2002

Telemedicine and dialysis: A sociological evaluation of telemedicine supported remote satellite units. Results of a pilot project in North Norway

Telemedicine and dialysis: A sociological evaluation of telemedicine supported remote satellite units. Results of a pilot project in North Norway

Frank Larsen, Norwegian Centre for Telemedicine

The aim of the project was to improve the quality of dialysis care by providing patients and staff at the remote dialysis units (satellites) in the neighbouring county of Finnmark the same kind of follow-up as the staff and patients at the main dialysis institution, the University Hospital of North Norway (UNN). Videoconferencing technology was used for daily two-way audio visual communication between staff at UNN and the staff at the remote units and between the staff at UNN and the patients twice a month. The equipment was used for clinical consultations, administrative purposes, visits, and education and staff development. In addition medical technical devices such as ultrasound and stethoscope were connected to the videoconferencing equipment, and two software programs were used for monitoring the hemodialysis machines and patient related information (electronic patient record).

The aim of the study was to assess the feasibility of telemedicine as a mean to improve the quality of care and the education of the staff, but also the ability to integrate teledialysis in to daily work practices. To do this, interviews and questionnaires were done with patients at the remote units and the staff at both UNN and the remote units. Interviews were conducted with seven patients, where four of them can be characterized as active during telemedicine visits. The judgement of the services by the patients was positive, but local staff played an important role as mediators between the patients and the staff at UNN. If a patient needed to have a confidential discussion with the nephrologists, the other patients were suppose to use headphones. Due to different reasons the headphones were never used, so some of the patients didn't feel that they could say everything that they wanted. The staffs were satisfied with the experience of using teledialysis applications, and most satisfied with the videoconference equipment and the electronic patient record. The problem of confidentiality was also expressed by the staffs. The remote units had minor problems in integrating the services in to their daily work practices, but they needed to develop some new skills for the use and handling of software programs, ultrasound and stethoscope. The staff at UNN had some problems in integrating the services into their work practices, both nurses and nephrologists, especially the daily communication was time consuming.

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