Gazette: What is new about the SAPHIRE Project compared to your previous ex perience with medical research studies and how do you see your team’s involvement in the development of the Hospital Pilot Application?
Prof. M.D.: Most of our research is strictly medical, clinical studies and also some fundamental research in genetics, molecular medicine and stem-cell therapies.
We have done some work in e-health together with the Polytechnic University in Bucharest, in ECG monitoring from the distance, but our ex perience with ICT when we started in the SAPHIRE Project was quite limited.
My colleagues and I have been very enthusiastic about this project, as we have chosen to develop our pilot application on the population of patients with acute coronary syndromes and we have huge ex perience with this pathology, we have written books on it.
We were also familiarized with intensive care continuous monitoring and with telemetry and Holter monitoring systems, so linking usual in-hospital monitoring with guidelines models and adapting the data to the patient’s profile from the Electronic Health Record sounded very new, very promising and easy to be exploited as a new exciting tool in the care of acute cardiovascular patients.
Our workload in the hospital is getting bigger every day, Cardiology is developing very fast, doctors are young and lack ex perience many times and we have looked upon SAPHIRE Hospital Pilot Application as a future system to make things easier for us in the hospital.
However, we had to overcome some difficulties when we analysed our requirements. Like the lack of a Hospital Information System at SCUB.
Gazette: What other challenges have you met in your work with SAPHIRE? Do you expect any other problems?
Prof. M.D.: Choosing to model Cardiology guidelines has been a first important challenge.
If you look in the literature, the guidelines that everybody modelled during the last 10-15 years were very simple, like guidelines for chronic cough or hy pertension.
But going into acute coronary syndromes has been quite daring for our technical partners and a big challenge for us.
It has been tremendously difficult to model these complicated guidelines first into flowcharts, then into a computer model and we have to acknowledge here the surprisingly open-mind and capacity of our technical partners to understand all the medical issues, to correctly interpret them and to coo perate with us into defining correct medical standards.
We have to confess that, as doctors, we have understood much less of the technical staff involved into building the SAPHIRE architecture, compared of how much our partners have understood from the medical things!
In the end, it has proved to be a very successful collaboration and we hope to make all the project a success in both medical and technology fields.
To answer your last question, yes, we expect some difficulties when we will actually start the Hospital Pilot, in April 2008; we need to plan very carefully, to prepare our staff to deal with the system, to get our patients to sign the informed consents, to correctly respond to alerts, to ensure artifact protection and medical validation of all steps.
That is why we have built a number of o perational scenarios and we have proposed a testing period on a simulator, to begin one month before the actual start of the pilot.
Gazette: Which do you think is the most promising feature of SAPHIRE from the medical point of view?
Prof. M.D.: Obviously, the ability to provide standardized recommendations and alerts, in conformity to the latest European Guidelines that are patient-specifically generated according to the patient profile in the EHR and to the real-time sensors data from wireless monitoring.
I guess SAPHIRE will be the only system to integrate all these features.
If SAPHIRE will be exploited to cover all the medical guidelines and will be adapted to all kinds of EHR systems and monitoring sensors, it can develop into a “must have” tool to ensure optimal, standardized healthcare via e-health.
Gazette: What would be your future plans regarding SAPHIRE when the project will be finished? Will you continue working in this field?
Prof.M.D.: Definitely yes. In fact, we are looking forward to exploitation plans for SAPHIRE.
They are huge in the medical domain and even in the Cardiology Department of SCUB.
We look forward to develop the system in the scope of training young doctors and medical students, maybe adapt it to new guidelines in Cardiology.
We also confess that we expect that, having the SAPHIRE system at work in our Department we might be able to shorten the Coronary Care Units (CCUs) stay for critical or unstable patients, as many times we have many such patients than beds in the CCUs.
The SAPHIRE Project should be safe enough to allow these patients to be followed via the monitoring and alert systems in the regular wards and this is a very medically exciting issue about SAPHIRE in an Emergency Hospital.
We even plan a cost reduction study for the hospitalization of these patients.
Gazette: Last words about SAPHIRE and the medical world?
Prof.M.D.: We are trying to disseminate the SAPHIRE Project into the medical world. These kinds of projects are very familiar in the health informatics, but we have found very few echoes with the doctors, even on academic grounds.
Ithink clinical medicine has passed beyond traditional bed-care to more sophisticated facilities and that the medicine of the future will definitely be computer-linked and computer-assisted.
Many will say that a computer will never replace good clinical judgment. True, but medicine is developing so fast, supra-specialization gains field in many medical domains, information gets more and more complicated and up-dates are so many, that, having to deal with human lives, medicine is more prone to human error and to human misconduct than other scientific fields.
Projects like SAPHIRE are therefore well-come to assist medical decision and their future is wide open
GAZETTE 
