Agenda

1. TTeC 12 June 2006BENEFITS FROM TELEMEDICINE IN NORWAY; LESSONS TO LEARN? Elin Brevik og Elin Johnsen

2. Agenda 1 Introduction 2 Results 3 Lessons

3. 1 Introduction Project information • HØYKOM provided the principal funding • Prepared at the Norwegian Centre for Telemedicine with NORUT Social Science Research as collaborative partner • Report available

4. 1 Introduction Aim of the Project • Investigate documented benefits from telemedicine for Norwegian health care: • Economic and qualitative aspects • Benefits and potential benefits

5. 1 Introduction Inclusion criteria • Address a problem • Define an alternative to the use of telemedical services • Account for empirical findings and how they are produced • Economic: estimate both costs and savings

6. 2 Results Qualitative benefits 60 studies found, 29 studies included Categories: • EPRs and electronic messages • Discipline-specific solutions • Patient-oriented solutions

7. 2 Results Electronic patient records and messages: • Less duplication of effort and fewer errors • Simpler routines and faster communication

8. 2 Results Solutions specific to particular disciplines: • Competence enhancement • Improved quality • Less travel • Better patient selection • Greater professional confidence • Health benefit where “time counts”

9. 2 Results Patient-centred solutions: • Greater patient empowerment • Greater openness • Greater confidence

10. 2 Results Economic benefits 24 studies found, 14 studies included Benefits: • Saved travel costs • Fewer hospital admissions • Saved time • Savings on postage and paper costs

11. 2 Results • Cost-effectiveness depends on: • The number of consultations and messages • Investment costs • Travel costs • Cost-effective when volume exceeds a critical level • Telemedicine results in lower costs when volumes are high

12. 3 Lessons • The reviewed studies • methodological limitations • The empirical field • mainly small scale and pilots • The research field - lack of documentation of benefits?

13. 3 Lessons Conclusions • The economic benefits depend largely on volume of use • Several qualitative studies show areas of benefits. But partly, the analyses do not clarify or discuss their basic premises • Limited basis for generalisations of results • Need for more studies and for developing methodological tools

14. Thank you for your attention.

15. Method of Internet search Search word: Egenmestring/selvmestring/empowerment (self-help/self-command/empowerment) + Internett (Internet), e-helse (e-health), helse (health) + it (it), teledermatologi (teledermatology), teledialyse (teledialysis), telemedisin (telemedicine), telepatologi (telepathology), telepsykiatri (telepsychiatry), teleradiologi (teleradiology), teleultralyd (teleultrasound) Search services: Bibsys; Google – here, also English terms + the search words Norway and Norwegian; PubMed – corresponds to Google and the websides to HØYKOM, about health (Projects: health/social); KITH; NFR; NORUT Social Research; NST; RHF; Shdir; SINTEF; Telenor Date filtering: Published from and after 2000. Not included: Preliminary projects in which the main project is completed, and projects that test  technology

16. The term telemedicine: • Work within professional medicine – diagnostics, treatment, supervision and monitoring – in which ICT is used to communicate relevant treatment information on certain patients • It also encompasses communication related to treatment between carer and patient, and self-help groups for patients • Some use “e-health” as a collective description