[Assessment of an electronic referral and teleconsultation system between secondary and primary health care]
Harno K, Arajarvi E, Paavola T, Carlson C, Viikinkoski P, Bockerman M, Kaariainen P, Ohinmaa A
Record ID 31999009145
The aim of this study was firstly to examine the ability of telemedicine supported outpatient clinics in Peijas Hospital to improve and replace present health care chains and, secondly, to compare the computer supported outpatient clinical model with outpatient clinics in Hyvinkaa hospital lacking these facilities and also the operating costs in Peijas Hospital with traditional outpatient treatment. From the information society viewpoint, it would be essential to find out the leverages by which enhanced information flow, accuracy and flexibility of information produce an improved effect on the mechanisms of health care production.
Core criteria in the assessment of health care quality are the speed by which health care can be delivered and the optimal allocation of resources according to medical needs. The use of the electronic referral system was not only limited to speeding up the information flow between health center and hospital outpatient clinics. Hospital specialists, supported by the intranet consultation, examined and treated more than half of the patients at their own health center. In addition, planned appointments at the outpatient clinic were carried out almost ideally according to hospital determined urgency.
The electronic referral and consultation improves co-operation between hospital and health centers, know-how of general practitioners and possibly also the quality and effectiveness of patient care. The interactive use of the electronic referral system increases the number of referrals from health centers, but not otherwise. On the other hand, telemedicine supported outpatient clinics are able to choose the right patients at the right moment to be treated in the outpatient clinic. The electronic referral system also allows more patients to be treated at lower expense. Because all patients are thoroughly examined beforehand, the number of repeat visits as well as operating costs remain lower.
New technology does not by itself breed new forms of work. When telemedicine was implemented into the traditional surgical environment, only marginal benefits were accomplished. After re-engineering of the health care processes investments are able to fulfill the benefits made possible by information technology. No longer can health care demand that technology comply fully with established routines and traditional views of health care.
It has been claimed, that information technology has an influence everywhere except on productivity statistics. The reason for this may simply be, that health care processes have not been planned prior to the implementation of telemedicine. User experience improves the learning curve and benefits may therefore be accomplished after a certain time delay. The cautious expectation of experts has been, that although the expenses of healthcare may not be decreased by telemedicine, the quality of health service will improve. Experience from the telemedicine supported outpatient clinic at Peijas Hospital supports better management of demand and operating costs. Improved information quality enables optional benefits, which have to be first harnessed for clinical use.
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Finnish Coordinating Center for Health Technology Assessment
Finnish Office for Health Care Technology Assessment (Finohta)
Finnish Office for Health Care Technology Assessment