In Belgium, a breast cancer screening programme offers women aged between 50 and 69 the opportunity of undergoing a mammography free of charge every two years. The technical quality of this examination is checked by means of a second reading of the plates by a panel of specialised radiologists. The aim of the IRISMAMMO telemammography project is to streamline and facilitate the transfer, reading and storage of mammograms and to improve the service provided for the general public by integrating the processes, thereby speeding them up and making them safer. Now that the regional mammography teletransmission service is in place and operational for six hospitals, other hospitals or health centres can use it. In the same way, we are proposing, pro-actively, to extend the teletransmission service by offering to open it up to other types of medical imagery, such as the teletransmission project for histological cuts, for instance. We are seeking new partners.
Description of the way to implement the initiative
This project was undertaken by a multidisciplinary team comprising the medical doctor in charge of the breast cancer screening programme, two universities for the scientific supervision and validation of the solutions implemented and the IT Centre of the Brussels-Capital Region which acted as the principal.
A number of options have been selected so as to take account of the infrastructure and the budget available in the hospitals and thereby enable as many of these as possible to join the project. E.g. The first hospitals equipped for the telemammography project continue to use their conventional ultrasound equipment combined with a digitalisation device. When the conventional ultrasound is replaced by a digital ultrasound, the digitalisation device, which remains the project property, is transferred free of charge to a new hospital which is a candidate to join the project.
The skills network set up thanks to the telemammography project will benefit hospitals and university units. The project involving a regional service for the storage and filing of medical imagery or the project to optimise the entire radiology duty system in the Brussels-Capital Region could not have been set in motion without this skills network.
Main results, benefits and impacts
All the European Health Sectors are confronted with increasing financing difficulties. Under the combined pressure of medical and technological progress, the ageing of the population and the development of information and communication systems, the demands made upon medical services is exploding, together with the costs of the services provided. This situation is pushing the authorities, health-related service providers and insurance organisations to consider new strategies to keep costs under control while maintaining access to medical progress. The main objective is to increase efficiency by streamlining practices and by optimising the availability of the resources.
The progress made in medical digital imaging and in information technologies now offers faster and more powerful diagnostic procedures, as well as new solutions for the hospital organisations. The Telemammography project developed in the Brussels-Capital Region show that such applications are possible today and meet real needs. The specific benefits for the various players:
For the patient:
- The period between the mammographic examination and the result is greatly reduced (from three weeks to three days). In addition to lessening the stress inherent in this type of examination, this also means that it is possible to react more swiftly in the event of a negative diagnosis, thereby increasing the chances that the treatment will be successful.
- Patients receive better care thanks to faster and more comprehensive access to their medical data, thereby reducing the number of examinations that have to be carried out.
For the hospitals:
- Fast and effective processing of a large volume of mammograms.
- Introduction of instruments to assist diagnosis.
- Solutions to the problems relating to the storage, transport and loss of X-ray plates.
- Promotes consultation and sharing of medical data specific to each patient in a secured environment.
- Reduces the amount of travelling done by specialised radiologists, who can carry out the second reading without having to go to the second reading centre. This could also be the case for a foreign expert.
For the Brussels-Capital Region:
- Social: by promoting access to better health care, by improving the cancer screening policy, the speed and therefore the precocity of the treatment.
- Political: by acting as a catalyser for progress in a new niche with a great deal of potential and a high technological value (first in Europe).
- Scientific: by promoting the emergence of regional and European research and development projects in the field of the transfer of medical imagery and telemedicine, and by authorising access by Brussels universities to a critical mass of medical data for research purposes.
- Technological and economic: by attracting to Brussels companies that are highly specialised in the medical field.
- Synergy: between very different partners in the private, public and university sectors.
Return on investment
Return on investment: Not applicable / Not available
Track record of sharing
The telemammography project has shown the real possibilities of this type of practice and made it possible to increase awareness among a number of players of the possibilities for the development of new services and applications. Numerous meetings and presentations have been held on the telemammography project in order to pass on as much information as possible to future private or public partners.
The telemammography project also aims to put forward generic solutions that can be transferred to other entities (partnership with the city of Beijing, for instance) and adapted to the transmission of other forms of medical imagery (teletransmission of histological cuts for anatomopathological consultations, for example). The contacts and infrastructure established have also enabled the partners involved to support telemedicine projects (optimisation of the duty system in the field of radiology, computer-aided diagnosis systems, centralised databases in medical imagery). Following on from this, a European project in the field of eLearning in medical imagery has been put forward and accepted for funding by the European Commission ("Emedi -Leonardo programme").
1. One should not neglect the lack of knowledge and medical imagery infrastructure within hospital institutions.
2. There is a lack of standard products at reasonable cost or a lack of technical standardization.
3. It is essential to have a regional strategy, a long term vision.
4. It is difficult to evaluate the current needs of a user and therefore it is essential that the project team is advised by a user's group.
5. Legislation should be adapted as currently, digital images are not legally recognized like the traditional images are.
6. One must pre-determine the type of financing, according to the type of project and according to the necessary budget.
7. The project needs to be integrated in a more general policy, in this case, the Belgian breast cancer screening programme.
8. Provide user training as much as possible to facilitate optimal use of the systems.
9. Choose a realist and change infrastructure in order to take account of the infrastructure and the budget available in the hospitals and thereby to enable as many of these as possible to join the project.
Scope: Regional (sub-national)