have the same setup program, they are easily operated with the content determined by the person using it. Setup consists of fields with images, photos or text, and an associated recorded message is played when a field is pressed. Text can also be keyed in and read aloud by means of synthetic speech, and video files can also be played.
Companies such as Cognita also specialize in ICT solutions for people who experience cognitive and physical disabilities. These solutions include the MobilTastatur 4, which simplifies the use of the cellular phone by replacing small keyboard number and symbols with four larger pictures. Other products assist with the use of the computer, computer screens, hearing apparatuses and voice enhancement.