NORWAY.ppt
Transcript of NORWAY.ppt
University Hospital of TromsøDepartment of Telemedicine
Telemedicine in NorwayTelemedicine in NorwayToday and in the futureToday and in the future
Steinar PedersenSteinar Pedersen
Department of TelemedicineDepartment of Telemedicine
The University Hospital of TromsøThe University Hospital of Tromsø
NorwayNorway
University Hospital of TromsøDepartment of Telemedicine
THE DEPARTMENT OF THE DEPARTMENT OF TELEMEDICINETELEMEDICINE
University Hospital of TromsøDepartment of Telemedicine
University Hospital of TromsøDepartment of Telemedicine
The historyThe history
■ Telenor R&D (1988-1992)Telenor R&D (1988-1992)
■ The Department of TelemedicineThe Department of Telemedicine
University Hospital of TromsøDepartment of Telemedicine
THE NETTHE NET
■ MeganetMeganet■ ISDNISDN■ ATMATM■ AnalogueAnalogue
lineslines
128 256 384US $ 4 US $ 8 US $ 12
US $ 10 US $ 20 US $ 30US $ 70 US $ 141 US $ 282
University Hospital of TromsøDepartment of Telemedicine
The servicesThe services■ RadiologyRadiology■ PathologyPathology■ OtorhinolaryngologyOtorhinolaryngology■ DermatologyDermatology■ CardiologyCardiology■ PsychiatryPsychiatry
■ Electronic Electronic information information
exchangeexchange
University Hospital of TromsøDepartment of Telemedicine
RadiologyRadiology
• Running since 1992• TMS without radiologist • 7500 patients a year
University Hospital of TromsøDepartment of Telemedicine
PATHOLOGYPATHOLOGY
• Running since 1992• Several hospital without pathologist • Low volume
University Hospital of TromsøDepartment of Telemedicine
OTORHINOLARYNGOLOGOTORHINOLARYNGOLOGYY
■ TROMSØ - ALTATROMSØ - ALTA■ 16-20 PATIENTS A 16-20 PATIENTS A
MONTHMONTH■ PATIENTS PATIENTS
SATISFACTIONSATISFACTION■ TRANSFER OF TRANSFER OF
MEDICAL MEDICAL
SKILLSSKILLS
University Hospital of TromsøDepartment of Telemedicine
DERMATOLOGYDERMATOLOGY
■ Tromsø-KirkenesTromsø-Kirkenes■ Tromsø Tromsø HammerfestHammerfest
■ 500 patients a year500 patients a year■ Light treatment Light treatment unitunit
University Hospital of TromsøDepartment of Telemedicine
CardiologyCardiology■ Ultrasound Ultrasound transmissiontransmission
■ EmergencyEmergency■ EvaluationEvaluation■ Distant teachingDistant teaching
University Hospital of TromsøDepartment of Telemedicine
PsychiatryPsychiatry
■ Difficult casesDifficult cases■ Second opinionSecond opinion■ Direct patient Direct patient
contactcontact■ PsychoanalysisPsychoanalysis
University Hospital of TromsøDepartment of TelemedicineRegionsykehuset i Tromsø
Telemedisinsk Avdeling
Distant teaching
TromsøTromsø
BalsfjordBalsfjord
OsloOslo
AltaAltaNordreisaNordreisa
NamdalNamdal
University Hospital of TromsøDepartment of Telemedicine
Distant teachingDistant teaching
University Hospital of TromsøDepartment of Telemedicine
NETWORK:NETWORK:- Arkhangelsk-Tromsø- Arkhangelsk-Tromsø- Arkhangelsk and- Arkhangelsk and other other hospitals hospitals
University Hospital of TromsøDepartment of TelemedicineUniversity Hospital of Tromsø
Department of TelemedicineSomatic Jan -96/Dec -96Somatic Jan -96/Dec -96
VIDEOCONFERENCESVIDEOCONFERENCES
0
10
20
30
40
50
60
70
Jan
uary
Feb
ruary
Marc
h
Ap
ril
May
Ju
ne
Ju
ly
Au
gu
st
Sep
tem
ber
Octo
ber
No
vem
ber
Decem
be
r
University Hospital of TromsøDepartment of Telemedicine
Videoconferencing in 1996Videoconferencing in 19966781
2702
0
1000
2000
3000
4000
5000
6000
7000
3D stolpediagram 1 6781 2702
Participants somatic Participants psyciartie
University Hospital of TromsøDepartment of Telemedicine
The activityThe activity
0
1000
2000
3000
4000
5000
6000
7000
8000
9000
3D stolpediagram 1 5946 6917 8339
1994 1995 1996
University Hospital of TromsøDepartment of Telemedicine
THE EFFECT ON THE THE EFFECT ON THE PATIENTSPATIENTS LIVING IN LIVING IN
REMOTE AREASREMOTE AREAS
■ ACCESS TO NECESSARY ACCESS TO NECESSARY
MEDICAL COMPETENCEMEDICAL COMPETENCE■ QUICKQUICK■ EQUALEQUAL
University Hospital of TromsøDepartment of Telemedicine
THE EFFECT ON THE THE EFFECT ON THE G.P. G.P. PRACTISING IN PRACTISING IN
REMOTE AREASREMOTE AREAS
■ SERVE THEIR PATIENTS SERVE THEIR PATIENTS
AT A HIGHER STANDARDAT A HIGHER STANDARD
■BREAK THE PROFESSIONAL BREAK THE PROFESSIONAL ISOLATIONISOLATION
University Hospital of TromsøDepartment of Telemedicine
THE EFFECT ON THE THE EFFECT ON THE CENTRAL MEDICAL CENTRAL MEDICAL
INSTITUTIONSINSTITUTIONS■ SERVE AS A COMPETENCE CENTRESERVE AS A COMPETENCE CENTRE
■ “ “SAVE” MONEYSAVE” MONEY
■ EARN MONEYEARN MONEY
University Hospital of TromsøDepartment of Telemedicine
The reimbursementThe reimbursement
■ The telemedicine diagnostic work is The telemedicine diagnostic work is
reimbursed by US $ 61 per patient reimbursed by US $ 61 per patient
■ The reading of X-ray is reimbursed The reading of X-ray is reimbursed
by US $ 23 per patientby US $ 23 per patient
University Hospital of TromsøDepartment of Telemedicine
Regionsykehuset i TromsøTelemedisinsk Avdeling
KOSTNAD PER PASIENTKOSTNAD PER PASIENT
0
100
200
300
400
500
6005
00
10
00
15
00
20
00
25
00
30
00
35
00
40
00
45
00
50
00
55
00
60
00
65
00
70
00
75
00
80
00
85
00
90
00
Antall pasienter
Ko
stn
ad
er
Amulant virksomhet
Telerediologi
COST PER PATIENT
University Hospital of TromsøDepartment of Telemedicine
Regionsykehuset i TromsøTelemedisinsk Avdeling
Cost per patient
0
1000
2000
3000
4000
5000
600030 40 50 60 70 80 90 10
0
110
120
130
140
150
Number of patients
TCVSPTTC*
Costs in NKr
University Hospital of TromsøDepartment of Telemedicine
The futureThe future
■ The combinationThe combination
■ The bandwidthThe bandwidth
Tomorrows applications will be a mixtures
of PC based videoconferencing and PC off
line multimedia communications
The communication will be on the bandwidth ”demanded” in a health care Intranet
University Hospital of TromsøDepartment of Telemedicine
MultimediaMultimedia■ Hart soundHart sound■ OtorhinolaryngologyOtorhinolaryngology■ DermatologyDermatology■ OphthalmologyOphthalmology■ PathologyPathology
University Hospital of TromsøDepartment of Telemedicine
MULTIMEDIAMULTIMEDIADORIS 97
ToolbarToolbar
Icon Display AreaIcon Display Area
ImageImageDisplayDisplayAreasAreas
University Hospital of TromsøDepartment of Telemedicine
Referral pattern
Access to information
Exchange of medicalinformation
Video consultation
HCS
HOSPITAL
University Hospital of TromsøDepartment of Telemedicine
THE NATIONAL PLANTHE NATIONAL PLAN■ Establish a common national IT Establish a common national IT
infrastructure infrastructure (The Intranet)(The Intranet)
■ Establish common telemedicine Establish common telemedicine applicationsapplications
■ Electronic information services for Electronic information services for patientspatients
■ Electronic patients recordsElectronic patients records
■ Establish common national Establish common national administrative administrative
proceduresprocedures