ALEC 2012

Teledermatology

Consultation at distance:Increased availability of care –

Collaboration between hospital and primary care

Mats WeströmChief Consultant

Division of PC, CCoNmats.westrom@nll.se

Background

Situation 2007 at the Dermatology department/reception at Sunderby Hospital :

• 80 percent increased referral rate over a period of 10 years (from 2100 to 3800/year)

• Waiting time for patients of low priority – 18 months

• Unoptimized care processes and patient flows, both externally and internally

• Difficulties for patients to reach the dermatology reception by telephone

Efforts

• Improved internal and external processes

• Regular meetings between dermatologist and GP Consultant (ALK=AllmänLäkarKonsulent) with two main purposes

– Producing Clinical Pathways among the most common dermatological problems

– Going through Referrals from Primary Health Care, and return those who either were incomplete, or didn´t follow the Clinical Pathways

• Introduce Teledermatology!

The birth of the project late 2009

• 2008: Exploratory study conducted by Luleå University of Technology (LTU)/Center for Distance-Spanning Healthcare (CDH) in order to examine the conditions for collaboration between Primary and Hospital Care

• Focus: how can ICT be used?

• Workshop results:– The need of easy consultation between GP and dermatologist– Competence-rising measures

• Pilot project: distance-consultations in real time including five selected Primary Health-care-centers and the Dermatology department

• Technical tests – CMA-desktop & Logitech webcam

E-health pilot – the service

• Consultation scheduled every Tuesday morning

• Appointment set in the electronic health record (VAS) – with a secure message function

• Trialogue during consultation between dermatologist, general practitioner and patient

• Documentation in VAS by both parts

Preliminary Results

• For patients (particularly in rural areas) – less time spent on travelling

• Benefits with respect to environmental gains

• Patients appreciated to have their own GP by their side during the consultation – ”feels good and safe”

• The GP expressed advantages in the trialogue – ”all questions asked and answered directly”

more preliminary Results

• The dermatologist stated multiple positive effects:– Less referrels– Shorter waiting time– Easier and better for the patients

• Better collaboration between clinical practice in healthcare and research at the univesity, and also primary and hospital care

• Totally 145 consultations on distance performed january 2010 – june 2011

• Final report during autumn 2012

Future improvement

• Another five Primary Health Care Centers included in the service – ie Pajala 220 km away from Sunderby hospital – and more to come

• Important to create regulations and guidelines for registration and fee for e-health appointments

• Improving scheduling and finding easier way of booking – of great importance when the service gets widely spread

FINALLY

ITCHING AFTER MOSQUITO BITE

• can be a very difficult scin condition

• easily treated with local corticosteroid (strength II-III)

• has two great advantages– dosn´t require consultation with dermatologist– Most important: keep tourists away from our wonderful, light,

warm and beautiful summer in Luleå and Norrbotten

SEE YOU AT KLUBBVIKEN (CLUB BAY)I´LL BRING THE CORTICOSTEROID!