Design and Implementation of a Portal for the Medical Equipment Market: MEDICOM
Stergios Palamas1; Dimitris Kalivas2; Ourania Panou-Diamandi1; Cees Zeelenberg3; Chris van Nimwegen3
1National Technical University of Athens, Biomedical Engineering Laboratory, 9 Iroon Polytechniou Str., Computer Building, 15773 Athens, Greece
2Technological Education Institute of Piraeus, Department of Electronics, 250 Thivon Str., 12244 Athens, Greece
3Nederlandse Organisatie voor Toegepast Natuurwetenschappelijk Onderzoek (TNO)-Prevention and Health, Department of Technology in Healthcare, Zernikedreef 9, P.O. Box 2215, 2301 ce Leiden, Netherlands
(J Med Internet Res 2001;3(4):e32)
Electronic commerce, medical devices, equipment and supplies, Internet, CORBA, XML, RDBMS
The main objective for a European electronic marketplace for medical devices is to establish an environment hosting all the interactions of consumers (health care organizations and professionals) and providers (manufacturers, distributors, and resellers of medical devices). This objective is to be accomplished by concentrating the forces of organizations that are interested in globalization of the medical-products market. This has become necessary because the growth of the medical market requires introducing modern technologies for developing products and for establishing marketing policies. Our objective was to build a service that relies on seamless information exchange on the Internet to facilitate business relations (marketing, sales, and after-sales processes).
The MEDICOM (Medical Products Electronic Commerce) system is an Internet-based system that includes a unique Portal, which more or less acts as the yellow pages (a list of business and professional firms alphabetically by category; typically part of a telephone directory) for finding both products and providers. Its main advantage is fast, reliable, up-to-date information retrieval that eliminates all unrelated content that a general-purpose search engine would retrieve. The Portal accepts the end-user requests and generates a list of results containing text descriptions of devices, UMDNS (Universal Medical Device Nomenclature System) Attribute Values, and links to the providers' servers (for Web pages, online catalogues, and post-market surveillance systems) for access to more-detailed information in a way that is transparent to end-user customers. The post-market surveillance system collects information about adverse incidents; information on these incidents needs to be exchanged among competent authorities, health care institutions, and manufacturers, to deal with the consequences of the incidents and prevent reappearance of the same incidents.
The requirements of the medical-devices electronic-commerce community along with the technical requirements of the MEDICOM system have been analyzed within the framework of the MEDICOM project . The European Commission, under the ESPRIT program, supported the project.
The end users of the MEDICOM system are clinicians; doctors; hospital administrative staff; clinical engineers; and in general everyone who uses medical devices, is involved in purchasing medical devices, or technically supports medical devices. The end-user requirements are, in summary:
The medical equipment providers (manufacturers, distributors, and resellers) form the second user group of the system. Their main requirements are:
Technical requirements are:
In addition to the user requirements and technical requirements, some MEDICOM system-design issues have been considered:
Since UMDNS was already widely used in Europe and the European Commission had adopted UMDNS as an interim standard, it was decided to use UMDNS as the classification basis throughout the MEDICOM system .
The MEDICOM system has been implemented using a modularized and distributed architecture. The main components of the system are shown in Figure 1. The Portal provides the end-user interface, handles system management, and ensures database compatibility throughout the system. It also provides necessary communication services, technical support for MEDICOM integrators, and additional services for the end users.Figure 1. The MEDICOM system architecture
The MEDICOM Portal provides access to the whole system and coordinates the operation of the servers (catalogue and PMS servers) hosted by the manufacturers. The Portal hosts a database composed of 2 parts: (a) the Common Database, which stores a set of encoded parameters that will be included on all servers and (b) the Short Description Database, which contains the short descriptions of all medical products registered to the system.
The Portal is responsible for maintaining, altering on demand, distributing across the subsystems, and ensuring the consistency of the information in the Common Database. The structure of the Common Database includes the following data (see the next 2 paragraphs for explanations of some of the terms): Supported Languages, Geographic Regions, UMDNS Codes, UMDNS Attributes, Predefined UMDNS Attribute Values, Manufacturers, Authorized Representatives and Distributors, Incident Reports Classification Codes, Healthcare Institutions with PMS Client Systems, Quality Certificates of Medical Devices, Organizations Classification Codes, Specialism Codes of End Users, Producers Mailing Lists, End-users Job Titles, and Authorities.
The UMDNS Code is a unique identifier for each product category. Each product category (that is, each UMDNS code) is characterized by a set of features (for example, the operational voltage and the resolution). In the UMDNS, these features are called UMDNS Attributes. The set of values of each attribute are the attribute values. An example is the Device Category Scanners, Ultrasonic, General Purpose, which is assigned the unique UMDNS code 15976. For this device category there are 5 attributes (features) defined in the UMDNS coding system: System, Doppler/C.V.I., Transducers (arrays), Application, and Accessories. These attributes are intended to be the most important features of this device category. Each of the attributes has one or more values. The values can be restricted to a predefined set of values or can be unrestricted. For example, the attribute Transducers has a set of predefined values (Phased, Linear, and Curved Linear); the attribute Application can take any value. Using the attribute and attribute values, the UMDNS codification ensures that for each device category a common set of important feature characteristics will be supplied.
Authorities (Competent Authorities and Notified Bodies) receive reports on serious incidents involving medical devices. The reports are submitted by the manufacturers or the health care institutions. Generally, the authorities have to monitor the manufacturer's investigation and intervene when necessary.
The Short Description Database contains summarized descriptions of medical devices, whose extended descriptions are presented by the manufacturer's servers. The Short Description includes a text description, the manufacturer and/or authorized representatives and/or distributors, the UMDNS code, important product features, and links to the corresponding HTML pages of the manufacturers' servers (where extended information exists). The contents of the Short Description Database will be updated as a result of a manufacturer's-server request.
To satisfy the end-user requirements the Portal provides the end-user with the following services:
In addition to providing services to the end users, the Portal provides the following services to the manufacturers:
The objective of the evaluation was to validate the usability of the complete MEDICOM functionality. To evaluate the system effectiveness and efficiency, representative users were asked to complete typical tasks. The evaluation procedure was based on ISO/IEC (International Organization for Standardization/International Electrotechnical Commission) 9126, Information technology - Software product evaluation - Quality characteristics and guidelines for their use .. Additionally, simple questionnaires were used to assess user satisfaction.
The users of the system were divided into 3 groups:
End-user functionality was evaluated by AUSL (Azienda Unita' Santaria Locale Di Modena) of Modena, which is the health care organization responsible for public service in the province of Modena, Italy. Manufacturer functionality was evaluated by Esaote S.p.A. (a medical-device company). Service-provider functionality was evaluated by the Prevention and Health Division of TNO.
The overall user evaluation of the MEDICOM system was very positive. The MEDICOM system was characterized as an innovative concept that brings significant added value to the process of medical-equipment commerce.
Searching for a product in a specific product category resulted in a list of matching products that was highly representative of the actual market. The amount of information in the short description of each product was considered well chosen. The searching procedure was easy to use, even by persons without specific computer experience. The on-line help was often used and the information returned was adequate. The resulting list of matching products never contained products that should not be included (that is, that did not match the searching criteria). In comparison to the searching procedures that were used up to then the MEDICOM system proved to be more effective, more efficient and more user friendly.
Researching the overall competition to MEDICOM showed that no company offers the complete set of MEDICOM services. Some companies only present basic company information or list their products, with neither search nor ordering options. Some companies present only part of the possible product mix, or they supply products from only one manufacturer or from a few manufacturers. Most companies offer only basic customer service or give their telephone number and/or e-mail address. Although there are Web sites where it is possible to order products made by many manufacturers, these Web sites are not strong potential competitors to MEDICOM, since they are not portals and their product mix is not as wide as MEDICOM's product mix.
The MEDICOM Portal targets the manufacturers of medical devices by stressing the importance of the Internet as a mean of providing information and promoting their products. The Internet is a new and cost-effective way of diffusing product information, offering technical and after sales support, providing information about new products and services, evaluating the competition, finding new distributors and suppliers, and reaching global customers.
For health-care professionals, MEDICOM provides a wide range of accurate information about new medical products and services. It will increase health-care professionals' knowledge about the market and it will improve communication between them and the manufacturers for after-sales and technical support. Most importantly, it will facilitate the involvement of all actors in the purchasing process for new medical equipment by providing a wide range of accurate information, by giving access to detailed technical features and commercial conditions on-line, and by offering an overview of the products' competition.
The ESPRIT project MEDICOM partially supported this work. Partners in the MEDICOM project were ICCS-NTUA and Epograf Ltd from Greece, Selisa S.A. from France (project coordinator), TNO from Netherlands, AUSL Modena and ESAOTE S.p.A. from Italy, and Pixelpark from Germany. We would like to express our thankfulness to all participants in the project for their fruitful collaboration.
|AUSL: Azienda Unita' Santaria Locale Di Modena|
|CORBA: Common Object Request Broker Architecture|
|ISO/IEC: International Organization for Standardization/International Electrotechnical Commission|
|IT: Information Technology|
|MEDICOM: Medical Products Electronic Commerce|
|PMS: Post Market Surveillance|
|RDBMS: Relational Database Management Systems|
|TNO: Toegepast Natuurwetenschappelijk Onderzoek (Netherlands Organization for Applied Scientific Research)|
|UMDNS: Universal Medical Devices Nomenclature System|
|XML: eXtensible Markup Language|
|Submitted 06.08.99; peer-reviewed by N Oliveria; comments to author 09.02.00; revised version received 23.11.00; accepted 18.01.01; published 26.12.01|
Please cite as:
Palamas S, Kalivas D, Panou-Diamandi O, Zeelenberg C, Nimwegen Cv
Design and Implementation of a Portal for the Medical Equipment Market: MEDICOM
J Med Internet Res 2001;3(4):e32