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ALEC 2012 Teledermatology Consultation at distance: Increased availability of care – Collaboration between hospital and primary care Mats Weström Chief Consultant Division of PC, CCoN mats.westrom@nll.se. Background.
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ALEC 2012TeledermatologyConsultation at distance:Increased availability of care –Collaboration between hospital and primary careMats Weström Chief Consultant Division of PC, CCoN mats.westrom@nll.se
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!