Denmark does telemedicine

A week ago I posted some rather snarky remarks about ther resistance to full cooperation by physicians in a study of using telemedicine to augment treatment of people in ICUs.

In contrast the NYTimes did another article this week about a forthcoming report in the Commonwealth Fund about how telemedicine is  being handled in Denmark. They tell about a 77-year-old man who has respiratory problems from smoking.

…he can go to the doctor without leaving home, using some simple medical devices and a notebook computer with a Web camera. He takes his own weekly medical readings, which are sent to his doctor via a Bluetooth connection and automatically logged into an electronic record.

“You see how easy it is for me?” Mr. Danstrup said, sitting at his desk while video chatting with his nurse at Frederiksberg University Hospital, a mile away. “Instead of wasting the day at the hospital?”

He clipped an electronic pulse reader to his finger. It logged his reading and sent it to his doctor. Mr. Danstrup can also look up his personal health record online. His prescriptions are paperless — his doctors enters them electronically, and any pharmacy in the country can pull them up. Any time he wants to get in touch with his primary care doctor, he sends an e-mail message. […]

Several studies, including one to be published later this month by the Commonwealth Fund, conclude that the Danish information system is the most efficient in the world, saving doctors an average of 50 minutes a day in administrative work. And a 2008 report from the Healthcare Information and Management Systems Society estimated that electronic record keeping saved Denmark’s health system as much as $120 million a year.

The most interesting thing about this, however, is that what is making this possible in Denmark and not in the US is difference in attitude. It’s not about technology.

“It was a natural progression for us,” said Otto Larsen, director of the agency that regulates the system. “We believe in taking care of our people, and we had believed this was the right way to go.” […]

Kurt Nielsen, the [Thy-Mors] hospital’s director, says that while the doctors are not particularly adept at information technology, they have gradually embraced it. And it helps that the staff was involved in developing the innovations.

“My staff at the hospital is very, very satisfied,” he said. “We build these systems in an incremental way, and seek their input throughout.”

Everyone would acknowledge that implementing EHR, telemedicine and other technologies in a  population of 6 million is a much smaller financial and procedural challenge. But when your society (i.e., the US and its health industry) seems to lack “we take care of our people” as a top value, the likelihood of putting truly reachable technological systems in place is nearly insurmountable.

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