Aas IH 2002 "Telemedicine and changes in the distribution of tasks between levels of care."
Reference
Aas IH. Telemedicine and changes in the distribution of tasks between levels of care. J Telemed Telecare 2002;8 Suppl 2:1-2.
Abstract
"The present investigation, which was part of a larger study, was designed to answer the question, 'Has telemedicine produced changes in the distribution of tasks between the general practitioner and specialist, or between the local hospital and university/central hospital?' Qualitative interviews were carried out with 30 persons involved in four telemedicine services in Norway: teledermatology, tele-otolaryngology, telepsychiatry, and a telepathology frozen-section service. The results indicated that telemedicine does not produce large changes in the distribution of tasks. The reported effects were largest and most complex for telepsychiatry, followed by teledermatology. Local variations in how telemedicine is practised may explain the variation in the findings between telemedicine applications."
Objective
"To answer the question 'Has telemedicine produced changes in the distribution of tasks between the general practitioner [GP] and specialist, or between the local hospital and university/central hospital?"
Tools Used
Type Clinic
Primary care and specialty care
Type Specific
Specialty: dermatology, otolaryngology, psychiatry, and pathology
Size
unknown
Type of Health IT
Telemedicine
Workflow-Related Findings
"Telemedicine does not produce large changes in the distribution of tasks. The reported effects were largest and most complex for telepsychiatry, followed by teledermatology. Local variations in how telemedicine is practised may explain the variation in the findings between telemedicine applications."
"Teledermatology leads to some change in the performance of tasks for primary care and the dermatology departments, but these changes are not large. The change consists of the GPs [general practitioners] diagnosing some patients themselves, those GPs who are involved in telemedicine receiving patient referrals from other GPs and (of course) the involvement of GPs in telemedicine sessions. The involvement in teledermatology may result in learning for the GPs and this may allow the GPs to take care of some dermatology patients without referral."
Telemedicine results in primary care staff doing more patient care work. "Learning effects allow [general practitioners] GPs to take care of some patients themselves and their involvement in telemedicine requires more work than a conventional referral."
"The trend in the changes in the distribution of tasks between levels of care, where they occur, is for an increased involvement for lower levels of care."
Study Design
Only postintervention (no control group)
Study Participants
The study included 30 respondents: 2 worked in teleotolaryngology, 6 in teledermatology, 12 in telepsychiatry, and 10 in telepathology.