empirica Projekte zum Thema eHealth & Telemedizin

The overall goal of this study by empirica GmbH (Bonn, Germany) and data information intelligence GmbH (Leipzig, Germany), is to provide statistical insights on the current state of deployment of eHealth across Europe and to define an appropriate longer-term procedure for estimating and assessing the eHealth market and its potential, thereby supporting COCIR (European Coordination Committee of the Radiological, Electromedical and Healthcare IT Industry) and industry in their efforts towards developing the European and global market and realising the benefits of eHealth. The specific objectives are to:

• Identify and collect existing market (research) data which can be used to produce an initial market sizing and 5 years forecasts for the overall eHealth or HC ICT market across Europe.
• Provide a segmentation in terms of products/solutions, geographies and customers.
• Design a comprehensive, consistent research and methodology framework as a fundamental step towards a more comprehensive market research and analysis activity as continuation of this market sizing and forecast exercise, which will evolve over the years to come.

The study aims to cover as many of the 27 EU Member States plus Norway and Iceland as feasible and where such data can be obtained within the temporal and budgetary limitations of the study.

This is the second study in a series of three linked studies to develop eHealth benchmarking at European level. The study will cover all 27 EU Member States plus Norway and Iceland as well as Canada and the USA. It will conduct background research and review existing measurement tools and systems for ICT for Health, as well as available eHealth statistics, in order to establish a framework for data compilation and to make progress towards the future establishment of an effective eHealth benchmarking system in Europe, collect the data on an agreed set of eHealth related phenomena from existing sources including professional bodies and regional and national ministries. The study will compile data from existing sources rather than generate original data and – depending on the data availability – provide a measurement for each of the agreed indicators in each country, identify, analyse and report good practice in developing and applying eHealth measurements and benchmarking frameworks for informing policy-making (in all 29+2 countries), and develop and deliver 29(+2) Country Briefs summarising key results for each of the European countries and plus Canada and the USA and make all study results available through a dedicated Online Knowledge Base. Thus this study will significantly enhance the capacity of the i2010 initiative to achieve its goals in relation to monitoring and benchmarking eHealth, a key aspect of information society developments in the old and the New Member States.

In 2004, Europeans made approximately 180 million trips of four nights or more outside their own country. Ensuring their access to seamless and safe healthcare has become a top priority for the European Commission. Information and communication technology plays a key role in this process as it facilitates the transfer of vital medical data across borders. So far, national health IT solutions have coexisted without any interaction. The EC funded Smart Open Services project will for the first time unite key Member States and industry players in a joint effort to get medical data and prescription information to any doctor in the Union - when and where it is needed, and in comprehensible form.

The EC Large Scale Pilot in eHealth aims to develop "Smart Open Services" providing patients travelling across Europe access to the same quality of care as in their home country. As its acronym "S.O.S" suggests, one focus is on getting medical data to doctors urgently when needed, another is on enabling patients travelling in another country of the EU to use a local pharmacy to obtain their prescription medicines ("e-prescription").
The proper consent of patients is crucial to the acceptance of these services. In meeting patient concerns about unauthorised access or loss, the project will build on the now extensive knowledge available and on reliable and safe methods to store and transfer personal data. Building on national initiatives, it is expected that a minimum data set, incorporating emergency and demographic data, can be agreed upon. Limiting the data set facilitates translational work and ensures that the doctor in charge of the treatment fully understands the patient's data - which may be coming from a country with a different language than the doctor's own. Citizens can thereby be sure to receive appropriate medication and care. To achieve the new services, the participating countries will for the first time establish IT links between their healthcare systems.

The Smart Open Services project has the potential to lay the groundwork for a future pan-European eHealth infrastructure which would revolutionise healthcare provision by reducing medical errors and avoiding unnecessary treatment.

This study for the European Commission will make a substantial contribution towards accelerating the implementation of the European eHealth Action Plan. Specifically, the study will actively support ongoing initiatives and implementation work on interoperable EHR and ePrescribing systems by illustrating and widely spreading new knowledge about their socio-economic impact and lessons learned from successful, beneficial applications.

The value added by eHealth will be measured in quantitative terms based on a small number of successful implementations covering a wide variety of types of applications, of healthcare provider organisations and health systems, and of local, regional or even national frameworks. Whereas the individual examples will provide insights on success factors and requirements, the aggregation of results will allow to draw macro level conclusions.
It is foreseen that the study will deliver the following key outputs:

• A methodology for evaluation of the socio-economic impact, tailored to the context of interoperable EHR and ePrescribing systems
• Ten evaluated good practice case studies
• A validation and dissemination workshop in Brussels, at which preliminary results will be presented for in-depth discussions with selected global experts
• Synthesis of outcomes, providing insights on the socio-economic impact of interoperable EHR and ePrescribing systems, on critical success factors in the process of design, development, piloting, implementation, and routine operation, on lessons learned, and finally on implications for European and Member State health policies.

Best results have been obtained when involving local doctors, nurses and other stakeholders, experts and promoters who have a good integrative understanding of medical/clinical, health policy and ICT-related issues and who are aware of new developments and emerging technologies.

EU FP7 Large-scale integrating project: develop a multiscale modelling technology based on conventional diagnostic imaging methods that makes it possible, in a clinical setting, to predict for each patient the strength of his/her bones, how this strength is likely to change over time, and the probability that the he/she will overload his/her bones during daily life. With these three predictions, the evaluation of the absolute risk of bone fracture will be much more accurate than any prediction based on external and indirect determinants, as it is current clinical practice. These predictions will be used to: i) improve the diagnostic accuracy of the current clinical standards; ii) to provide the basis for an evidence-based prognosis with respect to the natural evolution of the disease, to pharmacological treatments, and/or to preventive interventional treatments aimed to selectively strengthen particularly weak regions of the skeleton. For patients at high risk of fracture, and for which the pharmacological treatment appears insufficient, the VPHOP system will also assist the interventional radiologist in planning the augmentation procedure. The various modelling technologies developed during the project will be validated not only in vitro, on animal models, or against retrospective clinical outcomes, but will also be assessed in term of clinical impact and safety on small cohorts of patients enrolled at four different clinical institutions, providing the factual basis for effective clinical and industrial exploitations.

EU FP7 Large-scale integrating project: Based on advanced text, image and structured data mining of about 3m individual patient data from various hospitals new knowledge and decision support will be developed to improve patient safety in antibiotic use, to fight the fast emergence of resistances among pathogens, misuse and overuse of antibiotics.

In half a century of antibiotics use, new challenges have surfaced: the fast emergence of resistances among pathogens and the overuse of antibiotics. Antimicrobial resistance results in escalating healthcare costs, increased morbidity and mortality and the (re-)emergence of potentially untreatable pathogens. For infectious diseases DebugIT will

• Detect patient safety related patterns and trends
• Acquire knowledge
• Invest this knowledge to upgrade quality healthcare.

The DebugIT project, with its innovative approach, is a prime example of how ICT tools can be used to address the emerging challenges in healthcare. This project addresses several of the overriding call topics at once by tackling the problems around antibiotics and of antimicrobial resistance of infectious diseases in an international consortium uniting world class research facilities, SMEs and industry partners.
It is an example of partnering at the European level to keep pace with soaring research costs by making use of complex IT technology technologies. This program addresses the main socio-economic challenges in healthcare, namely to make Europe's healthcare systems safer and sustainable.

EU FP7 Large-scale integrating project: An advanced telemonitoring approach will be developed to close the loop between patients and professionals, giving appropriate access to monitoring, diagnosis and treatment results and reacting immediately, adapting personalized care plans and using automated decision support to derive therapy recommendations.

Each year Cardiovascular Disease (CVD) causes over 1.9 million deaths in the EU, causing direct health costs of €105 billion. Coronary Heart Disease (CHD), half of all CVD deaths, is the single most cause of death in Europe. Heart Failure (HF) – a CHD being the most frequent cause of hospitalization for people over 65 – has 10 million patients in the EU. Current treatment of HF entails recommendations from clinicians on medication, diet and lifestyle. Patients only receive feedback at doctors visits, or when facing symptoms. Daily monitoring, close follow up, and help on treatment routine is lacking. Non-adherence to the treatment regime is a major cause of suboptimal clinical benefit.
HeartCycle will provide a closed-loop disease management solution to serve both HF and CHD patients, including hypertension, diabetes and arrhythmias as possible comorbidities. This will be achieved by multi-parametric monitoring of vital signs, analysing the data and providing automated decision support, to derive therapy recommendations.

European Commission, Directorate General for Public Health-supported project to improve the involvement of patient associations in health-related European studies and research.

Based on the WHO definition:

Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity,

we have in recent years seen a shift in health policy priorities towards considering a broad spectrum of citizen and patient needs. Globally, health system policy makers are now subscribing to the new paradigm of citizen or patient-centred services. If empowering the citizen is to imply more than just generic policy declarations, one needs to provide him with the means and tools to become a well-informed and self-assured patient, to involve him in decision processes in a way best suited to his level of understanding and knowledge, and to provide him with optimal medical services in situations when he does not want to, or is physically or mentally unable to be part of such processes. Value Plus will provide patient organisations with the tools to influence policy-making at EU-level and to participate in EC-funded projects of concern to their constituency. Empirica is supporting these efforts through the statistical analysis of past and ongoing EC-funded projects which show elements of patient involvement to derive insights on barriers and facilitators for greater patient involvement.

Die Mobilität der Menschen ist gestiegen. Viele Produkte und Dienstleistungen können bei Bedarf in anderen Ländern gekauft werden. Medizinische Hilfe außerhalb des eigenen Landes zu erhalten, stellt für viele Europäer aber auch heute noch ein Problem dar. Und das obwohl bereits 1971 von der EU und deren Mitgliedsstaaten mit den sogenannten eFormularen und der später eingeführten Europäischen Krankenversichertenkarten eine passende Rechtsstruktur geschaffen wurde. Das Wissen um diese Struktur ist jedoch nicht weit verbreitet und die zugehörigen Verwaltungsabläufe zwischen den Mitgliedsstaaten haben sich nicht in dem selben Tempo entwickelt  wie Tourismus und Arbeitsmobilität.
An dieser Stelle setzt das TEN4Health Projekt an. Es trägt mit seiner Arbeit zu einer Optimierung der medizinischen Versorgung mobiler Europäer bei. Initiiert von führenden Krankenkassen, wird das TEN4Health Dienstleistungspaket den Zugang der Bürger zu medizinischer Versorgung in allen beteiligten Krankenhäusern der Mitgliedsstaaten sicherstellen. Dieses Leistungspaket basiert auf einem sicheren Internetdienst und auf der Integrierung in die europäischen Infrastrukturnetzwerke für eHealth.
Kernkomponenten dieses Packets sind:

• Informationen über örtliche Regularien, den Eigenanteil sowie andere Aspekte der medizinischen Versorgung für Bürger in eigener  Sprache im Falle eine Behandlung im Ausland
• direkte Online-Überprüfung des Versicherungsstatus für medizinische Anbieter und direkte Sicherstellung der Kostenübernahme.
• effiziente Unterstützung bei der schnellen, elektronischen Bearbeitung auf nationale Ebene
• Elektronische Kostenerstattung über die Grenzen der Mitgliedsstaaten hinweg, unter besonderer Berücksichtigung einer interoperablen Ausgestaltung.

Finanzierungsprobleme stellen sich zunehmend als Ursache für die mangelnde Verbreitung effektiver eHealth Lösungen heraus. Aus diesem Grund hat die Generaldirektion Informationsgesellschaft und Medien der Europäischen Kommission eine Studie über die „ Beurteilung von Finanzierungsmöglichkeiten zur Unterstützung und Stärkung der Investitionen in eHealth“ in Auftrag gegeben. Ziel der Studie ist es, Möglichkeiten für die Finanzierung von eHealth-Lösungen im Rahmen allgemeiner Investitionen im Gesundheitssystem aufzuzeigen. Daraus soll eine Reihe verschiedener Finanzierungsmodelle für eHealth zur Unterstützung von Entscheidungsträgern entwickelt werden. Die bevorzugten Finanzierungsvarianten unterscheiden sich je nach Art der eHealth Lösung sowie des sozioökonomischen und administrativen Umfeldes. Verschiedene Auswirkungen sowie Kosten-Nutzen-Szenarien werden hervorgehoben.
eHealth Lösungen können auf die unterschiedlichsten Weisen finanziert werden. So z.B. als Teil der allgemeinen Gesundheitsfürsorge, in Public-Private-Partnerships (PPP), mittels Leasing, durch Forschungsfördermittel u.v.m. Darüber hinaus sind öffentliche Mittel auf lokaler, nationaler, EU- und internationaler Ebene verfügbar. Die optimale Finanzierungslösung für ein konkretes Projekt kann dabei durch die Art der angestrebten Investition festgelegt werden. Verschiedene Finanzierungsmöglichkeiten können in den verschiedenen Phasen des Lebenszyklus der eHealth Investition verwendet werden. Beispielsweise kann ein Test eines Krankenhausinformationssystems anfangs durch Regierungsmittel für IuK Entwicklungen unterstützt werden. Sobald das System in Betrieb ist, kann es ausreichend hohe Erträge erbringen, um selbstfinanziert weiterlaufen zu können.

Ausgehend von der Vision eines am Patienten orientierten Gesundheitssystems entwickelt Empirica Szenarien IKT-gestützter Gesundheitsmodelle, die auf kosteneffizienten Gesundheitstechnologien basieren. Dabei verbindet Empirica seine Erfahrung in der Evaluation von Informations- und Kommunikationstechnologie im Gesundheitswesen mit der Szenariotechnik als innovativem Werkzeug der Politikberatung. Ein Szenario-Workshop und ein Politik-Workshop garantieren die Breitenwirkung des Projekts in der Gesundheitssystemforschung, bei eHealth Experten und europäischen Entscheidungsträgern in Politik und Gesundheitswesen. Außerdem werden Einblicke in zukünftigen Forschungsbedarf erwartet.

In this study for the European Commission DG INFSO and Media a survey of almost 6,000 primary care physicians on their use of ICT and internet for communication with patients and between primary and secondary care and other health agencies will be carried out in all 27 Member States of the European Union and in Norway and Iceland. The fieldwork will start in the third quarter of 2007. The purpose of the present study is to: measure the use of ICT by primary care physicians in the EU and EEA countries, which is to be achieved by means of a survey of primary care physicians and their use of ICT and Internet for communicating with patients and between primary and secondary care and other eHealth agencies. Through this survey up-to-date information and data on eHealth developments will be obtained and an appropriate benchmarking framework and procedure for eHealth defined, thereby - and through the 29 Country Briefs for each of the 27 Member States, Norway and Iceland - enabling member states to monitor their performance to improve public services. The study is a continuation of the earlier benchmarking exercise for eEurope 2002 and was carried out as a Eurobarometer survey.

Trotz des langsamen Vordringens von eHealth Anwendungen in den medizinischen Alltag, gibt es mittlerweile eine größere Zahl von eHealth-Anwendungen und -Dienstleistungen (d.h. Gesundheitsanwendungen und -dienstleistungen, die auf IuK-Technologien beruhen), die sich bewährt haben. Diese Anwendung stellen einen beträchtlichen Erfahrungsschatz dar, der bislang nicht für die breite Fachöffentlichkeit erschlossen und kommuniziert wurde.
Ziel des Projektes ist es deshalb:

• Gute Beispiele und den mit ihnen verbundenen Nutzen zu identifizieren und beschreiben;
• Ansätze zur Verbreitung und zum Transfer von praktischen Erfahrungen zu entwickeln und zu implementieren;
• Die Nutzung von eHealth dadurch zu fördern, dass aktuelle Probleme angesprochen werden und Lösungen dazu präsentiert werden.

ICT can make a vital contribution to improving the safety of European patients by helping to reduce medical errors and other negative incidents, thereby saving lives, and enhancing efficiency, in particular in the field of risk management in healthcare. The eHealth for Safety study has the following overarching goals:

• Identifying key issues, topics and challenges where ICT can have a high impact on patient safety and risk management in healthcare, and which have particular relevance in the European context, as well as on the level of the Member States
• Developing both a ten year vision/strategy and concrete recommendations for RTD measures (within the EU’s 7th framework programme and for longer term research activities)

These goals translate into a three-phase approach, consisting of (1) baseline research, (2) empirical analysis, and the development of (3) a synthesis report as well as a roadmap for further research. Good practice case studies will form part of the study in order to demonstrate concrete applications of ICT tools to enhance patient safety.

The semantic aspects of interoperability have only recently been recognised as the major enabling factor for the safe and sensible communication of patient data. Health language is very large and diverse, and as such not equalled by other professional languages. This SemanticHEALTH SSA develops a European and global roadmap for deployment and research in health-ICT, focusing on semantic interoperability issues of e-Health systems and infrastructures. The roadmap will be based on consensus of the research community, and validated by stakeholders, industry and Member State health authorities. It

• identifies key short-term (2-5 years) and medium-term (4-10 years) needs to achieve semantic interoperability of e-Health systems
• analyses unsolved issues arising in the context of realistic approaches to priority clinical and public health settings
• takes account of the impact of non-technological (health policy, legal, socio-economic)aspects
• reflects and integrates results of related FP6 studies.

The consortium and associated experts represent centres of excellence from fourcontinents and the WHO.
empirica is involved in semanticHEALTH as a subcontractor.

The EHR has evolved to become centre-stage in the national health informatics strategies in Europe. There is a need for interoperability standards that can permit clinical computer systems to share health record data whilst preserving faithfully the clinical meaning of the individual authored contributions.
Q-REC’S main objective is therefore to create an efficient, credible and sustainable mechanism for the certification of Electronic Health Record (EHR) systems in Europe by addressing

• EHR Systems Quality Labelling and Certification Development
• Resources for EHR interoperability
• Benchmarking Services

The core objectives of Q-REC will be to define a Model with harmonised guidelines and procedures for EHR systems certification and to incorporate the formal test plans into a Benchmarking Process Manual for quality labelling and certification of EHR systems across Europe.
The main kinds of outputs that will be accumulated through the Q-REC work packages are as follows.

• A State of the Art Report on existing EHRs Certification Schemata;
• A Labelling Terminology and Functional Profiles for classification of EHRs to be certified;
• Model Certification Guidelines and Procedures;
• A Benchmarking Services Manual for EHRs Quality Labelling and Certification;
• An Inventory of Resources for HER Interoperability, with registers of Quality
• Conformance Criteria, EHR-Archetypes, XML schemes, Health Coding Systems and relevant EHR Standards;
• A fully worked out Business Plan.

empirica is involved in Q-REC  as a subcontractor.

The recent emergence of Grid technology opens new perspectives to enable interdisciplinary research and technology development at the cross roads of medical informatics, bioinformatics and system biology impacting healthcare. The HealthGrid roadmap, to be developed by the SHARE project, will provide a comprehensive coverage of the RTD domain and the uptake of Grid applications in healthcare, including inter alia infrastructure, security, ethical, legal, financial and economic issues.
The roadmap will focus on identifying requirements for further research and technology development. It will also sketch a realistic picture with respect to desirable applications/ICT implementations and indicate which technologies may have the potential to make a substantial contribution in this context. This will be supported through the presentation of good practice examples.
Each section of the roadmap will detail actions to be taken in terms of objectives and possible methods or approach as well as recommended milestones for completion, stakeholders responsible, appropriate methods of coordination etc. All relevant stakeholders will be involved in a bottom up approach so as to ensure the relevancy and positive impact of the roadmap. Care will also be taken to include issues related to standards and security requirements for handling medical data. Non-European issues will be also factor in to our roadmap in order to ensure international interoperability.
empirica is involved in SHARE as a subcontractor.

Derzeit starten verschiedene EU Mitgliedsstaaten Initiativen um eHealth Infrastrukturen und Anwendungen einzuführen. Man beschäftigt sich mit entscheidenden Fragen wie technischer, semantischer und Arbeitsablauf Interoperabilität allerdings fast ausschließlich auf regionaler oder nationaler Ebene. Dies droht die weitere Entwicklung eines europäischen Marktes im Bereich eHealth Anwendungen und grenzübergreifender eHealth Dienstleistungen zu beinträchtigen. Aufbauend auf den Aktivitäten in den Mitgliedsstaaten, den Resultaten europäischer Forschung und den Resultaten internationaler Bemühungen wird das Projekt einen Prozess zur Beschleunigung der transeuropäischen Nutzung interoperabler eHealth Infrastrukturen und Anwendungen in Gang bringen. Das Projekt wird:

• Fragestellungen im Zusammenhang mit Interoperabilität und Verbindungsfähigkeit ("connectivity"), Barrieren und Lücken, und Lösungszugänge identifizieren.
• Sich auf fundamentale Interoperabilitätsfragen (wie die Identifizierung der Akteure und Organisationen, adäquate Maßnahmen zur Erreichung von Interoperabilität, Integrationstests und Zertifizierung) fokussieren.
• Ähnliche Schlüsselfragen im Bereich elektronische Rezepte (ePrescription) und Nachrichten analysieren.
• Einen Maßnahmenplan und konkrete Projekte mit allen relevanten Akteuren entwickeln – geleitet von einem offenen Diskussionsprozess zwischen den Gesundheitsbehörden der Mitgliedsstaaten.

Die Mobilität der Patienten und grenzüberschreitende medizinische Dienstleistungen sind wichtige Prioritäten der EU und ein Fokus des eHealth Aktionsplans. Bedürfnisse, Lücken und weitere Schritte zu identifizieren wird dabei helfen, konkrete Lösungen zu verwirklichen um diese Ziele zu erreichen. Interoperabilität wird es erlauben, effektivere Gesundheitsdienstleistungen anzubieten, egal wo sich der Bürger gerade aufhält und woher innerhalb Europas er kommt.

Obwohl mittlerweile eine hohe Zahl von eHealth-Anwendungen und -Dienstleistungen (d.h. Gesundheitsanwendungen und -dienstleistungen, die auf IuK-Technologien beruhen) potentiell verfügbar ist, sind sie im medizinischen Alltag noch nicht weit verbreitet. Ein Grund dafür ist, dass es nur wenige zuverlässige Informationen über die langfristigen Auswirkungen und die Nachhaltigkeit dieser Systeme gibt. Daher lässt sich auch kaum einschätzen, inwieweit eHealth bei der Finanzplanung im Gesundheitssystem bevorzugt berücksichtigt werden sollte.
Die Ziele des Projekts sind:

• Entwicklung einer Methode zur Evaluation von eHealth-Systemen, die auf die Optimierung der Ressourcenallokation in der täglichen Pflege abzielen.
• Ermittlung von 100 Anwendungen mit Beispielcharakter aus dem Bereich eHealth. Als solche gelten Beispiele, die sich in der Praxis bewährt haben und dauerhaft verbesserte Ergebnisse, gesteigerte Effizienz und - soweit vorhanden - eine positive Kosten-Nutzen-Bilanz aufweisen.
• Anwendung der Evaluations-Methode auf 10 ausgewählte eHealth-Angebote aus ganz Europa.
• Entwicklung eines Onlinewerkzeuges mit dazugehörigem Handbuch, als vereinfachte Evaluationsmethode für Entscheider im eHealth-Bereich.
• Erstellung einer Vision zur Einschätzungen der zukünftigen Auswirkungen von eHealth-Anwendungen in der Europäischen Union.

Das MobilAlarm Projekt untersuchte einen innovativen, nicht ortsgebundenen Notruf-Dienst, der gezielt für ältere und behinderte Menschen entwickelt wurde. Er kann auch von anderen Bürgern genutzt werden, die z.B. durch eine chronische Krankheit gefährdet sind. MobilAlarm ermöglicht es, zu jeder Zeit und an jedem Ort einen Notruf auszulösen. Der Dienst wurde auf seine Marktfähigkeit und sein Anwendungspotential untersucht. An diesem europaweiten Projekt waren Partner der gesamten Wertschöpfungskette beteiligt: Vom Gerätehersteller über die Service-Zentralen bis hin zu Patientenverbänden.

The IST Impact Study analyses and assesses the socio-economic impact of Information Society Technology research and development projects supported by the EU framework programmes (FP4 and FP5) in three domains:

• eHealth applications,
• mobile communications and systems,
• microelectronics and microsystems.

empirica is responsible for the eHealth area. Output is to be used for improving programme performance and suggesting recommendations for future strate-gies.
The study’s methodological framework builds on the basic model of causality which considers that RTD projects have downstream consequences that can be described in terms of a range of project outputs (publications, new tools and techniques etc.) and a range of resultant outcomes affecting different sets of actors.
The study will assess the performance of projects and programmes focusing on the following evaluation criteria: effectiveness, efficiency, impacts, additionality, relevance, progress factors. A key feature of the methodology is the analysis of results by type of stakeholders.
Quantitative project and programme data are collected by e-mail questionnaires. Data analysis techniques include multivariate techniques capable of identifying groups of results and type of stakeholders/projects (cluster analysis) and searching for correlations between them.
In addition, qualitative stakeholder interviews will provide information to allow for a well-grounded interpretation of the statistical data, setting these into the ‘societal’ context. Further-more, they will provide a qualitative view on those impacts downstream the impact chain which are difficult to assess using quantitative tools.

• Databank Consulting (project coordinator)
• Idate
• Teleport Sachsen Anhalt
• Wiseguys

Ziele des TEN-HMS-Projektes waren es, ein modular aufgebautes Telemonitoring-System für die Betreuung chronisch kranker und älterer, behinderter Bürger weiterzuentwickeln, den konkreten Nutzen einer telematisch unterstützten Betreuung zu Hause methodisch belastbar nachzuweisen sowie Modelle für die breite Markteinführung vorzubereiten und zu erproben. Insbesondere wurden dabei die folgenden drei Nutzendimensionen untersucht:

• medizinische Ergebnisse ("Medical Outcome")
• Patientensicht (Lebensqualität) sowie
• Auswirkungen auf das Gesundheitssystem (Kosteneinsparung)

Das Projekt wurde im Januar 2000 begonnen und nach 31 Monaten im Juli 2002 formell abgeschlossen. Der Schwerpunkt lag bei der medizinischen Betreuung von Herzinsuffizienz-Patienten; daneben werde aber auch ein kleines Pilotprojekt mit Dialysepatienten durchgeführt.