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Telemedicine in practice: Examples and experiences from Northern Norway Eli ARILD
Outline of presentation • Why TM in Northern Norway? • Overview of telemedicine routine services in Northern Norway • VC – online • S&F – offline
TROMSØ Artic- circle OSLO Why Telemedicine in Northern Norway?
Why Telemedicine in Northern Norway? • Long distance • Unstable weather and long winters • Scattered population • Equal access to medical services • Exellent telecommunication network
Rekvisisjon Telemedicine Network Network Requester Provider Rekvisisjon Rekvisisjon Vida Mira BOS ISDN ATM X.400 PSDN Model for telemedicine applications Organisational level Healthcare service level Technology level Telemedicine Application Telemedicine Services • Telemedicine Workstations • Telemedicine program modules • Standard software and hardware computer products • Telecommunication services
Routine TM services • Dermatology • Pathology • Otorhinolaryngology • Radiology • Cardiology • Psychiatry • Endoscopic surgery • Ophthalmology • Dialysis • Distant teaching • Requests & Reports
VIDEOCONFERENCE • Started in 1989 • GP and a patient in remote studio • Communication patient-specialist, patient-Gp and specialist-GP • GP; the specialist’s ” prolonged arm”
VC - Patients experience • Less waiting time • Make a diagnosis early • Reduced stress • Saving of time • Reduced costs • Reduced needs for sick leave => satisfied patients A comparative study of teleconsultations versus face to face consultations – EJ Nordal, D Moseng JTT,2001
VC - advantages • Less travelling • Reduced waiting time • Save time and money • Better access to expertise • The patients ”meet” the specialist • Standard equipment available
Patient unsuitability for VC • Ca. 20% unsuitable (Dermatology)
VC - disadvantages • VC require management and planning • The specialist and the GP have to be present at the same time • Expensiveequipment - studios
Offline • Based on web or e-mail service - available ”everywhere” and “everytime” • Low bandwidth demand • Reduced equipment demand - reduced costs?
Offline • The specialist ”disappears” • The patient ”disappears” • Reduced medical skills? • System error? • Selection
Network Provider Requester Rekvisisjon Rekvisisjon Conclusion • Telemedicine is a tool for more efficient communication and co-working