Abstract
(English)
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The main goal of the MOEBIUS project has been to demonstrate and validate the Extranet mobility concepts. Furthermore, additional goals were to establish, pilot and test in a real environment:
· the integration of an IP-based mobile extranet platform,
· to use this platform for applications in different sectors, e.g. healthcare and business,
· to verify the interoperability of the various technologies,
· to provide a reliable infrastructure at both network and application level.
The health care part of the MOEBIUS project was the major focus of the last year of the project,' it consisted of the following clinical trials:
· .Obesity trial aiming at risk reduction (Risk Reduction Trial in young obese patients). This trial included a diet, an exercise programme and a specific drug therapy on an interactive platform to achieve an integrated weight control programme. Energy intake was prescribed for each subject on the basis of estimated daily maintenance energy requirements. Dieticians at the site periodically gave instructions on dietary intake,. recording procedures were installed as part of a behaviour modification programme. In addition, individuals were included in a physical activity programme. Finally, patients were given orlistat to support the weight management strategy. 15 patients fulfilled the inclusion criteria and were entered in the trial, 13 successfully completed the 4 month trial. The trial was a success from a medical perspective (patients lost weight, reduced their blood pressure and showed lower blood glucose levels), but also from a technical point of view (integration of different devices on a handheld platform). All 13 patients were satisfied with trial procedures and indicated that they would be willing to pursue this line of investigation.
· .ACT -Anti-Coagulation Trial
In the ACT Trial we tested 5 patient requiring chronic anticoagulation. In order to observe these patients for a prolonged period of time, the trial continued until September 2002. Two patients could be followed for several weeks. Both were satisfied with trial procedures and indicated that they would be willing to pursue the test. From a medical perspective the test result was satisfactory.
The Moebius trials revealed that the following criteria must be met for a successful deployment of telemedicine: the illness must be widespread, an improvement in outcome must be documented, the conventional treatment of the illness must be associated with high costs and it must be possible to provide support by telemedical means. The major emphasis in the MOEBIUS health care applications was to use innovative approaches to therapy and disease management. Communication technology is a crucial aspect of this innovative approach in order to provide advantages both for the patient and for the doctor but also for society.
From the patient's perspective one important goal of a given therapy is to enable the patient to maintain his normal lifestyle as much as possible. Within the MOEBIUS concept, the patient is provided with specific devices and tools which should help him to control his therapy through self- monitoring at home. From the perspective of the medical professional, the possibility to access a centralised server with all patients' medical records on line is one further step towards improving the necessary therapeutic regimen. The information provides the basis with the potential for a better long- term outcomee. The information can assist the physician in assessing the efficacy of the treatment. In addition, it can provide informations with respect to a particular patient's progress, but allows at the same time to directly compare the outcome of a specific treatment regimen with those of other patients. Such comparisons can be helpful for quality assurance programmes and provide third parties with a useful tool to assess the efficacy of a specific therapy. The MOEBIUS concept could contribute to achieve the goal of maintaining a high quality of medical service.
In brief, an Integrated Mobile Healthcare Solution (IMHCS) will:
· enable remote monitoring and survey of ambulatory patients;
· act as a connected mobile treatment diary thus improving the day-to-day support of patients; detect abnormalities in a patient's condition or well-being by assessing specific parameters
· the detection of abnormalities automatically alerts the patient and/or the doctor);
· provide a centralised repository of medical data for the participating physicians.
Users of the system will consist of patients, doctors, medical supervisors, statisticians, and technicians. In addition to the MOEBIUS application components, messaging systems outside the scope of the MOEBIUS extranet, such as for example the standard Short Message Service (SMS), may be utilised. Patient records will be stored in a centralised database, which shall be secured against intrusion of any kind, whilst simultaneously being highly available to authorised users.
In the field of business applications, Mobile Application for Remote Access (MARA) extends the Extranet solutions to mobility. MARA model is a virtual company: a company whose actors are distributed all over the world, and are mobile. MARA offers a virtual environment to various classes of users, such as salesman force, management, trusted customers, giving to each of them the access to the business information and services according their need and regardless of their physical location.
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