Scalable+Pilot+Projects

=Scalable Pilot Projects=

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An overview of the functional strands of the SOS project, and the thematic areas suggests a number of areas where support would be helpful as a laboratory for collaborative action research with users in context.[|SOSPrioritySupportAreasv2..docx]======

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The Venezuelan team builds on a model of telehealth that is community led and owned, building on local engagement and empowerment, and where a number of areas have been identified as requiring support. Three inter-related areas leverage existing expertise and interests and could be explored in the context of two particular disease areas.======
 * ======Remote diagnosis and monitoring of disease (bio-chips, mobile sensors/speckz, mobile phone applications)======
 * Remote data collection, representation and sharing (MCAs, Mobile and Open Source applications)
 * ======Remote decision support and training of health care personnel (Videoconferencing, mobile phones/assistants)======

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The Edinburgh group has significant experience of developing mobile bioinformatics applications for remote diagnosis (including biochips and speckled computing), as well as user-led evaluation of tele-monitoring systems and infrastructure (for Intel and others), with eLearning to support clinical training in developing regions. The group is also working with colleagues in Oxford and the US on Open Source platforms for collecting both patient records data and infectious disease data for monitoring,======

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The Aberdeen group are a centre for telecare delivery in rural communities, working with other remote European and Scandinavian telehealth networks in the core disease and primary care areas of interest to the SOS team (including teledermatology, telepathology, and infectious), using compatible video-conferencing systems to those used in some fo the Venezuelan centres for remote diagnosis, intervention and training.======

Availability of something like the Intel Medical Digital Assistant would facilitate the collection, sharing and use of data and health information in these contexts, and would also provide a vehicle for facilitating the process of data collection as part of the pilot, and as part of the research itself.

The SOS team have highlighted the fact that infectious disease diagnosis is a problem in very remote areas such as Cacuri, for example where remote diagnosis in situ would be greatly supported by the availability of something like the mobile biochip of the kind developed by Til Bachmann's team at Edinburgh. Here support for local healthcare workers is also essential, and something like a mobile clinical assistant could provide a vehicle for both tailored healthcare support materials, as well as a means of collecting and sharing patient data witha wider, distributed team.
 * Pilot Concept**

The Nueva Esparta region presents another (very different) context where tele-monitoring would also meet a real need. Here chronic respiratory diseases are a common condition over a wide territory, with many remote communities and very few clinics. The challenge here is to look at viable low cost solutions for monitoring a large distributed population with few nursing resources such as mobile 'speckz' linked to a mobile phone as a low cost mobile application for monitoring respiratory disease recently successfully trialled by Prof. DK Arvind at Edinurgh. Having acess to this, and a mobile clinical assistant on initial assessment visits might provide a means of both maintaining a database of patients for monitoring from the centre, as well as providing support for health care staff and patients themselves.

The SOS team in the Medical School in Caracas uses high quality video-conferencing for joint case consulting and training in some of the centres, including some very remote centres where satellite equipment has been brought in for this purpose, together with mobile phone and VOIP applications.This is a familiar modus operandi for case consulting and training with the rural telehealthcare team in Aberdeen, and has been a useful basis for the partnership to date, together with Skype and online tools. A mobile assistant such as the MCA would be instrumental in filling the gap on site, given the need to collect, share and store data for research purposes as well as clinical ones.

- engagement / buy in with users in exploring and developing both research and development of the approach - understanding of the process of sustainably implementing remote healthcare diagnostics in a developing nation setting - understanding of generic and context-specific barriers to use (social, technical, clinical, organisational, economic) - better, faster and cheaper diagnostics that improve health in poor rural communities - perceived benefits by users - ownership by local communities
 * Criteria for Success**

Based on collaborative action research with and by SOS team, heealth care team, users, regional health service partners and user communities.
 * Core Aims**

__Social/Clinical/Organisational__ - requirements for clinically usable, acceptable use (e.g. of mobile applications for remote diagnosis) - perceived barriers risks, costs, benefits, usability - care pathway delivery scenarios with the SOS team and with regional health service policy makers - protocols for use - training /health information requiremements in the site/ specific disease context, for specialists, local health care workers

__Technical and Data Infrastructure__ - quality and reliability of data - recording, representation and re-use of data - usability of systems/interfaces - technical interoperability, standards issues - explore potential for support on different Open Source platforms