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Telemedicine (Medische informatica)
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Vo National technical agreement
NTA 8028 (en)
Telemedicine (Health informatics)
november 2007
ICS 35.240.80
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NTA 8028:2007
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Vo Policy Committee 303 "Information provision in the healthcare sector"
The Netherlands Standardization Institute shall, with the exclusion of any other beneficiary, collect payments owed by third parties for duplication and/or act in and out of law, where this authority is not transferred or falls by right to the Reproduction Rights Foundation. Auteursrecht voorbehouden. Behoudens uitzondering door de wet gesteld mag zonder schriftelijke toestemming van het Nederlands Normalisatie-instituut niets uit deze uitgave worden verveelvoudigd en/of openbaar gemaakt door middel van fotokopie, microfilm, opslag in computerbestanden of anderszins, hetgeen ook van toepassing is op gehele of gedeeltelijke bewerking.
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Apart from exceptions provided by the law, nothing from this publication may be duplicated and/or published by means of photocopy, microfilm, storage in computer files or otherwise, which also applies to full or partial processing, without the written consent of the Netherlands Standardization Institute.
Although the utmost care has been taken with this publication, errors and omissions cannot be entirely excluded. The Netherlands Standardization Institute and/or the members of the committees therefore accept no liability, not even for direct or indirect damage, occurring due to or in relation with the application of publications issued by the Netherlands Standardization Institute.
Hoewel bij deze uitgave de uiterste zorg is nagestreefd, kunnen fouten en onvolledigheden niet geheel worden uitgesloten. Het Nederlands Normalisatie-instituut en/of de leden van de commissies aanvaarden derhalve geen enkele aansprakelijkheid, ook niet voor directe of indirecte schade, ontstaan door of verband houdend met toepassing van door het Nederlands Normalisatie-instituut gepubliceerde uitgaven.
Het Nederlands Normalisatie-instituut is met uitsluiting van ieder ander gerechtigd de door derden verschuldigde vergoedingen voor verveelvoudiging te innen en/of daartoe in en buiten rechte op te treden, voor zover deze bevoegdheid niet is overgedragen c.q. rechtens toekomt aan de Stichting Reprorecht. ©2007 Nederlands Normalisatie-instituut [Netherlands Standardization Institute] P.O. Box 5059, 2600 GB Delft, The Netherlands Telephone: + 31 (0)15 269 0390, Fax + 31 (0)15 2 69 0190
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NTA 8028:2007
Contents Foreword ..........................................................................................................................................................2 Scope................................................................................................................................................5
2 2.1
Normative references .....................................................................................................................5 Legislation .........................................................................................................................................6
3
Terms and definitions.....................................................................................................................7
4 4.1 4.2 4.2.1 4.2.2 4.2.3 4.2.4 4.2.5 4.3 4.4 4.4.1 4.4.2
Telemedicine....................................................................................................................................8 Definition of telemedicine ..................................................................................................................8 Elucidation of the definition of telemedicine......................................................................................8 Care processes .................................................................................................................................8 Care processes involving at least two actors....................................................................................8 Processes involving the transfer of data from/about care consumers ..............................................8 Processes that bridge distance .........................................................................................................8 Applications that make use of information and communication technology (ICT) ............................9 Objectives of telemedicine ................................................................................................................9 Other aspects ..................................................................................................................................10 Telemedicine and prevention ..........................................................................................................10 Telelearning and telemedicine ........................................................................................................10
5 5.1 5.2 5.2.1 5.2.2 5.3 5.3.1 5.3.2 5.3.3 5.3.4 5.4 5.4.1 5.4.2 5.5 5.5.1 5.5.2
Quality aspects..............................................................................................................................10 Introduction......................................................................................................................................10 Quality at the level of care provision ...............................................................................................10 Patient orientation ...........................................................................................................................10 Effectiveness and efficiency of care................................................................................................11 Quality at the level of information provision ....................................................................................11 Control of data.................................................................................................................................11 Interoperability: standardization and connectivity ...........................................................................12 User convenience............................................................................................................................12 Quality aspects of an information system .......................................................................................12 Quality at the level of business processes......................................................................................12 Process description and organizational structure ...........................................................................12 Responsibility and administrative management..............................................................................13 Quality assurance............................................................................................................................13 Internal quality system ....................................................................................................................13 External auditability of the process .................................................................................................14
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Appendix A (informative) Registers of accredited professions in the Dutch healthcare sector...........15
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NTA 8028:2007
Foreword It is inevitable that there will be an even greater demand for healthcare in the future as a result of the ageing population, extended life expectancy and related increased health problems. The shift from hospital-based care to extramural care, and shortened periods of hospitalization will intensify the ever-increasing pressure on primary, secondary and tertiary care systems. This increasing demand will not be accompanied by a corresponding growth in the number of healthcare practitioners. If policies remain unchanged, the gap between the demand and the supply of labour in the healthcare sector will soon widen.
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Use of information and communication technologies (ICT) is currently undergoing significant growth within the healthcare sector. Originally, ICT was mainly used within institutions, but its use is now widespread throughout the healthcare sector and applications that make use of ICT facilities are now even finding their way into patients' and clients' homes. New forms of care provision will be needed if the increasing demand for care is to be satisfied at an affordable price. Telemedicine is one example of such a new form of care provision. Situations in which telemedicine is being used are typically those in which actors at various locations actively cooperate in a particular process.
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There are a growing number of telemedicine initiatives in the Netherlands, most of them small-scale. It is as yet unclear when the term telemedicine can rightly be used, because the term telemedicine is being described and interpreted in different ways and there is no unequivocal conceptual framework for the various forms. Normalization can contribute to the alignment and harmonization of telemedicine activities. For parties in the healthcare sector it is therefore important to define telemedicine more clearly. A widely accepted definition of telemedicine is also of importance for a safe, speedy and socio-economic acceptable introduction of the phenomenon. The aim of this document is to improve communications between the various interested parties and to stimulate the application of telemedicine in the Dutch healthcare sector.
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It is expected that telemedicine will lead to more efficient care, because of the improvement in communications between healthcare practitioners for example, which may itself lead to more patient-oriented referral policies. It is also expected that telemedicine will improve the quality of care, for example because healthcare practitioners will be better and more quickly informed about the patient, and they will have easier access to support from medical specialists. It can also be expected that the quality of life of the person needing care, the care consumer, will improve thanks to telemedicine; this might for example be brought about by the fact that the patient can be monitored in his own home, and receive advice without the need to travel to a healthcare practitioner or institution. This normative document contains agreements about the concept of telemedicine. These agreements also concern the formulation of those quality aspects which are important for telemedicine. The document before you has the status of framework document; quality requirements can be further elaborated in follow-up documents.
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NTA 8028:2007 Participants This NTA has been drawn up by members of the Telemedicine Project Group. This group consisted of members representing: — the Council of Healthcare Insurers (CVZ) — CZ Healthcare Insurer — De Friesland Healthcare Insurer — H2W Partners
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— Intel Corporation — inview
— Royal Netherlands Society for the Advancement of Pharmacology (KNMP) — KSYOS TeleMedicine Centre
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— Mextal
— Royal Haskoning — Tunstall
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— Wacomed
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— Vitaphone
— Mr J.G. Beun (in a private capacity)
The Project Group was chaired by Mr A.R. Bakker.
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In addition to the Project Group four ‘reading members’ followed the development and content of the NTA closely, these were: the national Health Care Inspectorate [Inspectie voor de Gezondheidszorg, IGZ], the Ministry of Public Health, Welfare and Sport [Ministerie van Volksgezondheid Welzijn en Sport, VWS], the National ICT Institute for Healthcare (NICTIZ) and Mr E. Kloosterman, an employee of the Norwegian Institute for Telemedicine. A ‘response group’ was also established and its members were given the opportunity to make (non-binding) comments and recommendations on the content of the NTA. From the side of NEN, the NTA process was coordinated by Mrs F.M. Boomsma, a standardization consultant for NEN's Healthcare Division.
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