University hospital of North Norway

Transcription

1 Electronic epicrisis/ case summary ETTIN STARTED, a brochure for new users of electronic epicrisis as a telemedicine service. What is an electronic epicrisis/case summary? The epicrisis is sent directly from the hospital s electronic patient record via the health network to the regular P s patient record, using secure network communication. Why use an electronic epicrisis/case summary? It saves time at the general practitioners offi ce, because there is no need to write or scan the epicrisis into the patient record system. It avoids the risk of transcription errors at the P s offi ce. Ps can edit the content of the patient record quickly and easily. Communication is faster than postal delivery. What are the requirements? The P practice must have installed an electronic patient record system from ProfDoc, InfoDoc or WinMed. The P must be linked to a health network. Both the hospital and the P practice must have a communications program for secure transmission of personal data. An ISDN line must be connected. Minimum requirements for the PC: Windows 95, 98, 2000 or NT 4.0 with SP 4 installed. The hospital must provide an electronic messaging service.

2 Recording heart sounds ETTIN STARTED, a brochure for new users of the Heart Sounds telemedicine service. What is the Heart Sounds telemedicine service? For telemedicine referrals involving heart sounds, the P listens to the patient s heart using an electronic stethoscope, and records the heart sounds. A referral letter using a standard template accompanies the recording. These documents are sent by to a selected specialist at the hospital or external institution, who interprets the heart sound and sends a reply. Basic equipment needed: Sender (P): Health network access such as an ISDN line - one basic connection. program for sending encrypted . Link to an electronic health network, or equivalent. The recipient (specialist) needs a PC with the same program for receiving and sending encrypted as the sender, and a network connection. Additional equipment for the Heart Sounds service: Electronic stethoscope PC sound card receive the help you need to get started. A handbook in Norwegian is available for new users of the Heart Sounds telemedicine service.

3 Still images in dermatology ETTIN STARTED, a brochure for new users of still images as a telemedicine service for dermatological conditions. What is telemedical referral using still images? For telemedicine referrals involving still images, the P photographs the area in question using a digital camera and sends the photographs together with the referral via a PC to the specialist. The specialist may reply immediately or later. Basic equipment needed: Sender (P): Network access such as an ISDN line, one basic connection. program for sending encrypted . Link to an electronic health network, or equivalent. The recipient (specialist) needs a PC with the same program for receiving and sending encrypted as the sender, and a network connection. Additional equipment for still images in dermatology: Digital camera receive the help you need to get started. NST has published a handbook in Norwegian for new users of still digital photography for dermatological conditions.

4 Teledialysis ETTIN STARTED, a brochure for new users of teledialysis. What is videoconferencing? Videoconferencing is an online service involving a two-way ( point-to-point ) or multidirectional ( multipoint ) audiovisual link. All the parties involved can see and hear each other at the same time. The patient is in one studio with the local doctor or nurse, while the specialist staff are in another studio. Basic videoconferencing equipment needed: A codec microchip for data compression Monitor with speakers Camera Microphone Network (IP or ISDN) Connection to a health network for the use of IP-based videoconferencing equipment and software. Alternatively, ISDN-based videoconferencing equipment can be used on its own. Equipment that may be connected to the videoconferencing unit: Ultrasound equipment Electronic stethoscope Software: Dialysis involves advanced medical technology, and requires continuous monitoring at the location where treatment takes place. The dialysis software is used during patient rounds, in communication between the nurses, and for follow-up and monitoring of patients by both nurses and doctors. receive the help you need to get started. NST has published a handbook in Norwegian for new users of teledialysis.

5 Dermatology videoconferencing ETTIN STARTED, a brochure for new users of videoconferencing as a telemedicine service for dermatological conditions. What is videoconferencing? Videoconferencing is an online service involving a two-way ( point-to-point ) or multidirectional ( multipoint ) audiovisual link. All the parties involved can see and hear each other at the same time. The patient and the P are in one studio, while the specialist is in another studio. The basic equipment which you need comprises: A codec microchip for data compression Monitor with speakers Camera Microphone Network (IP or ISDN) Connection to a health network for the use of IP-based videoconferencing equipment. Alternatively, ISDN-based videoconferencing equipment can be used on its own. Additional equipment for dermatology videoconferencing: Close-up camera contact with staff who work together with users of telemedical services. Here, you can have your questions answered and receive the help you need to get started. NST has published a handbook in Norwegian for new users of videoconferencing for dermatological conditions.

6 Videoconferencing ETTIN STARTED, a brochure for patients, users and patient organizations considering the use of videoconferencing for health purposes. Do you need to: create networking groups for special-interest organizations, professional groups, user groups, etc.? give or receive advice as a carer, patient, user, parent or guardian, student or professional? teach or be taught? consult a specialist? monitor one or more patients, but fi nd it diffi cult because of distance, time, or disability? In these cases, videoconferencing may be the solution. Videoconferencing should supplement the services available, not replace them. It can be used in many contexts: support: advice to carers, discussions between health professionals, education, counselling of disabled people and/or their children. monitoring of patients. psychiatry: caregiver and patient can meet at a distance. consultations: the patient and P meet a specialist at another site. networking groups: between patients, professional groups, special-interest organizations. Videoconferencing is a point-to-point or multipoint simultaneous sound and video link. Videoconferencing can be used between two or more studios at the same time. Basic studio equipment: Network link (ISDN or IP), codec for data compression, camera, screen, and sound equipment. For IP-based videoconferencing, the simplest solutions consist of a small unit with a built-in camera connected directly to a PC. The health networks will support the use of videoconferencing for the institutions linked to their networks.

7 ENT Videoconferencing ETTIN STARTED, a brochure for new users of videoconferencing as a telemedicine service for ear, nose and throat conditions. What is videoconferencing? Videoconferencing is an online service involving a two-way ( point-to-point ) or multidirectional ( multipoint ) audiovisual link. All the parties involved can see and hear each other at the same time. The patient is in one studio with the local doctor or nurse, while the specialist is in another studio. Basic videoconferencing equipment needed: A codec microchip for data compression Monitor with speakers Camera Microphone Network (IP or ISDN) Connection to a health network for the use of IP-based videoconferencing equipment. Alternatively, ISDN-based videoconferencing equipment can be used on its own. Additional equipment for ENT videoconferencing: Endoscope Frame grabber card Video head Camera control Light source receive the help you need to get started. NST has published a handbook in Norwegian for new users of videoconferencing for ear, nose and throat conditions.

8 Still images for ENT ETTIN STARTED, a brochure for new users of still images as a telemedicine service for ear, nose and throat conditions. What is telemedical referral using still images for ENT? For telemedicine referrals involving still images, the P photographs the area in question using a digital camera and sends the photographs together with the referral via a PC to the specialist. The specialist may reply immediately or later. Basic equipment needed: Sender (P): Health network access such as an ISDN line - one basic connection. program for sending encrypted . Link to an electronic health network, or equivalent. The recipient (specialist) needs a PC with the same program for receiving and sending encrypted as the sender, and a network connection. Additional telemedical equipment for still images in ENT: Endoscope Frame grabber card Camera control Light source receive the help you need to get started. NST has published a handbook in Norwegian for new users of still digital photography for ear, nose and throat conditions.

9 Retinal photography ETTIN STARTED, a brochure for new users of telemedical screening for diabetic retinopathy. What does telemedical referral using still digital photography involve? In screening for diabetic retinopathy, diabetic care nurses take digital photographs of the optic fundus as well as undertaking other investigations of the patient - for example, sight tests (visus) and pressure measurement. The referral information consists of the series of photographs and accompanying text, which are sent electronically to a specialist. The specialist may reply immediately or later. Basic equipment needed: Sender: Network access such as an ISDN line, one basic connection. program for sending encrypted . Link to an electronic health network, or equivalent. The recipient (specialist) needs a PC with the same program for receiving and sending encrypted as the sender, and a network connection. Additional equipment for retinal photography: Fundus camera linked to a Nikon D1X digital camera. receive the help you need to get started. A handbook in Norwegian is available for new users of retinal photography.

10 Fees and possibilities for funding: The scale of fees is intended to provide for fair remuneration to both the P and the specialist. For Ps in Norway, there are currently (2002) no specifi c fees for telemedicine. The fee schedule for Ps and doctors in private practice specifi es two rates for patient contributions: 2ad (d for day) Consultation with a P, where the patient pays NOK 114,- 3ad (d for day) Consultation with a specialist, where the patient pays NOK 200,- If additional time is spent because of telemedical services, it is possible to claim the 2cd consultation fee as well: NOK 103,-. The Norwegian Centre for Telemedicine: - uses the EU defi nition of telemedicine:... the investigation, monitoring, treatment and management of patients and the education of patients and staff using systems which allow ready access to expert advice and patient information no matter where the patient or relevant information is located. Telemedicine solutions contribute to a more equitable distribution of health services, as a larger part of the population has easier access to specialists and many patients do not need to travel. The NST s services are free of charge for the public health service and Ps in Norway. CONTACT Telephone Internet address The Norwegian Centre for Telemedicine tjenester@telemed.no The Northern Norwegian Health Network support@nhn.no The Central Norwegian Health Network fi rmapost@mnhelse.no The Western Norwegian Health Network driftansvarlig@ihelse.net The Southern Norwegian Health Network post@helse-sor.no The Eastern Norwegian Health Network helsenett@ost.no Also contact the section responsible for health care in your municipality and the head of IT services for more information about plans for telemedicine.

11 Costs Simple solutions for home use start at about NOK 10,000. Videoconferencing equipment for groups or teaching is more expensive, and may cost well over ten times as much. It is wise to contact the municipality, as a number of municipalities already have such equipment, or may be motivated to acquire it when they see the range of the different applications for which it can be used. Sharing resources in this way makes it possible to improve the services available to the people who live in the municipality, and saves money. NST can also contribute with suggestions for potential users and shared applications. To get started, this is what you need to do: See for further information. Contact management and the head of IT services in your municipality. They can provide information about access to equipment, plans, opportunities for sharing resources, etc. Contact NST by tjenester@telemed.no or at telephone NST has published a videoconferencing handbook in Norwegian. The Norwegian Centre for Telemedicine: - uses the EU defi nition of telemedicine:... the investigation, monitoring, treatment and management of patients and the education of patients and staff using systems which allow ready access to expert advice and patient information no matter where the patient or relevant information is located. Telemedicine solutions contribute to a more equitable distribution of health services, as a larger part of the population has easier access to specialists and many patients do not need to travel. The NST s services are free of charge for the public health service and Ps in Norway. CONTACT Telephone Internet address The Norwegian Centre for Telemedicine tjenester@telemed.no The Northern Norwegian Health Network support@nhn.no The Central Norway Health Network fi rmapost@mnhelse.no The Western Norway Health Network driftansvarlig@ihelse.net The Southern Norwegian Health Network post@helse-sor.no The Eastern Norwegian Health Network helsenett@ost.no Also contact the section responsible for health care in your municipality and the head of IT services for more information about plans for telemedicine.