Présentation du système de téléassistance de séances de dialyse dans des centres à distance de l’unité centrale, réalisé en partenariat avec le Centre Norvégien pour la Télémédecine et les Soins Intégrés (NST) Randi LAUKLI, représentant le département de télémédecine de l’Hôpital Universitaire de Tromsø, en Norvège

1. Teledialysis
from project to routine service
Eli Arild
Project manager

2. • Limited use of
telemedicine in Europe
• Telemedicine in
chronic disease
management
• Partnership of nine
European regions
• Project period: 2010-
2012

3. The Regional Telemedicine
Forum aims to:
•Create new knowledge and skills for all
involved stakeholders
•Improve regional policies and strategies
•Successfully transfer telemedicine
services between regions
http://regional-telemedicine.eu/

4. Agenda
• Background
• The teledialysis project
• Project evaluation results
• Experiences after the project period

5. Kidney replacement therapy
HAEMODIALYSIS
PERITONEALDIALYSIS
Home dialysis
TRANSPLANTATION
Hospital dialysis
Home dialysis
Satellite dialysis

6. ONE UNIT!

7. Aim of the project
• Improve communication between
remote dialysis units in the neighboring
county of Finnmark (Alta and
Hammerfest) and the University
Hospital (UNN), where nephrologists
are located

8. Teledialysis on YouTube
• http://www.youtube.com/user/telemedisi
n?blend=2&ob=5#p/a/u/1/hmfJCqwzzc
Q

9. Patient follow up before TM
• Tromsø • Satellites
– unlimited access to – limited access to an
nephrologist ambulatory nephrologist
– regular rounds every 4th week
– specialists in every – limited access to the
field available patients chart (spread
– professional milieu information)
– in case of emergency limited
diagnostic tools and
treatment options
– professionally isolated
health staff

10. New technology
• Videoconferencing
• Electronic patient record
• Dialysis machine program
• Ultrasound
• Electronic Stethoscope

11. New service delivery
routines

12. Results

13. Videoconference
• Used for daily two-way audio-visual
communication between UNN and
satellite units:
– For consultations
– For administrative purposes
– For distance education
– For tele-visits with the patients (twice a
month)

14. • Both patients and personnel were satisfied
with services
• 4 of 7 patients were active
• Utility consideration:
– 1. Videoconference
– 2. Electronic patient record
– 3. Dialysis machine program
– 4. Ultrasound
– 5. Stethoscope

15. Avoided hospitalizations
• Venous thrombosis
– Cardioasular surgeon/nephrologist.Ultrasound employed
– Pseudoaneurysm disclosed
• Skin rash.Infection?
– Eczema disclosed
• Chest pain,Myocardial infarction
– Videoconference
• Hematoma at the fistula
– Ultrasound guided puncture of the fistula
• Technical problem
– Videoconferencing with technologist solved problem

16. Cost and cost savings
• Investment costs
• Time costs for health staff
• Technical staff
• Travel costs
• Costs of overnight stays
• Emergency admissions
• Specialists travels

17. Results are published
• Markus Rumpsfeld, Eli Arild, Jan
Norum, and Elin Breivik: Telemedicine
in haemodialysis: a university
department and two remote satellites
linked together as one common
workplace
• J Telemed Telecare July 2005 11:251—
255; doi:10.1258/1357633054471885

18. Recommendations
• Plans and routines
• Simple as possible
• Laws and security
• Technical support
• Training

19. Conclusion
Project was immediately implemented
into a routine service,and has been
extended to all satellites

20. Telemedicine home to
dialysis patients
• Survey of the need for new telemedicine
solutions for use at home by patients
with kidney failure
• VC link established this week to first
home dialysis patient

21. Do you want more information?
eli.arild@telemed.no
Photo:
Grytøy in
Troms,
North of
Norway
Photos by Oddvar Hagen