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

OSLO

TROMSØ

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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

Model for telemedicine applications

Telemedicine Workstations • Telemedicine program modules• Standard software and hardware

computer products• Telecommunication services

Telemedicine ServicesTelemedicine Application

Requester Provider Network

ATM X.400PSDN ISDN

BOSMira Vida

Rekvisisjon Rekvisisjon

Organisationallevel

Healthcareservicelevel

Technologylevel

Telemedicine Network

Rekvisisjon

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

• Expensive equipment - studios

Offline

• Based on web or e-mail service - available ”everywhere” and

“everytime” • Low bandwidth demand• Reduced equipment demand - reduced costs?

Offline – in Norway: DORIS

Offline• The specialist ”disappears”• The patient ”disappears”• Reduced medical skills?• System error?• Selection

Conclusion• Telemedicine is a tool for more Telemedicine is a tool for more

efficient communication and efficient communication and co-workingco-working

Requester

Rekvisisjon

Rekvisisjon

ProviderNetwork