Rheumatology patients on heavy medication need to be examined regularly to evaluate the pharmacological treatment, possible side effects and general wellbeing. To reach all the patients in the county, medical specialists in rheumatology placed at Nus previously staffed also the rheumatology departments of Skellefteå and Lycksele Hospitals once a week. A large part of the time was thus spent on travels instead of working with patients. Therefore, a rheumatology surgery was established in Skellefteå hospital in 2010 followed by Lycksele Hospital in 2014, both staffed remotely by specialists at Nus. The target group is patients with stable rheumatologic disease, those in need of regular control of anti-rheumatic drug therapy and those in need of short-term follow-ups. For this purpose, special rooms have been equipped with videoconferencing systems and a high-resolution video camera on a flexible stand. The operation is made possible by specially trained nurses and physiotherapists in the local hospitals, who work in a team with the rheumatologist at Nus. The local staff receives the patient and performs a routine examination before the connection to Nus is established. The specialist thereafter communicates with the patient via video and if needed, further examinations can be carried out with support from the local staff with or without using the high-resolution camera.
Besides leading to a more efficient use of the specialists, this work model contributes to skills development for nurses. For example, with this approach it becomes the nurses' role to listen to the heart and lungs and to investigate the status of the patient’s joints, which is an important part of the follow-up. It also leads to increased availability of specialist as several patients can be managed in the context of the local services. Virtual visits cannot completely replace face-to-face appointments, but works well for many patient groups and types of appointments.
This text has been originally released in the following report: Telemedicine Survey in the County Council of Västerbotten -An analysis of the present situation, conditions and areas of improvement.