ALEC 2012 Teledermatology Consultation at distance: Increased availability of care – Collaboration between hospital and primary care Mats Weström Chief Consultant Division of PC, CCoN

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 : 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!