The potential of telemedicine: barriers, incentives and possibilities in the implementation, phase

Between 1998 and 1999, the Swedish Institute for Health Services Developmen t (Spri) evaluated three applications in which specialist competence was be ing accessed via telemedicine. The results indicated that these kinds of ap plication can be cost-effective in an organization well adapted to new tech nology and that telemedicine can improve continuity of care for patients. H owever, the new technology was seldom supported by the old organization and better education and technical support are needed. In a study called 'Ince ntives and Implementation', the Federation of Swedish County Councils inter viewed people in Swedish health-care with a lot of experience of telemedici ne. The interviewees agreed that telemedicine was likely to affect the whol e structure of health-care. Peripheral competence was expected to increase and, referral patterns to change, as well as the functions of the personnel and the hospitals, New working conditions and methods of work were expecte d to be made possible by telemedicine and health-care was expected to becom e more process oriented, partly because patients are likely to be more dema nding and better informed. To be able to utilize this potential, health-car e managers will have to show more interest in and commitment to telemedicin e. Old organizational patterns must be called into question and be develope d along, with information technology and telemedicine. It is also important to give priority to training in telemedicine for physicians and nurses.