The WHO Department of Blood Safety under the directorship of Dr Jean E. Emmanuel developed the concept of creating a university-related Academic Institute for International Development of Transfusion Medicine (IDTM) that would take responsibility for both the development of a post academic master's course in Management of Transfusion Medicine (MMTM) and applied health sciences–related research. In the year 2000, upon request of WHO, the concept was introduced to the Dean of the Faculty of Medical Sciences of the University of Groningen. The response was unequivocally positive. The Dean of the Faculty thus proposed the creation of an academic institute within the Faculty of Medical Sciences to the Rector Magnificus and to the board of the University, who without hesitation charged the Dean to organize. The director of the Regional Blood Establishment was asked to create an organizational structure and subsequently asked to lead the practical development and implementation of the concept [6]. The original objectives that were formulated were:

1. To develop and implement post graduate master's courses on management of TM;
2. To promote a connection between the development of theoretical knowledge and practical implementation;
3. To create internal and external resources to finance transfusion medicine education;
4. To serve as an international knowledge resource for the management of transfusion medicine;
5. To promote and implement applied scientific research in the field of development and governance of transfusion medicine;
6. To provide modular post graduate academic training programs in the governance and management of transfusion medicine for economically restricted countries;
7. To support, advise and guide economically restricted countries to develop safe, efficacious, and sustainable national blood supply systems;
8. To develop applied research programs for transfusion medicine–related health sciences; and
9. To serve as a reference and knowledge economy organization to WHO, the WFH, and the International Consortium for Blood Safety (ICBS).

In 2001 the Academic Institute IDTM was thus established. This institute was set up in a simple and straightforward way, taking on board an office manager, a quality manager, and an executive secretary in addition to the director. The latter was provided by the\ University the academic position of special professor of international development of transfusion medicine at the Faculty of Medical Sciences, University of Groningen.

The design and curriculum of the WHO initiated post graduate education in transfusion medicine management and governance were realized in close collaboration with both WHO HQ Geneva and the WHO European Regional Office in Copenhagen. The concept of electronic distance learning (e-learning) [7] was felt preferable to allow fellows to follow the academic theoretical part (Modules) in their respective home countries, to be completed with real time practical management and governance exposure of limited length in the Netherlands, and an academic health science related scientific thesis, leading to a formal graduation (diploma) at the University of Groningen.

As e-learning needs a digital environment, technical support was gained through contract with a specialized company to build an e-Academy and its e-library, and to provide an advanced digital environment and support to run the course. The Academic Institute would be responsible for the contextual part, the ultimate curriculum of the course at post academic level with its corps of academic teachers, where the contracted company would be responsible for the digital system and environment. This concept has created a unique and globally accessible institution for post academic education in transfusion medicine [9].

However, concept and digital environment appeared to be too advanced to implement in situations that struggle with existing barriers and challenges. For that reason, an initiative was developed creating and implementation an advice and guidance organization focused on top down and sustainable organization, structures and infrastructure, governance, legal frameworks, quality systems and the management of these systems: International Development of Quality Management in Transfusion Medicine, the IQM consulting service [5]. IQM Consulting also operates at a non-profit base.

IQM Consulting offers a wealth of experience and knowledge in the field of TM and related Health Sciences research. The emphasis is on the principles of Quality as a Culture. Key elements in the approach are

• Integration of Transfusion Medicine in Health Sciences and Health Care, underpinning the clinical base of TM;
• Professional capacity building: knowledge and skills, knowledge economy, quality management;
• Applied academic Health Sciences-related research;
• Network, and reference, advice and guidance functions.

The academic institute decided to develop a tailor-made quality management system, based on ISO 9001:2000 principles and structure. June 2007 this was implemented and ready for auditing by Lloyd's Register, Rotterdam, The Netherlands. As a result, the institute has been certified by the ISO 9001:2000 Quality Management System This system is applicable to ‘institutionalized education (teaching and training) and scientific research (health sciences) to support developing countries.’ Since September 2007, the first fellows from economically restricted countries have entered and completed the course successfully. Implementation in the day-to-day practice is given a sustained follow up by IQM Consulting.

What knowledge and research are being offered?
The master's course is composed of 9 modular e-books, each intended for a study period of 4 to 6 weeks, followed by a multiple-choice e-exam, which can be repeated only twice (at 2-week intervals) (9). The modules were prepared by a selected academic faculty of expert teachers and transformed into e-books. The 9 e-modules (1 months) are organized into 3 parts consisting of an Introductory module (part 1) and 2 specific cluster modules (parts 2 and 3).

Cluster 1 consists of 4 general managerial elements (secondary and steering functions): Organization and Structure, Legal and Regulatory aspects, Human Resource Management, and Economic aspects and Costing.

Cluster 2 consists of the 5 managerial aspects of the primary functions: Societal Interface, Clinical Interface, Process Management, and Quality Management.

Each e-book consists of chapters that accommodate a 1-week e-study program (6-12 exposure hours) and a self-assessment test. Each module is concluded with a time-controlled e-exam. Being a higher education program at post graduate level, the course has set a relatively high threshold for passing the exams. However, fellows are allowed to repeat the e-exams twice, each with a 2-week interval. If the second reexamination also fails, the module has to be repeated completely. The fellow has to apply for the e-exam, which has to be done within 2 weeks after completion of the module. This is automatically and electronically monitored. The material is organized in a user-friendly manner with available off-line e-books to be studied and e-exams taken.

The master's thesis is based on a specific and applied health science–related research project in the field of TM. and applicable to the county of origin of the fellow. This accommodates, in a learning setting, the objective to promote and do health sciences–related scientific research in the field of development and management of transfusion medicine.

Fellows prepare a thesis on health sciences–related applied research in the field of transfusion medicine. The project themes do relate to challenges and research questions in their home country. It is anti2cipated that the thesis as a written document will contribute to the creation of a scientific base for the approach to the problem and challenges investigated and that this research will serve to provide applied scientific information to serve as a reference for making policies and defining strategies for comprehensive developments of the blood supply and clinical transfusion systems at the national and the global level. It ranges from community, public awareness and potential donor issues to manufacturing, safety including the scala of laboratory safety testing issues, quality issues, and clinical efficacy and documentation (hemovigilance and patient blood management).  After the first years and evaluation of the academic post graduate e-learning was performed [10].