Telemedicine in the Scandinavian countries


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Terhi Rasmussen, Finpro. Changes in Scandinavian healthcare sector - oppportunities for Finnish companies. Finpro seminar materials 19.4.2012.

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Telemedicine in the Scandinavian countries

  1. 1. Telemedicine in theScandinavian countriesQuick overviewFinpro ScandinaviaTerhi RasmussenConsultantCopenhagen
  2. 2. Agenda• General about telemedicine• Overview on research and development projects in Scandinavia• Challenges & barriers in telemedicine• Current focus areas• Opportunities for Finnish companies
  3. 3. What is telemedicine? Definition: “Telemedicine is the use of medical information exchanged from one site to another via electronic communications to improve patients health status.” ( ) • For instance it is used as a support to: – Diagnosing – Treatment – Prevention – Research – Education Telemedicine has been traditionally motivated by: • Geographical distances • Professional isolation • Scarce personnel resources20/04/2012 © Finpro 3
  4. 4. Proof-of-concept / Breaking news in telemedicine Whole System Demonstrator Programme in UK by the Department of Health & Telecare Services Association (TSA) – is the largest randomized control trial of telehealth and telecare in the world, involving 6191 patients, 238 GP practices across three sites, Newham, Kent and Cornwall. – WSD was set up to look at cost effectiveness, clinical effectiveness, organizational issues, effect on careers and workforce issues. – It focused on three conditions, diabetes, COPD and coronary heart disease. – The programme will provide a clear evidence base to support important investment decisions and show how technology supports people to live independently, take control and be responsible for their own health and care. • Headline Findings for Telehealth – 45% reduction in mortality rates – 20% reduction in emergency admissions – 14% reduction in bed days – Etc. • Website: • Project results are seen as real big news in telemedicine field in Scandinavia - To proof telemedicine on a large scale -It really works!20/04/2012 © Finpro 4
  5. 5. Telemedicine in the Scandinavia • Increased focus on digitalization and developing different e-health solutions, in particular due to increasing number of chronically ill patients What’s in it for the patient? • Patient empowerment • Increases flexibility and choice of treatment • Second opinion • Health care sector comes to the patient • “hospitalized” in your own home • Patient monitors and take care of himself, makes living for instance with a chronic disease easier What’s in it for the professionals? • Less dependent on time and place • Information can be collected and exchanged whenever and regardless of physical place • International cooperation enables communication with specialist around the world • Also possible to find information regarding rare conditions • It is possible to source expertise, when lacking specialists • To free some resources and achieve efficiency20/04/2012 © Finpro 5
  6. 6. Number of different research and development programs in telemedicine in the Scandinavian countries20/04/2012 © Finpro 6
  7. 7. Scandinavian telemedicine projects• The Regional Telemedicine Forum Project (RTF) – Collaboration of 9 European regions including Region of Southern Denmark (DK), Northern Norway (NO), Norrbotten Region (SE) – Works towards a wider use of telemedicine by delivering good practice guidelines, policy recommendations, and addressing the key challenges –• Dreaming Project – Goal is to keep elderly people in their home environment as long as their physical and mental conditions allow this – Services include monitoring and alarm handling services, elderly- friendly videoconferencing services – 6 countries taking part in pilots, Sweden and Denmark included • County Council of Uppsala • Heby community from Sweden • Langeland Community from Denmark • Southern Denmark Region –
  8. 8. Telemedicine projects in Denmark Det Borgernære Hospital /The citizen near hospital in Herlev Hospital • Corss sectoral cooperation in order to create more knowledge about telemedicin when used accross patient groups • Project was run from 2009-2010 AmbuFlex – Herning hospital • Individual self-monitoring for hear patients • Solution has potential for other patient groups as well involving controls • Telemedicinsk Forskningsenhed – A research unit of telemedicine at Frederiksberg University Hospital – Consists of a scientific research group working with clinical telemedicine solutions – Aim of the research unit is to provide evidence on clinical telemedicine solutions, quality of care development and furthermore engagement in innovation projects within the telemedicine and IT-technological fields – Currently working on a project called “The Virtual Hospital” – a clinical study investigating COPD patients treated at home using telemedicine compared to conventional hospital admission20/04/2012 © Finpro 8
  9. 9. New telemedicin test underway in Denmark• Information published in March 2012• The Danish government will support a large scale test of telemedicine• Parties involved are: – 2 regions: Capital Region and Central Denmark Region – 4 hospitals, – 10 municipalities – a number of GPs.• Monitors 2000 patients with different conditions – COPD (lung condition) – diabetes, – inflammatory intestine diseases – pregnant women with and without complications.• The idea is to develop a database, which registers the information from patients, while they are “hospitalized” in their own homes. The health personnel in all the sectors gets access to the patient data from their own PCs and can therefore rapidly decide if there is for instance need to adjust medication.• Project starts in 2012 and runs for two years a head• Financing: Public sector will finance total of approximately 8,8 million EUR• Half of which comes from The Public Welfare Technology Fund, while the regions and smaller partners finance the rest.
  10. 10. Telemedicine projects in Norway CHF home monitoring • A home telemonitoring service for chronic heart failure. CallMeSmart • Context-sensitive systems for mobile communication in hospitals. Connect 2.0 • Flexible collaborative networks and patient provider partnerships in health care: Critical factors. • It aims to create a next generation application to provide a seamless environment where patients can share their data from home, communicate with their health care providers, and obtain support from where ever and whenever they need it, all within the same system. Distributed knowledge in collaborative medical diagnosis • The use of telemedicine to share knowledge across work settings. • Acute conditions are among the most challenging situations in medicine. • The use of telemedicine, real-time videoconferencing (VC), supplements the spoken word with virtual sight and constitutes a new and appropriate tool for discussions and instructions in emergency situations. Source: Norwegian Center for Integrated telemedicine20/04/2012 © Finpro 10
  11. 11. Telemedicine projects in Sweden FIA, Future Innovative Work Practices in health care in the home • The objective of the FIA is to establish a unique distance-spanning working model for the future of health care by introducing new technologies and working methods at an entire medical centre (Björknäs medical centre in the municipality of Boden) with ancillary elderly accommodation (Ågård and Å-Center) and the Kvarnängen home help services group. • Focus on coordinated distance care planning. Specialist consultations via video conferencing between primary and specialist care. Telemedicine support program for better lifestyle and life quality for persons with overweight • The project idea is to test a support program with help of telemedicin (ICT), which can lead to better lifestyle habits and quality of life for persons with overweight • Try to reduce: inactivity, unhealthy eating habits, smoking and drinking, • Project is a co-operation between Luleå technical university, Center for innovation and e-health (EIC), Luleå community social services department and Health Solutions AB, Luleå/Stockholm. Source: www.liuse, luleå Technical univesity e-health innovation center20/04/2012 © Finpro 11
  12. 12. Challenges & BarriersAlso challenging are: How to scale-up the projects and make them work across sectors? And to speed them up? •Need for a larger scale business case in order to drive structural changes in the ways of organizing health care work• Different levels of authority and administration depending on if telemedicine is applied in social, Source: elderly, primary or secondary care Phanareth 20/04/2012 - Due to different ways of organizing care in the Finpro © different Scandinavian countries 12
  13. 13. The current situation and particular focus areas (in DK) • Telemedicine solutions are wanted on many different levels in the health care sector • Large scale implementing of telemedicine in DK has been slow • Good technical and infrastructural fundament for dissemination of telemedicine • 3 areas closest to be scalable: • Video conferencing – Eliminate unnecessary transport time – Reduce hospitalization – Can be used in psychiatric treatment – Enables to collect second opinions • Image exchange – Can streamline cooperation between the different actors in the health sector, better continuity in the patient treatment – Patient and care taker do not need to be accessible at the same time – Can be used in: radiology, dermatology, wound assessment, eye analysis/ control, ear-nose-throat diagnostics, pathology • Home monitoring – Save the hospitalization days and release specialist resources at the hospitals – Assisted monitoring with access to specialists, self-monitoring, hospitalization at home with virtual ward rounds Source: Udredning af telemedicin, Medcom 201020/04/2012 © Finpro 13
  14. 14. Opportunities for Finnish companies• Telemedicine is actively developed in all the three countries• Solutions for chronic diseases in particular• From the technological point of view: – Systems that can interact and exchange data with various existing systems – Can work as common platform, easy to integrate – Easy to operate• The interest organizations actively try to push telemedicine into new hospital design agendas – 20-25% in DK will be used on medico-tech solutions, where telemedicine will also be part of it• Services/solutions that are interesting: – Flexible/adjustable solutions – Provide an answer to lack of personnel – Increase patient empowerment – Cost savings and efficiency increase – Video conferencing, imaging exchange and home monitoring20/04/2012 © Finpro 14
  15. 15. Opportunities for Finnish companies • It is an asset if you have a solid proof-of-concept/business case • Success in scalability – To try it on the near markets due to similar size of the markets & mind-set • Example of cross-sector success, success in working together with health authorities - Sweden maybe easier to enter due to similar decentralized and fragmented structure to Finland - Denmark and Norway different way of organizing the health care authority and ownership which should be kept in mind, regions as slightly larger areas • You could consider Scandinavian markets as potential for finding cooperation partners – Synergy and service/solution development • The opportunity for telemedicine is there, it is likely to grow once the barriers are solved, however the speed and time horizon is unknown20/04/2012 © Finpro 15
  16. 16. Event in the future eHealth week 7th to 9th of May in Copenhagen • Themes: continuity of care – Patient empowerment – Chronic disease management – Opportunities in healthcare IT • More information: © Finpro 16
  17. 17. Telemedicine Associations • Nordic Telemedicine Association (NTA) – Facilitates Nordic co-operation and co-operation between Nordic countries and the rest of the world in the field of telemedicine and telecare – • Danish Society for Clinical Telemedicine – • The Norwegian Centre for Integrated Care and Telemedicine (NST) – © Finpro 17
  18. 18. Thank you!20/04/2012 © Finpro 18