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Telemedicine and eHealth in Norway: administration and delivery of services.

OBJECTIVES: This article reviews the situation in Norway concerning the administration and delivery of telemedicine and eHealth. METHODS AND RESULTS: By introducing the Norwegian hospital reform implemented in January 2002, the review provides the background allowing to understand the shift in strategy within this field in Norway. It also provides a historical context regarding the use and development of telemedicine in Norway. Since the implementation of the hospital reform, it can be argued that, presently, there has been a significant change in strategy from what can be described as a "muddling through"-strategy to a more rational approach, based on common and clearly defined goals. CONCLUSIONS: The hospital reform can be regarded as an important crossroads for the use of information and communication technology in Norway. The hypothesis put forward is that the development since the reform was implemented has strengthened both the willingness and the ability to make rational choices and take important steps forwards regarding the use of information and communication technology in the health sector in Norway, when discussing both telemedicine and eHealth.

Health Care Costs↗

Information technology strategies for health and social care in Norway.

OBJECTIVES: Provide an introduction to national IT strategies for the health and social sectors, and point out major challenges for the future of eHealth and Telemedicine in Norway. METHODS: The information provided in this article is based on reviews of national strategies and plans, and contact with projects and users in the health and social sectors. CONCLUSION: IT in health and social services has the potential to improve welfare, while simultaneously improving the efficiency of the systems. IT in home- and community-care will provide the users with better services closer to home in the coming years. National strategies and action plans are important, but the funding necessary for the recommended actions must also be provided. Organisational issues are important.

Community Health Services↗

Review on the state of telemedicine and eHealth in Iceland.

This article provides an overview of telemedicine and other eHealth activities in Iceland. Several telemedicine projects, which have been running since 1996, are described. The projects include teleradiology, teleobstetrics, telepsychiatry, maritime telemedicine, telemedicine in surgery, telepathology and a project for the use of telemedicine in various consultations. The role of the Icelandic Health-net for telemedicine, including projects for teleobstetrics and telemedicine for emergency medicine, is described with the projects included:. A few other eHealth activities, including electronic patient record and information systems, are also described.

Health Status↗

From "silos" to seamless healthcare: bringing hospitals and GPs back together again.

Linda Mann, a Sydney GP, proposes ways of potentially enhancing patient care and reducing hospital stays, without increasing overall healthcare costs. Her suggested solutions include making it simpler for all healthcare practitioners involved in caring for the same patient to share (rather than not share) all patient information by applying the information technology of today (rather than tomorrow). Also, pooling some funding from state and federal sources could allow for further "seamless care" at areas of reasonable overlap between the current "silos" of hospital-based and community-based care.

Australia↗

Systematic review: impact of health information technology on quality, efficiency, and costs of medical care.

BACKGROUND: Experts consider health information technology key to improving efficiency and quality of health care. PURPOSE: To systematically review evidence on the effect of health information technology on quality, efficiency, and costs of health care. DATA SOURCES: The authors systematically searched the English-language literature indexed in MEDLINE (1995 to January 2004), the Cochrane Central Register of Controlled Trials, the Cochrane Database of Abstracts of Reviews of Effects, and the Periodical Abstracts Database. We also added studies identified by experts up to April 2005. STUDY SELECTION: Descriptive and comparative studies and systematic reviews of health information technology. DATA EXTRACTION: Two reviewers independently extracted information on system capabilities, design, effects on quality, system acquisition, implementation context, and costs. DATA SYNTHESIS: 257 studies met the inclusion criteria. Most studies addressed decision support systems or electronic health records. Approximately 25% of the studies were from 4 academic institutions that implemented internally developed systems; only 9 studies evaluated multifunctional, commercially developed systems. Three major benefits on quality were demonstrated: increased adherence to guideline-based care, enhanced surveillance and monitoring, and decreased medication errors. The primary domain of improvement was preventive health. The major efficiency benefit shown was decreased utilization of care. Data on another efficiency measure, time utilization, were mixed. Empirical cost data were limited. LIMITATIONS: Available quantitative research was limited and was done by a small number of institutions. Systems were heterogeneous and sometimes incompletely described. Available financial and contextual data were limited. CONCLUSIONS: Four benchmark institutions have demonstrated the efficacy of health information technologies in improving quality and efficiency. Whether and how other institutions can achieve similar benefits, and at what costs, are unclear.

Biomedical Technology↗

Meet the cybernurse.

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Forecasting↗

Computer-assisted planning for orthopedic surgery.

Faced with challenging deformities and crippling arthritis, orthopedic surgeons frequently are called upon to perform increasingly complex reconstructive surgery. The desired goals of treatment include correction of deformities, relief of pain, and preservation or restoration of function.

Computer Simulation↗