Telemedicine and eLearning in eHealth: case of Norwegian lessons learned

Tromso workshop 2010 June
Currently I am following, speaking and participating a workshop on Telemedicine and eLearning for eHealth. A one week workshop in collaboration between ITM and NST (WHO centre).

Participants from Sudan, Ethiopia, Ghana, Trinidad Tobago, Norway, Italy, Peru, Brazil, Canada, Belgium.

notes taken Monday 7 June 2010, First content session Steinar Pedersen:
Lessons learned from telemedicine projects which can also be used for eLearning projects in the medical field

• TTT: things take time and be patient, build maturity before implementing technology in a field
• Move from the competence centre to the periphery
• Be aware of the National competition and join forces so the National strength can grow, build round tables. It is better economics and knowledge exchange.
• Anchor level should be as high as possible (top level stakeholders)
• Argue on quality not on cost saving (Inge take this into the m/eLearning overview
• Secure the infrastructure
• The hen and egg problem (interconnectivity problem)
• Link technological developments to health priorities
• Always try to put a medical doctor or nurse in a the middle of the good medical/technological news (much more convincing)
• Use radiologists (or other people that are used to follow things on screens)
• By introducing technology, discussions on medical hierarchy can take place, be aware of this potential dynamic
• Chance of success is better if you introduce it to existing part of the organization, ideally if this service is 24 hours good for organizing the receiving part of the service.
• Create solutions based on national and international standards (e.g. visa card logic, electric power sockets)
• People are ready to be very, very innovative when it comes to do what they already are doing very well even better
• The same doctors and nurses are not very interesting in doing what they were already doing in another way (no benefit, just different).
• Even if developments go very slow, it will be part of the future health care, in that case even the smallest steps count.
• Keep the doctors responsible

Questions from participants, answered by Stainer
Developing countries big challenge is developing policies, how did Norway do it?
They health minister was not that strong, so parallel pillars were build for decision making, but policies can also be taken from similar countries, so you can leapfrog into policies that work.
How to get commitment from all the stakeholders: that is really difficult
Metrics and triangulation, how do you do it? How many refers, how much money is saved in transportation, how satisfied are the health care workers and the patients (the patients seems to be more satisfied and the peripherals are more satisfied (in general) than in the centre.
Were there infrastructural challenges in Norway for setting up Telemedicine? We still need to fly over a CD-rom to exchange data between South and North Norway. When we started out with radiology, there was very low bandwidth, downloads were done overnight because it took so much time. But from a mobile side, there are more mobile subscribers than there are people in Norway. eHealth is also subscribed in the medical curriculum of medical students which is important for longterm implementation. Trust is very important to get successful projects.