Telemedicine in managing demand for secondary-care services

The sustained growth in demand for hospital services has inspired new ways of managing the demands for secondary care. In Finland, teleconsultations h ave been used alongside an electronic referral system for hospital outpatie nt clinics for the management of primary-care patients by specialists. Dire ct outpatient costs of the internal medicine department of a district gener al hospital with an electronic referral system and using teleconsultations were compared with those of a similar department at another hospital using a paper referral system. The former were at least 20% lower. Almost every p aper referral in the conventional system (over 95%) led to an outpatient vi sit, whereas only one-third of the teleconsultations resulted in actual out patient visits. Thus virtual integration of secondary and primary-care with an electronic referral system as part of an electronic medical record redu ced both the costs of hospital outpatient care and the demand for it.