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Dr. Jane Clemensen Director, ComMed: commed.dk jane@commed.dk Medical advisor for Medcom:

Telemedical treatment of patients with diabetic foot ulcers: From research to implementation: how to overcome juristically questions?. Dr. Jane Clemensen Director, ComMed: www.commed.dk jane@commed.dk Medical advisor for Medcom: www.medcom.dk jcl@medcom.dk. Agenda.

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Dr. Jane Clemensen Director, ComMed: commed.dk jane@commed.dk Medical advisor for Medcom:

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  1. Telemedical treatment of patients with diabetic foot ulcers: From research to implementation: how to overcome juristically questions? Dr. Jane Clemensen Director, ComMed: www.commed.dk jane@commed.dk Medical advisor for Medcom: www.medcom.dk jcl@medcom.dk

  2. Agenda The syncrone way of offering telemedicin The asyncrone way of offering telemedicine Barrieres we meet on our way from research to practice?

  3. How did it start? • One complication of the increasing diabetic population • Quality of life • - waiting time • - transportation • - amputations • - (pre-pension, social life) • Lack of • - prestige • - coordination • - expert knowledge JP, September 2002 3

  4. What did we do? • Basis for decision making • Satisfaction / security 4

  5. www.commed.dk www.pleje.net/info 10

  6. Clinical results: ”The new triangle” Tele - consultation • Immediate inter-individual cooperation • Involvement and dialogue • Witnessing • Melting together of competences • Upgrading of competences / Spreading of knowledge • Verbal and non-verbal communication 11

  7. Status andclinical results • In the southern part of DK it has been clinical practice for 4 years, • but in the asynchrone way: • Health Techonology Assesment (local): • Almost closed out-patient clinic • No waiting time for patients • Continuity in treatment • Reduction in amputations around from 52 - 40 per year • Better healing rates from 15 - 26% per week • Businesscase (national): • Reduction of amputations: 125 per year • Reduction in out patient visits: 9000 visits per year • Reduction in cost regarding transport • Reduction in hours used by visiting nurse • Estimated effect if full implementation on national basis: • 13.1 mill. euro – 2.1mill. euro = 12 mill. euro per year

  8. Barriers • Access to patient data cross sectors. • Who has the responsibility if anything goes wrong? • How do we secure sufficient written accept from patients? • Share of information between hospital, home and general • practioners. • Security questions like log of data and storage of data. • Financial reimbursement of telemedical services.

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