1st Annual EUBIROD meeting Dasman Center for Research and Treatment of Diabetes, Kuwait City Kuwait City, Kuwait, 2nd-4th May 2009

Technology Transfer in Romania

S.Pruna, Paulescu Institute, Romania

First BIRO Academy Residential Course, Kuwait City, Kuwait, 2nd May 2009

Slides

In Romania, several experiences were made along the years in the field of diabetes information systems. In this presentation Dr.Simion Pruna, a senior scientist in information technology from Paulescu, presents the main results of the technology transfer.

In his talk, Simion congratulates with the team of the BIRO project, described as one of the most innovative groups since the early nineties, when similar programs have been launched, but the technology, in particular open source software, was much less developed.

Simion has been working for many years to similar initiatives, starting from a Diabcare database in Bucharest and 10 other counties of Romania. The St Vincent Diabcare data collection service was initially organized through an e-mail network linking university teaching with diabetes care centres through the same interface.

The aim of the technology transfer in BIRO is to test in real practice conditions what initially designed purely on a theoretical ground. Here Simion remarks that there is substantial work required to implement a system e.g. BIRO. The first hurdle is the retrieval of original data that must be mapped against a common format as a basis for the production of 72 diabetes indicators. To populate this matrix can be harder than previous experiences e.g. Diabcare, already described to be heavy by distinguished researchers.

In his talk, Dr.Pruna described how technology transfer allowed partners to focus on healthcare systems, the IT infrastructure, and database collection programs in three New Member States: Cyprus, Malta and Romania. This experience showed that some basic aspects in data management are indeed relevant to succeed in promoting a shared information system. For instance, data types used in different databases can be heterogeneous and need to be compared to the common format. In BIRO we found that parameters are measured and recorded differently across partners.

That is not surprising in Romania, where the same problem exists within the country and the framework appears very fragmented and not allowing interoperable services. The result until now has been poor use of health data. Health information systems in diabetes are fragmented, inaccurate, cumbersome, untimely, and isolated. Furthermore, there are implicit business incentives for limiting the interoperability of different health information systems, leading to a diversity of attitudes and mix of skills that must be faced in the implementation of new protocols.

According to Simion, today we have powerful open source solutions that can dramatically help overcoming these problems, e.g. PostgreSQL, allowing to apply highly performing queries on data using average hardware on Linux OS. BIRO complies with this framework and allows to operate in difficult conditions where the infrastructure is limited.

In his conclusions, Simion highlights that now regions can deliver useful outputs. However, to make the process easier, the technology transfer exercise must be continued with the support of customized tools that are user oriented. Tests on Romanian data show that using BIRO is not only possible, but easily transferable. To succeed, it will be paramount that clinicians, scientific associations, and policy makers are all involved in this process of innovation.