Telemedical treatment of patients with diabetic foot ulcers: From research to implementation: how to overcome juristically questions?

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Telemedical treatment of patients with diabetic
foot ulcers From research to implementation
how to overcome juristically questions?
Dr. Jane Clemensen Director, ComMed www.commed.d
k jane_at_commed.dk Medical advisor for Medcom
www.medcom.dk jcl_at_medcom.dk
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Agenda
The syncrone way of offering telemedicin The
asyncrone way of offering telemedicine Barrieres
we meet on our way from research to practice?
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How did it start?
JP, September 2002
One complication of the increasing diabetic
population Quality of life - waiting time -
transportation - amputations - (pre-pension,
social life) Lack of - prestige -
coordination - expert knowledge
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What did we do?

• Basis for decision making
• Satisfaction / security

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www.commed.dk www.pleje.net/info
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Clinical results The new triangle
Tele - consultation

• Immediate inter-individual cooperation
• Involvement and dialogue
• Witnessing
• Melting together of competences
• Upgrading of competences / Spreading of
  knowledge
• Verbal and non-verbal communication

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Status and clinical results

• In the southern part of DK it has been clinical
  practice for 4 years,
• but in the asynchrone way
• Health Techonology Assesment (local)
• Almost closed out-patient clinic
• No waiting time for patients
• Continuity in treatment
• Reduction in amputations around from 52 - 40 per
  year
• Better healing rates from 15 - 26 per week
• Businesscase (national)
• Reduction of amputations 125 per year
• Reduction in out patient visits 9000 visits per
  year
• Reduction in cost regarding transport
• Reduction in hours used by visiting nurse

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Barriers

• Access to patient data cross sectors.
• Who has the responsibility if anything goes
  wrong?
• How do we secure sufficient written accept from
  patients?
• Share of information between hospital, home and
  general
• practioners.
• Security questions like log of data and storage
  of data.
• Financial reimbursement of telemedical services.