Because telemedicine does change many systems and threatens many personal positions all the possibilities that lies in the field of telemedicine could also be looked upon as problems. The technical solutions are mostly well functioning today, and the future solutions will even improve. The prices of the necessary equipment are still too high, but they are going to be cheaper. The main problems that lie ahead are the organisation of the health care system. The key issue here is the flow of money.
With telemedicine the patients in remote arias get quick access to necessary medical expertise. With telemedicine the excellent medical experts are only a phone call away. Neither the doctor nor the patients have to travel long distances in all kind of weather to meet the medical expertise. One of the major aims for the norwegian health care politic is to make the access to the medical competence independent of where the patients are living in Norway. Through telemedicine this aim is obtainable.
The major effect on the general practitioners is that telemedicine create a situation of personal guided teaching. This results in a much higher professional standard for the remote doctors. Results so fare indicate that the local doctor, after one year with telemedicine, is capable of looking after 50% of the patients he earlier used to refer to the specialist. Another effect of this is a higher status for the primary health care doctors. In remote arias this doctors already are have a better reputation than doctors who are not connected to the hospital in this way. This is also a way of breaking the professional isolation for the remotely situated general practitioners.
The effects on the central medical institutions are many. As the local doctors get a higher professional standard through telemedicine, the specialists shift from diagnostic to therapeutic work. This is a much better way of utilise the specialists` skill. The waiting list to the hospitals is shortened, and the hospitals save money. Instead of competing for the limited resources which the manpower of some medical experts are, the hospitals, assisted by telemedicine, can cooperate by splicing the money for salary and all have available, based on the demand, the necessary medical skill .
Telemedicine in Norway Today and in the future Steinar Pedersen Department of Telemedicine The University Hospital of Tromsø Norway
THE EFFECT ON THE PATIENTS LIVING IN REMOTE AREAS <ul><li>ACCESS TO NECESSARY </li></ul><ul><li>MEDICAL COMPETENCE </li></ul><ul><li>QUICK </li></ul><ul><li>EQUAL </li></ul>
THE EFFECT ON THE G.P. PRACTISING IN REMOTE AREAS <ul><li>SERVE THEIR PATIENTS </li></ul><ul><li>AT A HIGHER STANDARD </li></ul><ul><li>BREAK THE PROFESSIONAL ISOLATION </li></ul>
THE EFFECT ON THE CENTRAL MEDICAL INSTITUTIONS <ul><li>SERVE AS A COMPETENCE CENTRE </li></ul><ul><li>“ SAVE” MONEY </li></ul><ul><li>EARN MONEY </li></ul>
The reimbursement <ul><li>The telemedicine diagnostic work is </li></ul><ul><li>reimbursed by US $ 61 per patient </li></ul><ul><li>The reading of X-ray is reimbursed </li></ul><ul><li>by US $ 23 per patient </li></ul>
The future <ul><li>The combination </li></ul><ul><li>The bandwidth </li></ul>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
MULTIMEDIA DORIS 97 Toolbar Icon Display Area Image Display Areas
Referral pattern HCS HOSPITAL Access to information Exchange of medical information Video consultation
THE NATIONAL PLAN <ul><li>Establish a common national IT </li></ul><ul><li>infrastructure (The Intranet) </li></ul><ul><li>Establish common telemedicine applications </li></ul><ul><li>Electronic information services for patients </li></ul><ul><li>Electronic patients records </li></ul><ul><li>Establish common national administrative </li></ul><ul><li>procedures </li></ul>