When Dr. Javier Marco checks his patients he often uses a computer with a videoconferencing link. Many of his elderly patients live in remote villages in the foothills of the Spanish Pyrenees and no longer travel to where he works. "They're very satisfied. There is less inconvenience and the quality of care is better", he stated.
Coupled with a telelaboratory service that allows patient test samples to be analysed remotely, the internet-based HEALTH OPTIMUM solutions are having a profound impact on health care in the regions where they were tested and where they are continuing to be used. Doctors are saving time, public health care systems are saving money, and patients are receiving better co-ordinated and better quality care.
"At first, patients were surprised when they went to their local doctor's office and I was able to talk to them and see them over a computer, but surprise turned to satisfaction when they realised they wouldn't have to come to the hospital", stated Dr. Marco. "Barbastro (where he works), is the only hospital for a widely distributed population. Many people live up to a hundred kilometres away, the winters are hard and the roads can be bad."
But saving patients the inconvenience of travelling to hospital for routine consultations, when physical check-ups with a specialist are unnecessary, is not the only advantage. Because their general practitioner is present during the videoconference, they receive better co-ordinated care, with the GP and the specialist able to jointly study patient data, including scans and samples, over the telecounselling service.
"The benefits to all actors in the health care sector are enormous", noted Claudio Dario, the HEALTH OPTIMUM project co-ordinator at the Treviso Local Health Authority in the Veneto region of Italy.
The results are also quantifiable. In trials in Veneto, the telecounselling service has been used to link primary health care facilities to hospital neurology departments, allowing patients with head injuries to be accurately diagnosed by a specialist without having to be physically transferred to a hospital.
"This resulted in a 79 percent reduction in the number of people being referred to a specialist facility", stated Claudio Dario. "Before the deployment of this service 53 percent of patients would be referred to a specialist, now just 11 percent are because neurologists are able to diagnose the patient remotely and determine whether or not they need specialised care."
Not only does this save neurologists time and health care systems money, but the quality of care patients receive improves. "The reliability of the diagnosis is the same because neurologists have access to scans and data from the primary health care facility, and by not transferring patients who don't have to be there, they are not being subjected to unnecessary risks", Claudio Dario noted.
In the event that they do need to be referred to hospital and undergo surgery, the telecounselling system gives physicians access to information about the patient in advance and allows them to prepare more rapidly and efficiently. "By the time a patient arrives, the physicians are ready to put them on the operating table", the co-ordinator stated.
Saving time, increasing efficiency and improving care are also the main benefits of HEALTH OPTIMUM's telelaboratory service. Remote analysis equipment allows primary health care professionals to take samples of a patient's blood or urine, analyse the samples on the spot at the patient's bedside or in their home and send the results wirelessly to a specialist over a secure Public Key Infrastructure (PKI).
"It normally takes a day or more for samples to be physically sent to a laboratory and the diagnosis returned to the patient's doctor. Telelaboratory provides results in 10 minutes", Claudio Dario stated.
By proving the benefits of telemedicine solutions and deploying them in pioneering trials, the HEALTH OPTIMUM project has acted as a catalyst for the roll-out of services to meet the challenges facing public health care systems. All the regions that participated in the trials - Aragón in Spain, Veneto in Italy and Funen in Denmark - are continuing to employ and expand the services.
All of Veneto's health centres will be linked up within "one or two years", Claudio Dario stated, while new projects are being planned by the HEALTH OPTIMUM consortium to extend the system to Sweden and Romania. In Aragón, there are also plans to take the system region wide, stated Nieves Campillo, a representative of the regional government. "This has been a revolutionary project with important benefits and wide acceptance among the population", she stated.
Such a growing interest in telemedicine reflects the very real problems facing Europe's public health care systems. The continent's ageing population will increase demand for health care in the future even as lower tax revenues due to a relative decline in the number of young people joining the workforce lead to budget cuts. "Telemedicine gives health authorities the ability to do more with less", Claudio Dario noted.
For more information you can contact Claudio Dario, Treviso Local Health Authority Ulss 9, Via Borgo Cavalli 42, I-3100 Treviso, Italy, Tel.: +39-0422-323236, Fax: +39-0422-547664, or visit the HEALTH OPTIMUM project Web site.
This article has been reprinted from the IST Results Web site.