Local medical centres with decentralised specialist services and telemedicine - t@lmc

The report describes telemedicine services as potentially useful tools in such a centre for providing cooperation between the primary health care services and the specialist health care services in the Norwegian public health care system. A model with relevant health care services and telemedicine services is proposed.

Two aspects of the model are in focus:

• Such a centre with telemedicine could make the policlinic specialist services more accessible for people living in sparsely populated areas, with long distances to hospitals, and where it can be difficult to have specialists travelling.
• The centre might fill a gap in today's health care system, where a growing number of patients are in a grey area. Often elderly, such patients often need care and treatment for their general condition as well as follow-up with close cooperation between the specialist and primary care services. A centre with a local ward may fulfil their needs, where the grey-area patients may receive more integrated care and follow-up. Telemedicine can contribute to important professional backing from the specialist services to the primary services.

The report indicates potential qualitative benefits for the health care services - immediate and in the longer term. It also evaluates needs and challenges involved in realizing this potential. These needs and challenges concern "the social technology".

There are signs of changes in patient behaviour, and in the use of time and the allocation of tasks of the professionals.

A model is introduced for calculating changes in costs as a consequence of telemedicine in a local centre with telemedicine, and a separate case study of the economic aspects has been worked out.

Some professionals from the health care services have been interviewed, mainly representing services with experience in telemedicine work.

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