The General Directorate for Health of Regione Lombardia is the governing authority holding the legislative and administrative competencies in the healthcare sector, including planning and supplying of healthcare activities, quality monitoring and control, appropriateness and efficiency of services. According to the Italian Constitution, while the national level - Ministry of Health - is in charge for ensuring the general objectives and fundamental principles of the national healthcare system (healthcare financing, overall regulatory frames and monitoring systems), the regional level has the exclusive control and responsibility upon the healthcare system management, including eHealth.
The Region Lombardia has in place an infrastructure composed of about 150,000 healthcare and social professionals, 7,800 general practitioners and paediatricians, 2,500 pharmacies, 15 Local Healthcare Units, 112 public hospitals and 570 private healthcare service suppliers.
The regional healthcare system covers a population of 9.3 million citizens.

The Central Directorate for Health, Social/health integration and Social policies of the Friuli Venezia Giulia Region is responsible for planning and carrying out the activities regarding health and social services on the entire regional territory. To better meet the needs of the 1,227,622 inhabitants of Friuli Venezia Giulia, the regional territory has been divided into six areas and each one is served by a different Agency for Health Services.
The six agencies covering the regional territory are:

• the Agency for Health Services n.1 of the Trieste area
  (Azienda per i Servizi Sanitari n.1 – Triestina),
• the Agency for Health Services n.2 of the Gorizia area
  (Azienda per i Servizi Sanitari n.2 – Isontina),
• the Agency for Health Services n.3 of the Upper Friuli area
  (Azienda per i Servizi Sanitari n.3 - Alto Friuli),
• the Agency for Health Services n.4 of the Middle Friuli area
  (Azienda per i Servizi Sanitari n.4 - Medio Friuli),
• the Agency for Health Services n.5 of the Lower Friuli area
  (Azienda per i Servizi Sanitari n.5 - Bassa Friulana) and
• the Agency for Health Services n.6 of the Western Friuli area
  (Azienda per i Servizi Sanitari n.6 - Friuli Occidentale).

The Agencies for Health Services are coordinated and monitored by the Central Directorate for Health, Social/health integration and Social policies. Within the Directorate, the sector in charge of financial planning and implementation, control, Information systems and Quality assurance (“Area della pianificazione, programmazione attuativa, controllo di gestione, sistema informativo, qualità ed accreditamento”) has an Information Systems department (“Servizio Sistemi Informativi”) dealing with the planning and financing of all IT activities for health services within the regional territory. The Information Systems department’s mission is to provide the technical and technological support for IT investment planning and management, therefore contributing to the achievement of the Directorate’s objective of ensuring full and efficient health and social services to the citizens of Friuli Venezia Giulia.

The Cooperating Pool-Rhône-Alpes Health Information System (SISRA) has the mission to offer the best e-health service to patients of the Rhône-Alpes region. SISRA is an association of different sites and is structured through two main organisational bodies, the piloting committee and the operating committee. The piloting committee is mainly composed of healthcare professionals and politicians.
This committee is in charge of selecting the different projects on which SISRA is committed to work.
Once the project is accepted the committee identifies one provider in order to implement the project.
The six providers are:

• Hospices Civils de Lyon : Major Hospital of Lyon
• CHU-SE: University hospital center of Saint-Etienne
• CHU-G: University hospital of Grenoble (pilot of the ALIAS project)
• ADSIML-RA: Association for the development of the information system for general practitioners
• Centre Léon Bérard: Regional center specialised in cancer treatment
• ONCORA: Regional cancer research network

In order to really offer the best service to the patients, these subjects have developed several tools with the aim of increasing the quality of the treatment:

• STIC: this is the regional depository for patients identifiers, it merges identifiers coming form the different hospitals of the region in order to put the information in one file (1,500,000 identities).
• DPPR: this is the regional patients file. This file groups all the documents edited by any HCP connected to this network since the patients file creation (400,000 files as of today).
• DCC: this is a communicating cancer patients file.
• Trajectoire: this tool allows every practitioner to reserve a place in a re-education hospital.
• Spiral: this is a communication system between emergency operators in order to increase the quality and the speed of emergency services.

The laboratory leads research on fundamental issues in the areas of image and data, knowledge and services. It also investigates applications with an impact on society :

• Culture and heritage (digital libraries, critical edition, digitisation of old documents, archiving, 3D virtual museums…)
• Ambient intelligence (pervasive systems, sensor networks, intelligent video surveillance, secured communicating objects…)
• Biology and health (data mining, complex systems modelling and analysis, e-health…)
• Human learning (personalisation, cognitive assistance, collaborative learning…)
• Digital entertainment (video games, animated cinema, multimedia data processing…)

LIRIS (Laboratoire d’InfoRmatique en Image et Systèmes d’information) was created in 2003 through the merger of several former laboratories involved in Communication and Information Technology research. LIRIS is affiliated to CNRS (Centre National de Recherche Scientifique) under the label UMR 5205.

The laboratory involves 280 people with 94 faculty members and researchers from INSA de Lyon, Université Claude Bernard Lyon 1, Ecole Centrale de Lyon, Université Lumière Lyon 2 and CNRS.
The laboratory is organised in two departments:

Image department: It has approximately 40 faculty members (12 professors, 28 associate professors) and 3 permanent researchers. The department incorporates five research teams.
The research activities of the department cover a wide variety of methods for sensors (2D, 2D+t, 3D) data analysis, for a better understanding and for multidimensional data modelling.
Hence, the research activities cover the areas of image analysis, modelling, simulation and rendering.
Various data representation models are investigated, including regular grids of sensors, graphs, mesh, geometric models, procedural models, statistical or physical models.
The hybridization of these models can yield the enrichment of the representation space.
The developed techniques rest on the competencies of the research teams around image and signal processing, geometric modelling, algorithmic geometry, discrete geometry, topology, graphs, realistic rendering and augmented reality.

Data, Knowledge and Services (DCS) department: The DCS department is organized around five research teams involving 44 faculty members (11 professors, 33 associate professors).
The research activities of the department cover a wide variety of theories, methods, and applications of information technology to the management of data, knowledge and services.
It covers the following areas: knowledge discovery (data mining, complex systems modelling, knowledge engineering) Data and services engineering (security and confidentiality, modelling, integration and querying, service composition.

General Hospital Izola is a major general hospital in south west area of Slovenia on the border with Italy and close to the border with Croatia.
The hospital has 300 beds and additional Hemodialysis service for in-hospital and outpatient service. Around 15,000 patients are admitted per year and more than 150,000 outpatient patients are treated per year.
A total of 683 health and health allied workers are employed, and 76 doctors.
Population covered by the hospital is about 135,000, but during the summer period it increases threefold. Most of the tourists are from ALPINE area and during the summer almost 10% of the treatments offered by the hospital are to foreign tourists.

The University Clinic of Respiratory and Allergic Diseases Golnik (BGK) is a clinical, research and pedagogical institution. Its up-to-date technology equipment enables performance of first-rate diagnostics, treatment and highest quality health care.

The Clinic has 220 beds in eight clinical wards and two pulmonology and allergology outpatient clinics in Golnik and Ljubljana. It has 7,000–8,000 clinical admissions and 46,000 outpatients' consultations a year. 40% of our patients come from the Gorenjska region and 60% from other regions of Slovenia.
BGK covers an area of 1,000,000 inhabitants and its facility involves a wide spectrum of methodology and assessment tools being affiliated with respiratory, sleep, biochemical, immunological and pathological laboratories to provide an interdisciplinary approach to research and clinical management of our patients. The laboratories follow the guidelines of standards, work with respect to fixed national and international criteria and are included in the external quality control.

The University Clinic employs 37 doctors and 275 other healthcare professionals.
Many of them have academic titles and have a part-time employment at a university, mostly at The Faculty of Medicine of the Ljubljana University.
Great emphasis is also given to national medical education in the form of lectures in the media and popular science articles in newspapers and magazines. The number of all published articles in the last five years goes well beyond 900 and includes all categories of publications.

The most important specialisations of the University Clinic include asthma, COPD, lung cancer, and tuberculosis care, interstitial lung diseases, asbestosis, and other rare pulmonary diseases.
One quarter of all patients is admitted and treated for common cardiac diseases (heart failure, valvular heart disease, arrhythmia control).

The clinic is also involved in a number of international research projects. BGK is involved in 7th EU framework programme as collaborator in projects: IMCA II, Indicators for monitoring COPD and asthma in the European Union; OPCARE project of palliative care; TB-PANNET, Pan-European network for the study and clinical management of drug resistant tuberculosis; SICA-HF: Mechanisms of diabetic and weight-related co morbidity in heart failure; and 6th EU framework programme project MOSAR.
We are also involved in international project as a part of e-TEN European projects called DRUGHECK.

The Geneva University Hospitals (HUG) is a group of primary, secondary, and tertiary care facilities, employing 10,000 collaborators, serving 2,200 beds, 50,000 admissions and 800,000 outpatient visits each year.

Within the Department of Medical Imaging and Information Sciences, its Division of Medical Informatics, with more than 80 academic and professional collaborators, is responsible for the design, development and evaluation of its medical information systems, which include a multidisciplinary-multimedia electronic patient record, care provider order entry, clinical decision support tools, a picture archiving and communication system (PACS) as well as palmtop-based clinical assistants and many telemedicine applications.
Research activities of the Division include medical knowledge representation, distributed knowledge management, data mining and knowledge discovery, natural language processing, advanced medical image processing, information systems architectures, telemedicine, and internet-based learning.
The Division of medical Informatics is a WHO collaborating centre for eHealth.

The HUG’s resources comprise:

• 36 operating theatres
• 32 diagnostic and radiology units
• 10 diagnostic and nuclear-medicine units
• 3 radiotherapy units.

The HUG are organised in 12 medical departments combining almost 65 services and an operational department, all with administrative support.
This enables them to cover all medical, surgical and obstetric areas while providing treatment, preventative and palliative care:

• emergency services including paediatric and gynaecological/obstetric care
• short-hospitalization care, especially in general medicine, surgery, gynaecology and obstetrics
• medium-stay care, in geriatrics for example
• long-term therapy including rehabilitation or re-education
• psychiatric treatment for all ages.

Contact
Antoine Geissbuhler
ag@hcuge.ch

The Department of economy, health and regional affairs is one of the seven ministeries of the government of Geneva. According to the federal constitution, the Confederation is in charge of the organisation of the health insurance but the cantons are in charge of the healthcares network.
As far, they have to forsee healthcare needs, they have to establish collaboration rules with the healtcares providers, they have to warrant the quality of cares and survey the health professionals. They allow the subsidies to health institutions. The DARES as, for instance, a four years contract with the Hôpitaux universitaires de Genève. The DARES is involved in e-health projects since more than ten years.
He has a leading role in the National ehealth strategy. This projects are directly attached to the general secretary of the Department.

Contact
Adrien Bron
adrien.bron@etat.ge.ch

Garmisch-Partenkirchen Hospital is a major primary and secondary health care centre with 505 beds, run by the district of Garmisch-Partenkirchen.
It is situated in the German Alps approx. 90km South of Munich and provides health care for the local population as well as for the inhabitants of the surrounding districts.
It is the academic teaching hospital of the Ludwigs-Maximilians-University, Munich. Approx. 20,000 in-patients and 30,000 out-patients are treated every year by more than 150 doctors and 900 health care professionals. As Garmisch-Partenkirchen and its surroundings are well-known winter and summer tourist resorts, and due to its position close to the Austrian border there is a substantial part of external and international patients as well.
The IT-department is responsible for the hospital information system (HIS) covering all main departments and subspecialities. Thus, the HIS provides integrated electronic support for documentation, workflow and quality assurance.
Garmisch Partenkirchen Hospital participates in several regional telemedicine projects and performs a regular telemedical exchange with its regional partners.

Contact
Dr. Thomas Schmeidl
thomas.schmeidl@klinikum-gap.de

The Villach regional hospital is the second biggest hospital of Carinthia. It is part of the KABEG, a holding established and held by the region of Carinthia and was the first Austrian acute hospital to be accredited by the Joint Commission International. The hospital has 783 beds, about 106.000 treatments per year (244.000 days of occupancy) and about 1.700 employees. Its medical departments include Anesthesia and Intensive Care, Casualty Surgery, Internal Medicine, General Surgery, Gynecology and Obstetrics, Geriatrics, Neurology and Psychosomatics, Orthopaedics and Paediatrics as well as service departments such as a hospital pharmacy, an Institute for medical and chemical laboratory diagnostics, an Institute for Pathology, a Central X-Ray Institute, a Mobile Palliative Team and Medical-technical services (Physiotherapy, Ergotherapy, Recreation/occupational therapy, Logopaedics, Psychological Service).