Medica2015_Dienstag

ULTRASOUND DEDICATED MRI HEALTHCARE IT ULTRASOUNDULTRASOUNDULTRASOUNDULTRASOUNDULTRASOUNDULTRASOUND DEDICATED MRIDEDICATED MRI HEALTHCARE IT DEDICATED MRI HEALTHCARE IT DEDICATED MRI HEALTHCARE ITHEALTHCARE ITHEALTHCARE IT www.esaote.com Quality made in Europe TUESDAY @ MEDICA 7 EH @ MEDICA No 2 2015 Report: Sylvia Schulz Telemedicine is taking strides throughout Europe. While in Germany telemedicine projects appear to be off to a slow start (see the electronic health card), in other countries progress is going full throttle. In September, at the German-Dutch symposium ‘Using optimisation potential: Telemedicine and procurement management’ a number of Dutch approaches were presented. In the Netherlands, the National Expert Centre for Standardisation in E-health (Nictiz) was founded in 2002 to assist the Dutch government in e-health implementation. Ambitious targets were set and scheduled for completion by 2019; inter alia: • 80% of the chronically ill have access to their patent record via Smartphone app or internet • 75% of the chronically ill can measure certain parameters them- selves, e.g. diabetes patients, and forward the data to physicians or other healthcare providers • Every patient receiving homecare can access a physician 24/7 via a monitor. The annual reports published by Nictiz to document the progress indi- cate that the Dutch are indeed far from reaching their defined goals. To date, only 10% of the chroni- cally ill have electronic access to their patient record. In addition, while an impressive 40% of the chronically ill perform their own measurements, only 5% of the patients forward the data to the healthcare providers. However, Dutch people increas- ingly accept telemedicine. The KSYOS TeleMedical Centre, a ‘virtual’ hospital located in Amstelveen, is a telemedicine services success story. The company now employs more than seven thousand physicians and paramedics. The Centre provides care exclu- sively with the use of ICT. ‘Through these innovative services, care is deliv- ered independent of time and place and with the data travelling, rather than the patient: better, faster care, close to the patient at a lower cost,’ says Professor Leonard Witkamp, director of the KSYOS TeleMedical Centre since 2005. Witkamp was also named professor by special appointment of Telemedicine at the University of Amsterdam’s Faculty of Medicine (AMC-UvA) – a chair estab- lished on behalf of the Royal Dutch Medical Association (KNMG). There are currently several suc- cessful telemedicine services imple- mented by the Centre, such as Telefundus screening in diabetes and teledermatology. Diabetics previously had to see an ophthalmologist for their annual retina screening. Today, these patients go to an optome- trist located in their neighbourhood shopping centre, where digital imag- es are taken of the retina. These are assessed locally or remotely within two hours by a team of optometrists. The local ophthalmologist ran- domly and anonymously inspects the quality of the images and the assessment. Abnormal cases are pre- sented to the patient’s general prac- titioner (GP), who may refer these digitally to the local ophthalmologist by teleophthalmology consultation. Where previously 100% of patients went to the ophthalmologist, now only four percent are physically referred. ‘A huge improvement and acceleration of efficient care delivery at lower costs,’ Witkamp notes. Although teleconsultation is rolled out in many different medical specialties, teledermatology, as one of the first successful services, pre- sents a fine example. The GP opens the patient’s record, inserts the skin images obtained and adds medi- cal information. These findings are then submitted to the dermatologist remotely, and together the doctors make a final diagnosis and establish a treatment plan. Over 200,000 teleconsultations since 2005 show that teledermatol- ogy, provided the GP selects suitable patients, leads to a 74 percent reduc- tion of physical referrals, with an average response time of 4.6 hours (median 2.0 hours). According to Witkamp, ‘Savings of 20 to 40 per- cent in healthcare costs’ are realised ‘by improved efficiency and quality’. The role of hospitals will become more specialised, as Leonard Witkamp predicts: ‘Telemedicine will allow hospitals to focus on difficult and serious cases and the socially disadvantaged patients. In many centres throughout the region, GPs, pharmacists, opticians, physiothera- pists and others will deliver more routine care under the remote direc- tion and supervision of the doctor and specialist.’ European market for the physiother- apy platform. The firm is also seeking FDA approval for the system’s use in the United States. Meanwhile, the BioGaming platform has become available to licensed physiotherapists right across Europe for clinical use. Fundus screening enters shopping centres enters Telemedicine in the Netherlands ming is at Medica / Stand M19 Discussion was keen between Leonard Witkamp (centre) and symposium participants Source:LZG.NRW 3-D printed heartsThe CSI Congress (Congenital, Structural and Valvular Interventions) is one of the major fixtures for catheter therapy of congenital and structural heart defects. Key moments in this high profile event are live broadcasts and the audience can not only to listen to but also interact with the teams in the cath labs involved Report: Ralf Mateblowski At this year’s CSI gathering, three live interventions – one case of mitral valve insufficiency, a degenerated bio- prosthetic tricuspidal valve and a tran- scatheter aortic valve implantation, performed in Frankfurt/Germany in late June – demonstrated how patient- specific 3-D printed heart models can be used for surgical planning. Belgium-based manufacturer Materialise offers software solutions and services for 3-D imaging and 3-D printing. Just before he began to enable the first live case, Dr Sameer Gafoor of the Cardio-Vascular Centre Frankfurt summarised his experiences with the firm’s HeartPrint models. ‘To see the model means to change strat- egies,’ he said. Based on CT, MRI and/or 3-D ultra- sound image data, the transparent silicone models show the individual anatomy in amazingly realistic detail. This allows a physician in the pre- operative planning phase to literally get his hands on the structures he is going to see – down to the differ- ent tissue thicknesses of muscles and vessels, including calcifications! This kind of haptic exploration of the inter- vention site helps to decide whether catheter access will in the leg or the neck. In turn, that decision informs the choice of instruments to be used. In complex cases, interventional cardi- ologists and cardiac-surgeons can test their actual operating theatre strategy on the model, adapt their procedure, if needed, and even discuss it prior to the intervention, during the multidis- ciplinary cardio board. Thus, the entire team knows what’s in store. ‘Basically open heart interven- tions cannot be repeated,’ Dr Gafoor explained, pointing at two further advantages of 3-D print models for planning purposes – high surgical success rates and markedly improved patient outcomes. Even more: the ‘test runs’ with the 3-D models reduce intervention time, which in turn has several positive side effects: short- er anaesthesia times reduce health risks for the patient resulting in fast- er recovery. For the hospital this translates into quicker theatre turn-around-times and shorter length of stay. In short: sig- nificant cost savings. 3-D models are not only used for intervention plan- ning, they also support patient information very effec- tively: now the patient may bet- ter understand why the intervention is necessary and how it is going to be done. This should deepen trust in the physician and intervention acceptance – an important psychological factor, positively impacting on a patient’s attitude before, during and after the intervention. Obviously ‘learning by 3-D model’ is not limited to physicians, patients and families – it is also a perfect tool for training medical students and jun- ior cardio-surgeons. Last, but not the least, the medical technology manu- facturers benefit from 3-D models from the development, throughout pre-clinical trials to product market- ing. While the use of 3-D models in cardiology, as described above, is more or less still in the begin- ning cranio-maxillofacial surgery and orthopaedic patients already receive 3-D printed implants. In these disci- plines the innovation potential of 3-D print models to optimise patient-spe- cific care is already being realised and the results indicate immense poten- tial awaits exploration in cardiology – above all in paediatric patients, since a baby’s heart can be merely the size of a walnut. 3-D printed cardiovascular model from Materialise, a registered Class 1 Medical Device EH @ MEDICA No 22015

Pages Overview