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

2. Agenda 1Introduction 2Results 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: 1.EPRs and electronic messages 2.Discipline-specific solutions 3.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