GHP August 2015

ghp August 2015 | 41 achieve good, effective healthcare and medical ser- vices, while at the same time ensuring that patients do not have to travel as far. These complement the health centres, relieving pressure on them and in- creasing availability as the health rooms have much better opening hours than standard health centres,” says Björn Eriksson, Regional Director for Region Jämtland Härjedalen. The health room in Slussfors in the municipality of Storuman has been in use for almost two years now, with very good results. The health room is situated close to the school in the village, with keys and the staffroom for the home help service, offering access to assistance and trained personnel. “Slussfors is a pilot facility, and we have had the opportunity to try out and develop various devices and ideas here. The health room in Slussfors is work- ing well, and the municipality and medical services resources work together there to help patients with samples if so required,” says Peter Berggren of NHI. 83-year-old Carl-Axel Nordenberg, who was part of the health room’s reference group, has also found the health room to be positive. “It is 50 to 80 km to the nearest health centre for the people living here in the area. Slussfors is just 10 or 20 km away. The health room is extremely valuable for those of us who need a quick initial consultation with a doctor via a link and access to blood pressure readings and blood samples, and it offers us a high level of securi- ty. I know of at least one person who discovered that she had diabetes without knowing about it thanks to the health room,” he says. Focusing on innovations in training NHI and the Rural Medicine Center are now invest- ing major resources in the further development of the virtual health rooms, together with their partners and customers. These initiatives include remotely con- trolled cardiac ultrasound using robotics, planning and dimensioning tools for support care and medical services, and an app for diabetics which enhances security for adults and children alike. “We can make the virtual health rooms as good as we like – the only limits are in our own imaginations,” says Jonas Berggren, Chairman of NHI. Training initiatives are also important for ensuring that skilled assistance is always close at hand to the health rooms. “In Gällö in Jämtland, for example, we have launched a training course where municipal home help staff can learn all about the equipment found in the health room. We are also focusing on a self-learning system where residents and relatives can teach one another to use the equipment. We face a major challenge here, because the diagnostic equipment available at present is designed for use by care professionals, not by users. We have to design simple products which can be understood and used by anyone while at the same time safeguarding the diagnostic security required by healthcare and medi- cal services,” says Jonas Berggren of NHI. “Standard manuals are not always the best tools,” adds Peter Berggren of GMC. “Here, we are consid- ering simple 3-D instruction videos instead.” A separate, unique information exchange Further building up, refining and streamlining the digital doctor service is another initiative high up on NHI’s focus list, as is guaranteeing and streamlining information management to and from care provid- ers’ primary medical data and case note systems. Not least, this is taking place in close cooperation with NHI partners Microsoft, Sigma IT Consulting and Cambio. Cambio is one of Sweden’s leading stakeholders in the field of medical services systems, while Sigma is a leading Nordic supplier of inno- vative and effective IT solutions based on IoT and the cloud. Microsoft’s bold ambition to re-invent productivity and business process aligns very well with this initiative. “We are now working together with Sigma, Microsoft and Microsoft Azure technology to build our own flex- ible exchange which is being designed to integrate our information from NHI and the Rural Medicine Center with the Swedish hospital healthcare case notes system and the newly formed Swedish e-health account HälsaFörMig. With the e-health account, the intention is to gather all information on an individu- al’s health in a single location which is private and accessible to that individual him/herself. The aim is for this to work as a public health service which makes it possible for people to review their own health information both historically and at the pres- ent time, but also to share this information with med- ical services and research,” says Jonas Berggren. The service will be cloud based and the Microsoft servers are located within the European Union. Security and data privacy are key contractual and ar- chitectural elements and the setup will need to fulfill the Swedish and EU requirements in the area. Major gains and significant effects There are many social benefits to be gained from virtual health rooms and technology which is not dependent on distance. “We will see a clear improvement. Accessibility for residents is one of the benefits, as well as taking services out to patients and reducing the cost of travel and transport. Several million kronor are spent on medical travel in our region alone throughout the year. It will also provide us with an interface for cooperation and implementation of new concepts and innovations,” says Björn Eriksson of Region Jämtland Härjedalen. Jonas Berggren of NHI agrees. “The region stands to gain a lot by ensuring that the people who really need medical services are also the people who can access those medical services. It may not be possible to replace all visits to the doctor with a virtual health room, but many visits can indeed be replaced.” The cost of travel and locum cover are some of the biggest expenditure items for the regions in north- ern Sweden. “We recently carried out a health economics study as part of an EU project in which we looked at self-service units where patients could turn up and take their own blood pressure and blood samples. The results showed that there was a rapid return on investment (ROI),” says Peter Berggren of GMC. “Investing in these virtual health rooms is a vital step in the development of our new medical services. This is a way of streamlining and modernising medical services on patients’ terms. Care services will be more accessible and we will see a new, minimum, effective level of care,” says Björn Eriksson of Region Jämtland Härjedalen. Prouder staff and greater ease of recruitment are another major benefit. “Some of the staff that we have at the special housing in Gällö in the municipality of Bräcke have opted to undergo training on this. As a result, they feel proud- er about their work and are more encouraged to do a good job. We are expecting more people to apply to the care services when they find out more about the new care technology,” Sven-Åke Draxten, Chairman of the municipal board in the municipality of Bräcke. Major international interest NHI is focusing initially on developing and offering solutions in Scandinavia. “But in the long term, the needs are the same in other, similar areas all over the world, with corre- sponding needs for cost-effective, distance-spanning medical services,” says Jonas Berggren of NHI. On an international level, there are many sparsely populated areas which are grappling with similar dif- ficulties. There are major differences in ill-health fig- ures between rural areas and urban areas in Canada, the USA, Australia, Norway, Scotland and a number of countries in Asia, Africa and Latin America, and they also have growing ageing populations with com- plex needs, as well as major problems with recruiting and retaining doctors and other care personnel. Therefore, NHI is participating in the Rural Health project Room for Care by establishing a testbed for virtual healthcare in a village in Gunungkidul on the island of Jakarta in Indonesia. The aim of this project is to improve the capacity of the local Indonesian authorities, helping them to improve health and wellbeing among the rural population. In order to enhance their knowledge, stakeholders in Northern Sweden are also intending to build an R&D network together with other countries with sparsely populated areas. Annual conferences relating to health and social care in rural areas are planned for the next two years, with international participation. There is already well developed international cooper- ation with organisations such as the National Centre of Rural Medicine (Nasjonalt senter for distriktsme- disin, NSDM) in Tromsø in Norway, Nord-Trøndelag University College and Sør-Trøndelag University Col- lege, the Central Norway Regional Health Authority (Helse Midt-Norge) in Trøndelag, Northern Ontario School of Medicine in Canada, Flinders University in Australia and the Centre for Rural Health at the University of Aberdeen in Scotland. “But rural areas are not the only places with these needs. We are also seeing greater demand for distance-spanning medicine in urban areas. In addition to that, we are seeing demand for virtual health rooms in the field of occupational healthcare,” concludes Peter Berggren. industry insight