Eleven years of experience with low-bandwidth telemedicine in a nurse-led rural clinic in Scotland

Harvey, Sylvia; Peterkin, Gordon; Wootton, Richard

doi:10.1258/jtt.2010.100310

Cited by 10 publications

(6 citation statements)

References 8 publications

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“…The data from Norwegian hospitals showed a considerable reduction of telemedicine consultations in 2010. This observed decline might be due to organisational factors [ 29 ], such as lack of resources [ 30 ], or state-level policies, including reimbursement [ 31 , 32 ]. In 2009 the Norwegian Health Network was established to provide an infrastructure for secure communication in the health sector in Norway.…”

Section: Discussionmentioning

confidence: 99%

Adoption of routine telemedicine in Norwegian hospitals: progress over 5 years

Zanaboni

Wootton

2016

BMC Health Serv Res

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BackgroundAlthough Norway is well known for its early use of telemedicine to provide services for people in rural and remote areas in the Arctic, little is known about the pace of telemedicine adoption in Norway. The aim of the present study was to explore the statewide implementation of telemedicine in Norwegian hospitals over time, and analyse its adoption and level of use.MethodsData on outpatient visits and telemedicine consultations delivered by Norwegian hospitals from 2009 to 2013 were collected from the national health registry. Data were stratified by health region, hospital, year, and clinical specialty.ResultsAll four health regions used telemedicine, i.e. there was 100 % adoption at the regional level. The use of routine telemedicine differed between health regions, and telemedicine appeared to be used mostly in the regions of lower centrality and population density, such as Northern Norway. Only Central Norway seemed to be atypical. Twenty-one out of 28 hospitals reported using telemedicine, i.e. there was 75 % adoption at the hospital level. Neurosurgery and rehabilitation were the clinical specialties where telemedicine was used most frequently. Despite the growing trend and the high adoption, the relative use of telemedicine compared to that of outpatient visits was low.ConclusionsAdoption of telemedicine is Norway was high, with all the health regions and most of the hospitals reporting using telemedicine. The use of telemedicine appeared to increase over the 5-year study period. However, the proportion of telemedicine consultations relative to the number of outpatient visits was low. The use of telemedicine in Norway was low in comparison with that reported in large-scale telemedicine networks in other countries. To facilitate future comparisons, data on adoption and utilisation over time should be reported routinely by statewide or network-based telemedicine services.

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Section: Discussionmentioning

confidence: 99%

Adoption of routine telemedicine in Norwegian hospitals: progress over 5 years

Zanaboni

Wootton

2016

BMC Health Serv Res

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“…Where articles commented on the efficacy, safety or other clinical outcomes, these were categorized as assessing the clinical effectiveness of teleconsultations in delivering health care. There were 48 articles of which there were 12 pilots [14,15,30,34,43,48,62,63,65,86,88,108], 5 case reports/series [19,22,36,72,99], 7 case-controls [28,42,44,49,53,69,78], 1 qualitative study [10], 2 mixed method [102,105], 4 retrospective studies [35,58,80,92] [54], 1 descriptive study [90], and 1 service report [96].…”

Section: Clinical Effectivenessmentioning

confidence: 99%

The Use of Patient-Facing Teleconsultations in the National Health Service: Scoping Review

O’Cathail¹,

Sivanandan²,

Diver³

et al. 2020

JMIR Med Inform

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Background The National Health Service (NHS) Long-Term Plan has set out a vision of enabling patients to access digital interactions with health care professionals within 5 years, including by video link. Objective This review aimed to examine the extent and nature of the use of patient-facing teleconsultations within a health care setting in the United Kingdom and what outcome measures have been assessed. Methods We conducted a systematic scoping review of teleconsultation studies following the Joanna Briggs Institute methodology. PubMed, Scopus, the Cochrane Library, and the Cumulative Index to Nursing and Allied Health Literature were searched up to the end of December 2018 for publications that reported on the use of patient-facing teleconsultations in a UK health care setting. Results The search retrieved 3132 publications, of which 101 were included for a full review. Overall, the studies were heterogeneous in design, in the specialty assessed, and reported outcome measures. The technology used for teleconsultations changed over time with earlier studies employing bespoke, often expensive, solutions. Two-thirds of the studies, conducted between 1995 and 2005, used this method. Later studies transitioned to Web-based commercial solutions such as Skype. There were five outcome measures that were assessed: (1) technical feasibility, (2) user satisfaction, (3) clinical effectiveness, (4) cost, (5) logistical and operational considerations. Due to the changing nature of technology over time, there were differing technical issues across the studies. Generally, teleconsultations were acceptable to patients, but this was less consistent among health care professionals. However, among both groups, face-to-face consultations were still seen as the gold standard. A wide range of clinical scenarios found teleconsultations to be clinically useful but potentially limited to more straightforward clinical interactions. Due to the wide array of study types and changes in technology over time, it is difficult to draw definitive conclusions on the cost involved. However, cost savings for health care providers have been demonstrated by the goal-directed implementation of teleconsultations. The integration of technology into routine practice represents a complex problem with barriers identified in funding and hospital reimbursement, information technologies infrastructure, and integration into clinicians’ workflow. Conclusions Teleconsultations appear to be safe and effective in the correct clinical situations. Where offered, it is likely that patients will be keen to engage, although teleconsultations should only be offered as an option to support traditional care models rather than replace them outright. Health care staff should be encouraged and supported in using teleconsultations to diversify their practice. Health care organizations need to consider developing a digital technology strategy and implementation groups to assist health care staff to integrate digitally enabled care into routine practice. The introduction of new technologies should be assessed after a set period with service evaluations, including feedback from key stakeholders.

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“…It is estimated that less than 5% of the eligible patients currently have access to rehabilitation [13]. Telemedicine is not adopted by most healthcare systems and, hence, is not truly making its way to healthcare delivery beyond the ''pilot stage'' [14]. Moreover, more research is required into the pathogenesis of COPD in order to ensure the development of effective disease modifying therapy in the future.…”

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confidence: 99%