TTeC 12 June 2006

BENEFITS FROM TELEMEDICINE IN NORWAY; LESSONS TO LEARN?

Elin Brevik og Elin Johnsen

Agenda

1 Introduction

2 Results

3 Lessons

1 Introduction

Project information

• HØYKOM provided the principal funding

• Prepared at the Norwegian Centre for Telemedicine with NORUT Social Science Research as collaborative partner

• Report available

1 Introduction

Aim of the Project

• Investigate documented benefits from telemedicine for Norwegian health care:

– Economic and qualitative aspects

– Benefits and potential benefits

1 Introduction

Inclusion criteria

• Address a problem

• Define an alternative to the use of telemedical services

• Account for empirical findings and how they are produced

• Economic: estimate both costs and savings

2 Results

Qualitative benefits

60 studies found, 29 studies included

Categories:

1. EPRs and electronic messages

2. Discipline-specific solutions

3. Patient-oriented solutions

2 Results

Electronic patient records and messages:

– Less duplication of effort and fewer errors– Simpler routines and faster communication

2 Results

Solutions specific to particular disciplines:

– Competence enhancement– Improved quality – Less travel– Better patient selection– Greater professional confidence– Health benefit where “time counts”

2 Results

Patient-centred solutions:

– Greater patient empowerment

– Greater openness

– Greater confidence

2 Results

Economic benefits24 studies found, 14 studies included

Benefits:• Saved travel costs• Fewer hospital admissions• Saved time• Savings on postage and paper costs

2 Results

• Cost-effectiveness depends on:– The number of consultations and messages– Investment costs– Travel costs

• Cost-effective when volume exceeds a critical level – Telemedicine results in lower costs when volumes

are high

3 Lessons

• The reviewed studies – methodological limitations

• The empirical field– mainly small scale and pilots

• The research field

- lack of documentation of benefits?

3 Lessons

Conclusions

• The economic benefits depend largely on volume of use

• Several qualitative studies show areas of benefits. But partly, the analyses do not clarify or discuss their basic premises

• Limited basis for generalisations of results

• Need for more studies and for developing methodological tools

Thank you for your attention.

Method of Internet searchSearch word: Egenmestring/selvmestring/empowerment

(self-help/self-command/empowerment) + Internett (Internet), e-helse (e-health), helse (health) + it (it), teledermatologi (teledermatology), teledialyse (teledialysis), telemedisin (telemedicine), telepatologi (telepathology), telepsykiatri (telepsychiatry), teleradiologi (teleradiology), teleultralyd (teleultrasound)

Search services: Bibsys; Google – here, also English terms + the search words Norway and Norwegian; PubMed – corresponds to Google and the websides to HØYKOM, about health (Projects: health/social); KITH; NFR; NORUT Social Research; NST; RHF; Shdir; SINTEF; Telenor

Date filtering: Published from and after 2000. Not included: Preliminary projects in which the main

project is completed, and projects that test  technology

The term telemedicine:

• Work within professional medicine – diagnostics, treatment, supervision and monitoring – in which ICT is used to communicate relevant treatment information on certain patients

• It also encompasses communication related to treatment between carer and patient, and self-help groups for patients

• Some use “e-health” as a collective description