A qualitative description of telemedicine for acute stroke care in Norway: technology is not the issue
Identifieur interne : 000111 ( Pmc/Curation ); précédent : 000110; suivant : 000112A qualitative description of telemedicine for acute stroke care in Norway: technology is not the issue
Auteurs : Tove S Rensen [Norvège] ; Kari Dyb [Norvège] ; Ellen Rygh [Norvège] ; Rolf Salvesen [Norvège] ; Lars Thomassen [Norvège]Source :
- BMC Health Services Research [ 1472-6963 ] ; 2014.
Abstract
To assist small hospitals in providing advanced stroke treatment, the Norwegian Directorate of Health has recommended telemedicine services. Telestroke enables specialists to examine patients via videoconferencing supplemented by teleradiology and to provide decision support to local health care personnel. There is evidence that telestroke increases thrombolysis rates.
In Norway, telemedicine has mainly been used in non-critical situations. The first telestroke trials took place in 2008. The aim of this paper is to present an overview of telestroke trials and today’s status with telestroke in Norway. Based on the divergent experience from two health regions in Norway, the paper discusses crucial factors for the integration of telestroke in clinical practice.
This is a descriptive study based on multiple methods to obtain an overview of the practice and experience with telestroke in Norway. A Web and literature search for ‘telestroke in Norway’ was performed and compared with a survey of telemedicine services at the country's largest hospitals. These findings were supplemented by interviews with key personnel involved in telestroke in two of four health regions, as well as hospital field observations and log data of telestroke transmissions from five of the hospitals involved.
In Norway, experience in telemedicine for acute stroke care is limited. At the beginning of 2014, three of four regional health authorities were working with telestroke projects and services. Integration of the service in practice is challenging, with varying experience.
The problems are not attributed to the technology in itself, but to organization (availability of staff on duty 24/7 and surveillance of the systems), motivation of staff, logistics (patient delay), and characteristics of the buildings (lack of space).
Prerequisites for successful integration of telestroke in clinical practice include realization of the
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DOI: 10.1186/s12913-014-0643-9
PubMed: 25523241
PubMed Central: 4276053
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">A qualitative description of telemedicine for acute stroke care in Norway: technology is not the issue</title><author><name sortKey="S Rensen, Tove" sort="S Rensen, Tove" uniqKey="S Rensen T" first="Tove" last="S Rensen">Tove S Rensen</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Norwegian Centre for Integrated Care and Telemedicine, PO Box 35, NO-9038 Tromsø, Norway</nlm:aff><country xml:lang="fr">Norvège</country><wicri:regionArea>Norwegian Centre for Integrated Care and Telemedicine, PO Box 35, NO-9038 Tromsø</wicri:regionArea></affiliation></author><author><name sortKey="Dyb, Kari" sort="Dyb, Kari" uniqKey="Dyb K" first="Kari" last="Dyb">Kari Dyb</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Norwegian Centre for Integrated Care and Telemedicine, PO Box 35, NO-9038 Tromsø, Norway</nlm:aff><country xml:lang="fr">Norvège</country><wicri:regionArea>Norwegian Centre for Integrated Care and Telemedicine, PO Box 35, NO-9038 Tromsø</wicri:regionArea></affiliation></author><author><name sortKey="Rygh, Ellen" sort="Rygh, Ellen" uniqKey="Rygh E" first="Ellen" last="Rygh">Ellen Rygh</name><affiliation wicri:level="1"><nlm:aff id="Aff2">Norwegian Centre for Integrated Care and Telemedicine, Kirkeveien 9, NO-4816 Kolbjørnsvik, Norway</nlm:aff><country xml:lang="fr">Norvège</country><wicri:regionArea>Norwegian Centre for Integrated Care and Telemedicine, Kirkeveien 9, NO-4816 Kolbjørnsvik</wicri:regionArea></affiliation></author><author><name sortKey="Salvesen, Rolf" sort="Salvesen, Rolf" uniqKey="Salvesen R" first="Rolf" last="Salvesen">Rolf Salvesen</name><affiliation wicri:level="1"><nlm:aff id="Aff3">Nordland Hospital, NO-8092 Bodø, Norway</nlm:aff><country xml:lang="fr">Norvège</country><wicri:regionArea>Nordland Hospital, NO-8092 Bodø</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff4">University of Tromsø, 9038 Tromsø, Norway</nlm:aff><country xml:lang="fr">Norvège</country><wicri:regionArea>University of Tromsø, 9038 Tromsø</wicri:regionArea></affiliation></author><author><name sortKey="Thomassen, Lars" sort="Thomassen, Lars" uniqKey="Thomassen L" first="Lars" last="Thomassen">Lars Thomassen</name><affiliation wicri:level="1"><nlm:aff id="Aff5">Haukeland University Hospital, NO-5021 Bergen, Norway</nlm:aff><country xml:lang="fr">Norvège</country><wicri:regionArea>Haukeland University Hospital, NO-5021 Bergen</wicri:regionArea></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">25523241</idno><idno type="pmc">4276053</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4276053</idno><idno type="RBID">PMC:4276053</idno><idno type="doi">10.1186/s12913-014-0643-9</idno><date when="2014">2014</date><idno type="wicri:Area/Pmc/Corpus">000111</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000111</idno><idno type="wicri:Area/Pmc/Curation">000111</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000111</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">A qualitative description of telemedicine for acute stroke care in Norway: technology is not the issue</title><author><name sortKey="S Rensen, Tove" sort="S Rensen, Tove" uniqKey="S Rensen T" first="Tove" last="S Rensen">Tove S Rensen</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Norwegian Centre for Integrated Care and Telemedicine, PO Box 35, NO-9038 Tromsø, Norway</nlm:aff><country xml:lang="fr">Norvège</country><wicri:regionArea>Norwegian Centre for Integrated Care and Telemedicine, PO Box 35, NO-9038 Tromsø</wicri:regionArea></affiliation></author><author><name sortKey="Dyb, Kari" sort="Dyb, Kari" uniqKey="Dyb K" first="Kari" last="Dyb">Kari Dyb</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Norwegian Centre for Integrated Care and Telemedicine, PO Box 35, NO-9038 Tromsø, Norway</nlm:aff><country xml:lang="fr">Norvège</country><wicri:regionArea>Norwegian Centre for Integrated Care and Telemedicine, PO Box 35, NO-9038 Tromsø</wicri:regionArea></affiliation></author><author><name sortKey="Rygh, Ellen" sort="Rygh, Ellen" uniqKey="Rygh E" first="Ellen" last="Rygh">Ellen Rygh</name><affiliation wicri:level="1"><nlm:aff id="Aff2">Norwegian Centre for Integrated Care and Telemedicine, Kirkeveien 9, NO-4816 Kolbjørnsvik, Norway</nlm:aff><country xml:lang="fr">Norvège</country><wicri:regionArea>Norwegian Centre for Integrated Care and Telemedicine, Kirkeveien 9, NO-4816 Kolbjørnsvik</wicri:regionArea></affiliation></author><author><name sortKey="Salvesen, Rolf" sort="Salvesen, Rolf" uniqKey="Salvesen R" first="Rolf" last="Salvesen">Rolf Salvesen</name><affiliation wicri:level="1"><nlm:aff id="Aff3">Nordland Hospital, NO-8092 Bodø, Norway</nlm:aff><country xml:lang="fr">Norvège</country><wicri:regionArea>Nordland Hospital, NO-8092 Bodø</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff4">University of Tromsø, 9038 Tromsø, Norway</nlm:aff><country xml:lang="fr">Norvège</country><wicri:regionArea>University of Tromsø, 9038 Tromsø</wicri:regionArea></affiliation></author><author><name sortKey="Thomassen, Lars" sort="Thomassen, Lars" uniqKey="Thomassen L" first="Lars" last="Thomassen">Lars Thomassen</name><affiliation wicri:level="1"><nlm:aff id="Aff5">Haukeland University Hospital, NO-5021 Bergen, Norway</nlm:aff><country xml:lang="fr">Norvège</country><wicri:regionArea>Haukeland University Hospital, NO-5021 Bergen</wicri:regionArea></affiliation></author></analytic><series><title level="j">BMC Health Services Research</title><idno type="eISSN">1472-6963</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>To assist small hospitals in providing advanced stroke treatment, the Norwegian Directorate of Health has recommended telemedicine services. Telestroke enables specialists to examine patients via videoconferencing supplemented by teleradiology and to provide decision support to local health care personnel. There is evidence that telestroke increases thrombolysis rates.</p><p>In Norway, telemedicine has mainly been used in non-critical situations. The first telestroke trials took place in 2008. The aim of this paper is to present an overview of telestroke trials and today’s status with telestroke in Norway. Based on the divergent experience from two health regions in Norway, the paper discusses crucial factors for the integration of telestroke in clinical practice.</p></sec><sec><title>Methods</title><p>This is a descriptive study based on multiple methods to obtain an overview of the practice and experience with telestroke in Norway. A Web and literature search for ‘telestroke in Norway’ was performed and compared with a survey of telemedicine services at the country's largest hospitals. These findings were supplemented by interviews with key personnel involved in telestroke in two of four health regions, as well as hospital field observations and log data of telestroke transmissions from five of the hospitals involved.</p></sec><sec><title>Results</title><p>In Norway, experience in telemedicine for acute stroke care is limited. At the beginning of 2014, three of four regional health authorities were working with telestroke projects and services. Integration of the service in practice is challenging, with varying experience.</p><p>The problems are not attributed to the technology in itself, but to organization (availability of staff on duty 24/7 and surveillance of the systems), motivation of staff, logistics (patient delay), and characteristics of the buildings (lack of space).</p></sec><sec><title>Conclusions</title><p>Prerequisites for successful integration of telestroke in clinical practice include realization of the <italic>collaboration potential</italic> in the technology with consistent procedures for training and triage, availability of the equipment, and providing advice beyond questions concerning thrombolysis.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Elford, Rd" uniqKey="Elford R">RD Elford</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Gammon, D" uniqKey="Gammon D">D Gammon</name></author><author><name 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<front><journal-meta><journal-id journal-id-type="nlm-ta">BMC Health Serv Res</journal-id><journal-id journal-id-type="iso-abbrev">BMC Health Serv Res</journal-id><journal-title-group><journal-title>BMC Health Services Research</journal-title></journal-title-group><issn pub-type="epub">1472-6963</issn><publisher><publisher-name>BioMed Central</publisher-name><publisher-loc>London</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">25523241</article-id><article-id pub-id-type="pmc">4276053</article-id><article-id pub-id-type="publisher-id">643</article-id><article-id pub-id-type="doi">10.1186/s12913-014-0643-9</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group></article-categories><title-group><article-title>A qualitative description of telemedicine for acute stroke care in Norway: technology is not the issue</article-title></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>Sørensen</surname><given-names>Tove</given-names></name><address><email>tove.sorensen@telemed.no</email></address><xref ref-type="aff" rid="Aff1"></xref></contrib><contrib contrib-type="author"><name><surname>Dyb</surname><given-names>Kari</given-names></name><address><email>kari.dyb@telemed.no</email></address><xref ref-type="aff" rid="Aff1"></xref></contrib><contrib contrib-type="author"><name><surname>Rygh</surname><given-names>Ellen</given-names></name><address><email>ellen.rygh@telemed.no</email></address><xref ref-type="aff" rid="Aff2"></xref></contrib><contrib contrib-type="author"><name><surname>Salvesen</surname><given-names>Rolf</given-names></name><address><email>rolf.salvesen@nlsh.no</email></address><xref ref-type="aff" rid="Aff3"></xref><xref ref-type="aff" rid="Aff4"></xref></contrib><contrib contrib-type="author"><name><surname>Thomassen</surname><given-names>Lars</given-names></name><address><email>lars.thomassen@helse-bergen.no</email></address><xref ref-type="aff" rid="Aff5"></xref></contrib><aff id="Aff1"><label></label>Norwegian Centre for Integrated Care and Telemedicine, PO Box 35, NO-9038 Tromsø, Norway</aff><aff id="Aff2"><label></label>Norwegian Centre for Integrated Care and Telemedicine, Kirkeveien 9, NO-4816 Kolbjørnsvik, Norway</aff><aff id="Aff3"><label></label>Nordland Hospital, NO-8092 Bodø, Norway</aff><aff id="Aff4"><label></label>University of Tromsø, 9038 Tromsø, Norway</aff><aff id="Aff5"><label></label>Haukeland University Hospital, NO-5021 Bergen, Norway</aff></contrib-group><pub-date pub-type="epub"><day>19</day><month>12</month><year>2014</year></pub-date><pub-date pub-type="pmc-release"><day>19</day><month>12</month><year>2014</year></pub-date><pub-date pub-type="collection"><year>2014</year></pub-date><volume>14</volume><elocation-id>643</elocation-id><history><date date-type="received"><day>10</day><month>4</month><year>2014</year></date><date date-type="accepted"><day>9</day><month>12</month><year>2014</year></date></history><permissions><copyright-statement>© Sørensen et al.; licensee BioMed Central. 2014</copyright-statement><license license-type="open-access"><license-p>This is an Open Access article distributed under the terms of the Creative Commons Attribution License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0">http://creativecommons.org/licenses/by/4.0</ext-link>), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/publicdomain/zero/1.0/">http://creativecommons.org/publicdomain/zero/1.0/</ext-link>) applies to the data made available in this article, unless otherwise stated.</license-p></license></permissions><abstract id="Abs1"><sec><title>Background</title><p>To assist small hospitals in providing advanced stroke treatment, the Norwegian Directorate of Health has recommended telemedicine services. Telestroke enables specialists to examine patients via videoconferencing supplemented by teleradiology and to provide decision support to local health care personnel. There is evidence that telestroke increases thrombolysis rates.</p><p>In Norway, telemedicine has mainly been used in non-critical situations. The first telestroke trials took place in 2008. The aim of this paper is to present an overview of telestroke trials and today’s status with telestroke in Norway. Based on the divergent experience from two health regions in Norway, the paper discusses crucial factors for the integration of telestroke in clinical practice.</p></sec><sec><title>Methods</title><p>This is a descriptive study based on multiple methods to obtain an overview of the practice and experience with telestroke in Norway. A Web and literature search for ‘telestroke in Norway’ was performed and compared with a survey of telemedicine services at the country's largest hospitals. These findings were supplemented by interviews with key personnel involved in telestroke in two of four health regions, as well as hospital field observations and log data of telestroke transmissions from five of the hospitals involved.</p></sec><sec><title>Results</title><p>In Norway, experience in telemedicine for acute stroke care is limited. At the beginning of 2014, three of four regional health authorities were working with telestroke projects and services. Integration of the service in practice is challenging, with varying experience.</p><p>The problems are not attributed to the technology in itself, but to organization (availability of staff on duty 24/7 and surveillance of the systems), motivation of staff, logistics (patient delay), and characteristics of the buildings (lack of space).</p></sec><sec><title>Conclusions</title><p>Prerequisites for successful integration of telestroke in clinical practice include realization of the <italic>collaboration potential</italic> in the technology with consistent procedures for training and triage, availability of the equipment, and providing advice beyond questions concerning thrombolysis.</p></sec></abstract><kwd-group xml:lang="en"><title>Keywords</title><kwd>Telestroke</kwd><kwd>Technology</kwd><kwd>Qualitative</kwd><kwd>Overview</kwd><kwd>Norway</kwd><kwd>Acute stroke</kwd><kwd>Collaboration</kwd></kwd-group><custom-meta-group><custom-meta><meta-name>issue-copyright-statement</meta-name><meta-value>© The Author(s) 2014</meta-value></custom-meta></custom-meta-group></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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