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ALEC 2012
Teledermatology
Consultation at distance:Increased availability of care –
Collaboration between hospital and primary care
Mats WeströmChief Consultant
Division of PC, [email protected]
Background
Situation 2007 at the Dermatology department/reception at Sunderby Hospital :
• 80 percent increased referral rate over a period of 10 years (from 2100 to 3800/year)
• Waiting time for patients of low priority – 18 months
• Unoptimized care processes and patient flows, both externally and internally
• Difficulties for patients to reach the dermatology reception by telephone
Efforts
• Improved internal and external processes
• Regular meetings between dermatologist and GP Consultant (ALK=AllmänLäkarKonsulent) with two main purposes
– Producing Clinical Pathways among the most common dermatological problems
– Going through Referrals from Primary Health Care, and return those who either were incomplete, or didn´t follow the Clinical Pathways
• Introduce Teledermatology!
The birth of the project late 2009
• 2008: Exploratory study conducted by Luleå University of Technology (LTU)/Center for Distance-Spanning Healthcare (CDH) in order to examine the conditions for collaboration between Primary and Hospital Care
• Focus: how can ICT be used?
• Workshop results:– The need of easy consultation between GP and dermatologist– Competence-rising measures
• Pilot project: distance-consultations in real time including five selected Primary Health-care-centers and the Dermatology department
• Technical tests – CMA-desktop & Logitech webcam
E-health pilot – the service
• Consultation scheduled every Tuesday morning
• Appointment set in the electronic health record (VAS) – with a secure message function
• Trialogue during consultation between dermatologist, general practitioner and patient
• Documentation in VAS by both parts
Preliminary Results
• For patients (particularly in rural areas) – less time spent on travelling
• Benefits with respect to environmental gains
• Patients appreciated to have their own GP by their side during the consultation – ”feels good and safe”
• The GP expressed advantages in the trialogue – ”all questions asked and answered directly”
more preliminary Results
• The dermatologist stated multiple positive effects:– Less referrels– Shorter waiting time– Easier and better for the patients
• Better collaboration between clinical practice in healthcare and research at the univesity, and also primary and hospital care
• Totally 145 consultations on distance performed january 2010 – june 2011
• Final report during autumn 2012
Future improvement
• Another five Primary Health Care Centers included in the service – ie Pajala 220 km away from Sunderby hospital – and more to come
• Important to create regulations and guidelines for registration and fee for e-health appointments
• Improving scheduling and finding easier way of booking – of great importance when the service gets widely spread
FINALLY
ITCHING AFTER MOSQUITO BITE
• can be a very difficult scin condition
• easily treated with local corticosteroid (strength II-III)
• has two great advantages– dosn´t require consultation with dermatologist– Most important: keep tourists away from our wonderful, light,
warm and beautiful summer in Luleå and Norrbotten
SEE YOU AT KLUBBVIKEN (CLUB BAY)I´LL BRING THE CORTICOSTEROID!