Review of acute hospital services in the Mid - Health Service Executive

Tele-medicine
Review of acute hospital services in HSE Mid-West
An action plan for acute and community services
Telemedicine has been around for a very long time and is well established, particularly in the
USA where a 1999 survey recorded 132 active programmes, with activity in 48 states in over
1,450 telemedicine equipped facilities 139 . It cannot yet be considered mainstream in service
delivery but it is being increasingly seen as an important tool to support the way that health
services will need to change in the future in order to be sustainable.
Telemedicine and telecare is now addressed at the national level in some countries and is an
element of most new regional service strategies under development 140 141 142 143 144 145 146 .
Telemedicine and telecare are regarded as a key enabler of clinical networks, bringing
together the clinical expertise, specialist advice and decision making between services
delivered locally and those services delivered regionally.
Many hospital and community services are now using telemedicine for teleconsultation,
telediagnostic, telemonitoring, telecare and tele-education purposes. Most progress has
been made in radiology, dermatology, pathology and ophthalmology, where the imaging
aspects lend themselves to electronic transmission. Other specialties under development,
include cardiac medicine, paediatrics, neonatology, neurology, psychiatry, oncology, ENT,
general surgery, and all specialties are now taking telemedicine on board and testing it as a
mechanism to improve their current service provision.
There is now evidence that the burden of chronic disease management on acute care
services can be significantly lessened through telemonitoring to decrease the number of
visits to the A&E department and admissions to hospital 147 148 149 .
139 Grisby B. et al. Report on U.S. Telemedicine Activity. Association of Telehealth Service Providers. 1999.
140 National Telemedicine System. DOH Republic of South Africa 1998.
141 Delivering 21 st Century IT support for the NHS. DOH 2002.
142 Public Sector National Report Assistive Technology. ‘Independence and Well Being’. Audit Commission, February 2004.
143 Assistive Technology and telecare: Forging effective solutions for independent living. Policy Press 2003.
144 The use of ICT to support independent living for older and disabled people. DOH UK 2002.
145 Strategic Plan. VA Midwest Health Care Network. Department of Veterans Affairs 2006-2010.
146 National Telemedicine and Telecare Strategy. Department of Health and Children & Health Board Executive, Ireland 2005.
147 Meyer M et al. Virtually healthy: chronic disease management in the home. Dis Manag 2001; 5:5-12.
148
Vaccaro et al. Utilisation reduction, cost savings, and return on investment for Pacificare Chronic Heart Failure Programme,
‘Taking Charge of your Health’ Dis Manag 2002; 4:131-42.
149 Wiecha J. et al. The interdisciplinary eHealth team: chronic care in the future. J Med Internet Res 2004; 32:31-8.
128