Title On-line Leistungsunterstützte Umgebung für Minimal Angreifende Orthopädische Chirurgie
Project Number 2008-1-BG1-LEO05-00454
Project Type Innovationstransfer
Marketing Text Ziel des Projekts ist es, die Qualität und Attraktivität der medizinischen Bildungssysteme zu verbessern, durch Anpassung, auf die Bedürfnisse von bulgarischen und irischen Ausbildungssystemen nach in der Orthopädie entwickelten Kursen, und Integration von innovativen Performance-zentrierten Ansätzen und Kursen, die im Rahmen des Leonardo da Vinci EPICUROS Projekts entwickelt worden sind, damit diese Pilot in einem verbesserten Leistungsunterstützten System dienen.
One of the main directions of the Bulgarian national strategy to implement the electronic Healthcare in Bulgaria responding to the European eHealth strategy is to continuous and sufficient education of healthcare specialists on ICT usage and to building working telemedical applications etc.
This project focuses on transfer of innovative training approach and courses developed within the Leonardo da Vinci project for training and disseminating modern aspects of computer assisted surgery in the public health care sector. Its aim is to meet the training requirements of medical staff which have arisen due to developments in biomedical engineering and information and communications technology. In particular, new developments in applications ranging from image processing to robotics lead to new approaches to diagnosis (image processing and analysis) and minimally invasive surgery (arthroscopy). To this end, the project is setting up an integrated system for the dissemination of innovative techniques and training. A set of training courses developed by the Greek partners within the EPICUROS project for new technologies in minimally invasive surgery will be transferred and adapted to the new user needs, structured in a web-database and a communications network for video conferencing and live distance training on new procedures and operations. Through the system, training in new approaches, practices and techniques in the biomedical engineering field will be provided to doctors, medical staff and technicians. It will provide the users (orthopaedists, surgeons and anaesthetists) with instant and on-site access (at hospitals, clinics) to information about the techniques and methods used in diagnosis and computer assisted surgeries.
The On-lineOrtho project features well-balanced partnerships in terms of organisations involved and expertise required. It involves training organisations and universities, hospitals and university clinics. The project partners from UIo and BioMed were the main developers of courses within the EPICUROS project, and they will transfer their results in Bulgaria and Ireland. The partners from PU developed the IPSS _EE system for physics, microelectronics, informatics university education, and they will transfer their results to the medical sector. Masho EOOD are experts in information technology experienced in development of e-learning materials. They developed the environment fro training micro- and nanoelectronics in two pilot projects from LdV programme. They will be responsible for the implementation of ICT and the on-line surgery demonstrations. The partners from the Bulgarian medical university clinic and VITA hospital and from the Irish university clinic wish to implement the innovations in their daily practice and to participate in the selection, adaptation and use of the intelligent medical learning environment and the development of new learning materials.
The main outcomes will be the intelligent medical performance support environment for surgery training with regular life on-line arthroscopy demonstrations of specific cases and courses in computer assisted orthopaedics adapted to the needs of Bulgaria and Ireland. Besides the adapted old courses three new courses will be developed for anaesthetists, orthopaedic surgeons and medical students on completion of a needs analysis. These will be courses in selection of the content, adaptation and up-grade with new developed learning materials of a course in Hand Surgery, Knee/Shoulder Arthroscopy, Musculoskeletal Surgery and PNB (anaesthesia).
The expected impact is:
- Physicians, medical staff and technicians provided with on-the-job training in new approaches, practices and techniques in the biomedical engineering field and with information about the techniques and methods used in diagnosis and computer assisted surgeries, i.e. to the evidence based medicine.
- Increased European multidisciplinary research and training excellence in biomedical informatics and computer assisted medicine by fostering closer cooperation between ICT, medical device, medical imaging, physicians and training institutions.
- Broader benefits to the whole higher and vocational education sector: transferring the positive results and experiences from two Leonardo and Socrates projects to a new sector and new countries, the project will improve perceptions of the new task-oriented learning materials and the self-confidence in their use; inter-institutional and inter-disciplinary collaboration and knowledge sharing in university education will be fostered; community of learners with specific interests can serve as a model for future projects; the project will address the understanding of vocational learning processes and experiences in using performance-centred design and ICT in the hospital and higher medical education sector.
Една от главните насоки на българската национална стратегия за внедряване на електронно здравеопазване в България, отговарящо на европейската eHealth стратегия, е непрекъснато обучение на здравните специалисти за използване на информационните и комуникационни технологии (ИКТ) и разработване на ефективни теле-медицински приложения.
Този проект цели трансфер на иновационен метод за обучение и разработени курсове в рамките на проект по Леонардо да Винчи за обучение и разпространяване на съвременни методи в компютъризираната хирургия в сектора на здравеопазването. Целта на проекта е да отговори на нуждата от квалификация на медицинския персонал, която възникна като следствие от развитието на биомедицинското инженерство и ИКТ. На практика, новите разработки в областта на компютърните приложения – от обработката на образи до роботиката, доведоха до нови методи и подходи в диагностиката (обработка на образи и анализиране) и намаляване дела на инвазивната хирургия (артроскопия). Проектът цели да организира интегрирана система за разпространение на иновационни техники и обучение в тази област. Набор от квалификационни курсове, разработени от гръцкият партньор в рамките на проект EPICUROS за нови технологии в минимално инвазивната хирургия, ще бъдат адаптирани и трансферирани за нуждите на нови потребители, структурирани във Web-базирани бази-данни и комуникационна мрежа за видео-конференции и онлайн дистанционно обучение по нови процедури и операции. Чрез системата обучението по нови методи, практики и техники в биомедицинското инженерство ще бъдат предоставени на доктори, медицински персонал и техници. Тя ще осигури на потребителите (ортопеди и хирурзи) непосредствен онлайн достъп (в болници и клиники) до информация за техники и методи използвани в диагностиката и компютъризираната хирургия.
Проект IMEDEST се характеризира с добре балансирано партньорство като организации и експертиза, включва обучаващи организации и университети, болници и университетски клиники. Партньорите от UIo и BioMed са основните разработчици на курсовете по проекта EPICUROS, и те ще трансферират резултатите си в България и Ирландия. Партньорите от ПУ са разработили IPSS_EE системата, която реализира метода за учене-чрез-подпомагане изпълнение на задания, в областта на микроелектрониката, информатиката и инженерните науки и те ще трансферират резултатите си в медицинския сектор. Партньорите от Машо ЕООД са експерти в ИТ и разработването на учебни материали за целите на електронното обучение. Те са работили по разработване на среда за обучение по микро- и наноелектроника в два Леонардо проекта. Те ще отговарят за внедряване на ИКТ и он-лайн демонстративна хирургическа интервенция. Партньорите от българската университетска клиника и частна клиника ВИТА, и от ирландската университетска клиника искат да внедрят иновациите в тяхната ежедневна практика и да участват в подбора, адаптацията и използването на интелигентната система за учене в областта на медицината.
Очаквани резултати: интелигентна медицинска среда за учене-чрез-подпомагане изпълнение на задания по ортопедична хирургия с редовни он-лайн, в реално време, артроскопични демонстрации на специфични случаи и компютърно базирани курсове по ортопедия, адаптирани за нуждите на България и Ирландия; Едновремено с адаптиране на вече съществуващи курсове, ще бъдат разработени и нови курсове за анестезиолози, ортопеди и студенти по медицина след направен обстоен анализ на нуждите. Конкретните курсове са представени в работните пакети.
• на лекари, медицински и технически персонал ще бъде предоставена възможност за обучение на работното място по нови иновационни методи, практики и техники в областта на биомедицинското инженерство, както и възможност за обмяна на информация за техники и методи на диагностициране и компютъризирана хирургия, т.е. в областта на доказателствено-базираната медицина
• подобряване на европейските мултидисциплинарни изследвания и обучение в биомедицинската информатика и компютъризирана медицина, чрез тясно сътрудничество между разрабогчиците на ИКТ, на медицинска електроника, лекари и обучаващи институции.
по-широка полза за целия образователен сектор – университетско и професионално образование: трансфериране на положителните резултати и опит от два Леонардо и Сократ проекти в нов сектор и нови страни; интер-институционалното и интер-дисциплинарното сътрудничество и споделяне на знания и умения в университетското обучение ще бъде поощрено; създаването на общност от обучаеми със специални мултидисциплинални интереси може да служи за модел за бъдещи проекти. Проектът ще помогне разбирането и внедряването на професионалното обучение и опит в използването на метода чрез подпомагане на изпълнението на конкретни задания и ИКТ в болниците и висшето медицинско образование.
From the preliminary need analysis the following needs of the target organisations and learners were analysed and summarised:
a) Priorities at European and National level and needs of the health sector:
One of the main directions of the Bulgarian national strategy to implement the electronic Healthcare in Bulgaria  responding to the European eHealth strategy is to continuous and sufficient education of healthcare specialists on ICT usage and to building working telemedical applications etc. “The expansion of the knowledge base is accompanied by an unprecedented speed in transformation of frontier scientific inventions into practical use and products…. As probably the most promising of the frontier technologies, life sciences and biotechnology can provide a major contribution to achieving the European Community’s Lisbon Summit’s objective of becoming a leading knowledge-based economy”. The European Council reconfirmed the strategic goal for the European countries to become the most competitive and dynamic knowledge-based economies in the world and enforced the accelerated development of Information society and ICTs. The implementation of e-Health is an important component of the information society and was acknowledged as one of the main priorities in the European development plans. The new initiative of the European Commission i2010, place a significant role on the introduction of electronic health cards and unified information system as an integral part of the modern healthcare .
So, there is a need of new environments for predictive, individualised, evidence based, more effective and safer healthcare and the physicians and the other staff in health sector need to be trained to work with them.
b) Needs related to the target groups
In  the following data from the eEurope+ health survey are given: 1) The share of GPs with Internet access in Bulgaria is low. Between 14% and 19% form the GPs use Internet access in their offices. For comparison 78% of the GPs in EU -15 have such access; 2) According to NHIF 56.3% from GPs maintain electronic data for their patients in the reporting period by November 2004. In comparison only 8.5% of the medical specialists report electronically, and from the employed in hospitals only 3.7% report electronically; 3) The data show that only 2 % to 4 % from GPs exchange electronic data about their patients. One of the main directions of the Bulgarian National strategy is to continuous and sufficient education of healthcare specialists on ICT usage and to building working telemedical applications etc .
So, there is a need of courses for continuous (lifelong) training healthcare staff on the use of ICT for their specific purposes, e.g. systems targeting specific clinical needs such as prediction of diseases, early diagnosis, disease quantification, surgery planning, treatment and training.
One of the main principles of the electronic healthcare is the Evidence-based medicine and the online education of physicians . Evidence-based medicine de-emphasizes intuition, unsystematic clinical experience, and pathophysiologic rationale as sufficient grounds for clinical decision-making, and stresses the examination of evidence from clinical research. Lack of access to information remains one of the major barriers to evidence based medicine. Limited access to computer facilities, to literature databases and to continuing medical education programmes are just some examples out of the full range causing disparities in universal access to health care information .
Physicians need training in the skills necessary for practicing evidence-based medicine. There is a need of e-learning courses with demonstrations, simulation of the cases for predictive, evidence based planning and intervention and they will be more useful for the doctors in remote regions.
In order to decrease the barrier to evidence based medical information and to train the higher order skills of medicine doctors this project will transfer the positive results from the use of Performance Support Systems for training informatics, microelectronics, mathematics, sciences to the sector of medicine as well as the outcomes of the from the EPICUROS project which developed e-learning courses in orthopaedics.
The project aim is to improve the quality and attractiveness of medical training systems by adapting and integrating innovative approach and results from previous Socrates/Minerva and Leonardo da Vinci projects to the needs of Bulgarian and Irish medical training systems with courses in orthopaedics to serve as a pilot in an improved system of learning using the approach of performance support systems.
To this overall aim, the project will work toward achieving the following specific objectives:
1. Identifying and analysing user requirements of orthopaedists, surgeons, medical and technical staff in Bulgaria, Ireland, Greece
2. Selecting and analysing innovative content to meet these requirements
3. Transferring the performance support system approach in medical training and developing an intelligent medical performance support environment for surgery training
4. Pilot test of the system with physicians, medicine students and students in medical electronics.
The preliminary need analysis showed that there is a need of training physicians and medical staff in using and developing eHealth. Within the project we will identify and analyse the specific requirements of orthopaedists, surgeons, medical staff with regard to the stage of development of eHealth systems in each partner country. Based on the requirement analysis, orthopaedics specialists will determine the training content and develop the presentation scenarios of the training courses with regard of development of evidence-based medicine. The courses from the previous project will be up-graded and new learning materials on anaesthesia, knee and shoulder arthroscopy will be developed as well. The Intelligent Medical Performance Support Environment for Surgery Training will include a multilingual system of distance learning courses, which will be implemented using advanced virtual reality technologies for the representation and simulation of the human body and its movements in three-dimensional space. We will try to realise the idea of the virtual surgery, e.g. on Internet will be available the life video of a surgeon working in one hospital in Bulgaria and there is a videoconferencing with the other experts from Greece, Ireland and Bulgaria. It will be implemented not only for training purposes but to allow through videoconferencing the on-line collaboration of doctors from different European countries before, during or after the surgery in specific medical cases.
Target groups: Physicians – specialists in orthopaedics, anaesthetists, surgeons, teachers and students in medicine, medical managers. The doctors from remote regions particularly.
They all need courses for continuous (lifelong) training on the use of ICT for their specific purposes, e.g. systems targeting specific clinical needs such as prediction of diseases, early diagnosis, disease quantification, surgery planning, treatment and training.
With the new developments in biomedical engineering and information and communications technology raised the needs of training on modern aspects of computer assisted surgery in the public health care sector. In particular, new developments in applications ranging from image processing to robotics lead to new approaches to diagnosis (image processing and analysis) and minimally invasive surgery (arthroscopy).
The students in medical electronics and their teachers are also target group in this project. They need courses providing knowledge about the subject of the devices they are developing. They can not assist at real surgeries, so the virtual courses will correspond to their needs.
Potential users: Physicians in all specialities, medical managers, students in medical high school (colleges) who need to be prepared to use and work in the eHealth environment. They could benefit from the results of this project which courses in orthopaedics will serve as a pilot for developing an improved system of learning using the approach of performance support systems.
The experiences gained and the lessons learnt within the project would be useful for the ICT experts developing eHealth systems, e.g. the Bulgarian National Health Information Foundation.
The pilot test of the developed in the proposed project system will provide the physicians and surgeons as well the managers with data about the feasibility and effectiveness of the provision and use of an instant and on-site access (at hospitals, clinics) to information about the techniques and methods used in diagnosis and surgeries, being computer assisted or the best practices.
The indicator for the first objective will be need and requirements analyses of corresponding partner, feasibility analysis of the e-learning environment and the summarised report.
Indicators for the second objective are the syllabi, content selected and instructional design performed of three (new) courses in orthopaedics and computer assisted surgery.
The positive results of the functionality and usability tests of the IPSS and the adapted/upgraded e-learning materials for the courses will indicate that the third objective is attained.
The positive pilot test report and the evaluation report of the external evaluator will indicate the success of the whole project.
A plan for the implementation of the IPSS with the courses in the national and European eHealth systems will be indicator for the exploitation and sustainability of project outcomes.
New users of the system and the enlarged project partnership by the end of the project will be indicator of its impact and successful dissemination.
Although all members of the consortium speak English, our project respects the language diversities because the users will be doctors and students from each country for which the language should not be an impediment to access the performance support materials.
Erbringung von Freiberuflichen, Wissenschaftlichen und Technischen Dienstleistungen
Gesundheits- und Sozialwesen
Erziehung und Unterricht
Unterlagen für offenen Unterricht
Product information The preliminary need analysis showed that there is a need of training physicians and medical staff in using and developing eHealth. Within the project we will identify and analyse the specific requirements of orthopaedists, surgeons, medical staff with regard to the stage of development of eHealth systems in each partner country. Based on the requirement analysis, orthopaedics specialists will determine the training content and develop the presentation scenarios of the training courses with regard of development of evidence-based medicine. The courses from the previous project will be up-graded and new learning materials on anaesthesia, knee and shoulder arthroscopy will be developed as well. The Intelligent Medical Performance Support Environment for Surgery Training will include a multilingual system of distance learning courses, which will be implemented using advanced virtual reality technologies for the representation and simulation of the human body and its movements in three-dimensional space. We will try to realise the idea of the virtual surgery, e.g. on Internet will be available the life video of a surgeon working in one hospital in Bulgaria and there is a videoconferencing with the other experts from Greece, Ireland and Bulgaria. It will be implemented not only for training purposes but to allow through videoconferencing the on-line collaboration of doctors from different European countries before, during or after the surgery in specific medical cases.