Telemedicine
Providing access to interpreters using video conference equip-ment instead of the interpre-ter’s physical attendance at a patient consultation provides new opportunities for better or-ganisation of interpreting servi-ces in the Danish Healthcare System, including ensuring bet-ter use of inbet-terprebet-ter resources.
The purpose of the project is to ensure national dissemination of tele-interpreting by video conference throughout the whole of the healthcare sector.
In this way, video conferences will be regarded as a normal tool in day-to-day clinical prac-tice, increasing accessibility to interpreter support services and lessening the amount of time spent planning the interpreta-tion session and the waiting time in the event of delays.
As part of the tele-interpreta-tion project, the aim is to esta-blish a national infrastructure for video conferences, one that can be reused in other clinical situations, for example monito-ring, interdisciplinary conferen-ces, discharge conferences between the secondary and pri-mary healthcare sector, training,
Establishing the possibility of exchanging digital images of diabetic foot ulcers by mobile telephone from home care nurses in the patient’s own home to ulcer specialists at the hospitals frees up staff resources at hospitals and in the home care sector, while also increasing the quality of ulcer treatment.
The solution ensures more rapid and better coordinated treatment, allowing several patients to avoid complica-tions and admission. The
solu-tion saves on manpower, as staff resources in the hospi-tals can be freed up, and im-proves resource usage in the primary sector. The solution was initially demonstrated in the Region of South Den-mark, Zealand Region and eight local authorities.
Testing was coordinated with a similar project in Aarhus Municipality. The long-term strategy is national dissemi-nation.
The spearhead project is financed by the ABT Fund.
Dissemination plan for tele-interpretation Once spearhead departments have imple-mented tele-interpretation, the individual region will plan the regional dissemination.
The dissemination plan for the hospitals’
use of tele-interpretation is as follows:
December 2010:25% of hospital departments with patient contact December 2011:75% of hospital departments with patient contact December 2012:90% of hospital departments with patient contact
The project is subject to the following main timetable:
January–March 2010:Project start-up April–September 2010:Technical imple-mentation
October–November 2010:Organisational implementation
December–January 2011:Operation February–March 2011:Evaluation After the spearhead project, the plan is to initiate national dissemination.
Timetable for tele-ulcer treatment
Tele-interpretation Tele-ulcer treatment
The Board at Digital Health decided in April 2008 to initiate a pro-gramme for the increased use of telemedicine, home monitoring and self-care in connection with the implementation of the national strategy for the digitisation of the Danish Healthcare Service.
Practical implementation of the programme has been delegated to MedCom.
The purpose of the telemedicine programme is to:
G ensure national implementation and dissemination of advanced telemedicine solutions
G advance telemedicine concepts for subsequent national dissemination
G assess national telemedicine concepts in respect of their benefit potential and adaptation to the Danish infrastructure G gather and share knowledge of national and international
telemedicine concepts in relation to current clinical and healthcare policy challenges in Denmark, including running a number of experience forums
etc. The implementation project is financed by the ABT Fund and covers the period 2009–2012.
The project, here and now All five regions are actively par-ticipating in the project through cooperation agree-ments with MedCom, and are initiating testing in spearhead departments at the end of 2009. This includes testing of tele-interpretation in up to ten local authorities and surgeries, where the concept has not yet been tested.
projects
International telemedicine projects
MedCom has an international project line whose main focus is on telemedicine, welfare technology, infrastructure for the use of telemedicine services and standardisation of electronic communi-cation in the healthcare sector. The projects’ hallmark is that they meet a specific healthcare-related or social need while at the same time providing a solution to this. The results from the inter-national projects can often be transferred to inter-national projects, which thus further build on existing experiences.
There is a wide range of activities in the department: Project management and participation in European projects, expert support to both Danish and foreign partners, the drawing up of new project applications, etc.
MedCom is represented in several partnerships under European and international control. These activities, and participation in specific projects, have led to extensive expertise and participa-tion in a successful network within internaparticipa-tional healthcare IT.
The international department at MedCom has contributed to a range of projects, in which telemedicine solutions have been tested and disseminated.
Telemedicine is about those situations where information and communication techno-logy can be used to provide a healthcare service digitally over short or long distances, including providing support with diagnosis, treatment, prevention, research and trai-ning. Home monitoring covers those solutions where the telemedicine service is sup-plied to the patient in their own home.
Experience and commitment have enabled the internatio-nal team to contribute to buil-ding up an extensive portfolio of telemedicine solutions.
Several telemedicine solutions that were part of these pro-jects have now been dissemi-nated and are operational, including preparation for ope-rations from the Health Opti-mum project and the patient briefcase for chronic patients from Better Breathing.
One of the new projects worthy of mention is:
Healthy Growth – a project where a range of telemedi-cine, welfare technology solu-tions and aids are being developed, including the patient briefcase for COPD patients and robot technology rehabilitation chips for apo-plexy patients.
The most recently completed projects include, among others:
Health Optimum– a project focusing on healthcare servi-ces and clinical cooperation over long distances using digi-tal images/systems and video conference equipment.
Better Breathing– a project where a ‘patient briefcase’
given to patients with smo-ker’s lung (COPD) enabled them to be discharged earlier from hospital. The patient briefcase allowed the health-care professionals to monitor the patient's condition and carry out consultations over shorter or longer distances.
R-Bay – a project where radio-logical assignments and expert knowledge are offered across European national borders.
Photograph: Niels Nyholm
International projects
Welfare technology is user-oriented technology, especial-ly for elderespecial-ly people and/or persons with chronic illnesses or disabilities. The technology makes it possible to deliver welfare services in a new way that can both increase security and guarantee mobility and day-to-day tasks. The aids may be sensors, fall alarms or robot technology such as robot vacuum cleaners, etc. In this way, welfare technology at the same time can contribute to more efficient public or private service production.
The aim of welfare technology is for the cold technology to provide more resources to the warm hands of the social sec-tor. On the one hand, the technology will help to im-prove working conditions and free up time for staff in the service professions and, on the other, improve the quality of public sector welfare services at the same time as providing economic improvements in the area.
MedCom is already involved in various welfare technology projects. These include the
The international projects will continue to be conducted as a close collaboration between regions or local authorities, and will therefore remain close to the local and/or natio-nal measures taking place elsewhere in MedCom.
From 2010, there will be 12 international projects in MedCom. Many of these have the status of pilot projects, which with EU funds will allow new, wide-reaching International welfare technology projects
The future DREAMINGproject, which
covers home monitoring of elderly people with chronic ill-nesses in Langeland Municipa-lity and the PERSONAproject, which tests advanced welfare technology services in Odense Municipality.
Challenges
Telemedicine and welfare technology are more than just a technological solution and there are therefore certain challenges involved. The ob-stacles includes organisational challenges, among others those due to new clinical pro-cesses in the delivery of new treatment options.
The culture, too, especially in international projects, is a fac-tor which needs to be conside-red in telemedicine and wel-fare technology solutions, as training, nationality, social network, etc., affect access to new technology. There are also the legal aspects, in which patient rights, responsibility and the granting of licences are the key words.
Resolution of the many challenges and accompanying new aspects of telemedicine is being attempted, among other places, in the Metho-TelemedEU project, in which MedCom is a partner.
The Metho-TeleMed project gathers knowledge and skills from international academic expertise, European networks and the WHO in order to develop guidelines for the metho-dologies used in investigating telemedicine solutions in Europe. The main purpose of the project is to propose me-thodologies for the examination of telemedicine solutions for use in academic trials and policy decisions. The method devised in MethoTeleMed will be tested, among other pla-ces, in the forthcoming EU project, RENEWING HEALTH.
Evaluation opportunities with telemedicine
technological solutions to be tested, from telemedicine and standardisation to welfare technology. The projects will be targeted at some of the specific challenges facing the healthcare and social sector in the coming years, and it is to be hoped that the interna-tional projects can be involved in resolving these.
Among other things, welfare technology is an area which the international projects in MedCom will focus on in the future.
Photograph: Geir Haukursson
Approved standards Testing and certification Health Data Network (SDN) Video node
Statistics
MedCom – the Danish Health Data Network MedCom projects – dissemination as a percentage Number of messages, September 2009
Laboratory requests and referrals per month Providers with EDI, September 2009 Correspondence, pharmacies
GP and specialists’ systems, all doctors
Correspondence messages, all-to-all, September 2009 Development at local authority level
Health Data Network’s node e-records
Names Steering Group Primary Group Infrastructure Group MedCom
Back cover
Total number of messages per month
chnology , key figur e s, names
Toolkit
Toolkit
MedCom provides a range of different services to the healthcare sector. As well as project organisation and management, this includes:
G Communication standards G Testing and certification G The Health Data Network, SDN G Video node