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High quality healthcare by the virtue of

telemedicineChristina E. Wanscher

MA, Consultant

Danish Centre for Health Telematics

County of Funen

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Agenda

• Overview of how telemedicine can be an aid in providing high quality healthcare

• Illustrated by HEALTH OPTIMUM

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High Quality Healthcare

Through careful use of telemedicine and IT, it is possible to improve the efficiency, and to achieve clinical and economic benefits

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Healthcare strategy in Funen

• The Funen Hospital Management has the courage to use telemedicine services as an embedded part of the service delivery

• In collaboration with the Danish Centre for Health Telematics, HEALTH OPTIMUM has been introduced

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• An eTen market validation project with partners from Veneto Region in Italy, Aragon Region in Spain and Funen County in Denmark– Participants: 6 mio /Italy – 1 mio

/Spain and…. 6000 /Denmark

• Overall aim: Optimisation of healthcare though telemedicine

HEALTH OPTIMUM

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Before HEALTH OPTIMUMpatients living on the remote island of Aeroe had to travel long distances to Svendborg hospital in order to receive specialist treatment.

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Now because of HEALTH OPTIMUM, patients can travel to the local hospital nearby and receive tele-counselling in– Cardiology (Heart disease)– Endocrinology (Diabetes)

Then we introduced…tele-counselling

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This is possible because of..

• Investment in IT as tele-counselling includes:– video conferencing– Transfer station of digital images – Shared electronic healthcare

record– And a network connecting

everyone

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Danish Health Data Network

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And in addition…

• Some human preconditions– Specialist nurse willing to see and

examine the patient guided by the specialist

– Specialist doctor willing to see patients over a distance from the office and “feel” the patient through the nurse

– Patients that are willing to be treated via telemedicine LOCALLY – only see the specialist on “TV”

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To illustrate…

• Tele-counselling in cardiology and endocrinology

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Electronic Patient Record

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Tele-cardiology

Nurse conducts ultrasound at local hospital Specialist doctor views from a distance

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Portable echocardiograph

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ECHOCARDIGRAPHY

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Tele-endocrinologyTele-endocrinology

Nurse sees diabetic patient at local hospital

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Specialist doctor views from a distance

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The specialist can also consult with the patient directly

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• The project period ended in January 2006 – but the service continues

• All health professionals (including nurses and doctors) are very satisfied.

• 100 % of all patients wants to receive the HEALTH OPTIMUM service again (patient questionnaire)

HEALTH OPTIMUM

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Efficiency?

HEALTH OPTIMUM has proved that it is possible to improve the efficiency through the use of telemedicine

YES!• Optimised work flow between

specialist and nurse• Specialist’s time is optimised• Patient saves time

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Clinical benefits?

HEALTH OPTIMUM has proved that it is possible to achieve clinical benefits through the use of telemedicine

YES! • May improve chronic disease

management• Better healthcare, easier access to

specialist care• Reduced barriers for referral to specialist• Shorten the waiting lists – maybe

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Economic benefits?

HEALTH OPTIMUM has proved that it is possible to achieve economic benefits through the use of telemedicine

NOT really!• Telemedicine is not cheap• No reimbursement scheme has been

developed• BUT patients obtain economic

benefits..

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In Conclusion

• Are feasible and highly acceptable• Telemedicine should be seen a as a

strategic mean of improving health care

BUT• Projects must be supported by both

management and users• Work flow processes must be redrawn

with focus on optimising the benefits of telemedicine

• Risk management/Investments in IT

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Thank you for your attention

Danish Centre for Health Telematics www.cfst.dk

Christina E. Wanscher cew@cfst.dk

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Questions?

• How were the organisational processes changed?

• How many can have telemedicine consultations instead of ordinary consultations?