These services are available for: Uppsala


Tele-counselling and shared medical record for Plastic Surgery 

The Department of Plastic Surgery (DPS) at Uppsala University Hospital (UUH) has two main tasks; plastic surgery and burn treatment within which they serve large parts of Sweden. Between 2005 and early 2007, the department participated in an EU-project called SPEX (SPreading EXcellence) concerning spreading excellence through Telemedicine. In this project the department acted as Centre of Excellence (CoE) and collaborated with Mälarsjukhuset Hospital in Eskilstuna (MHE) who acted as a Point of Care (PoC). With SPEX, an agreement was made to secure economical benefits for both parties.
The tools used at the DPS at UUH, are shared desktop software called Bridgit, video conference software called VCON vPoint HD (vPoint), high quality streaming video and mobile phones able to send and receive photographs.
The PoC benefits from better consultation which is a kind of teaching ultimately allowing the PoC to treat more patients independently. The technology may be used in other areas within the hospitals. The contact between doctors at different hospitals will increase. A possible side effect is the PoC becoming a CoE for even smaller care units.
The basis of the agreement from 2006 was to create a win-win situation for UUH, MHE, and the patients . The gain for MHE is reduced costs for sending patients to other County Councils’ hospitals. For UUH the gain is optimized use of excellence as well as shorter waiting periods for other patients.
The next step is to adapt the technology better and expand the collaboration to see how it works in a larger scale. 


Telecounselling, Telelaboratory and Shared medical record for Radiology

A new common PACS for CCU is currently introduced. The radiology department at UAS has been using a digital system, called RIS/PACS, since 2001.
Today the amount of pictures taken in each examination is much greater than when the system was first introduced. Some examinations may generate a hundred times more data than before or even more. This gives higher resolutions and a better base for making decisions, but it has also put a lot of strain on the system. The growing quantities of data do not only make the short-term storage insufficient, but is also affected by bandwidth limitations within the long-term storage.
The new RIS/PACS system mean no new ways of working. There will of course be some differences in the user interface of the new system but most principles will be the same. The new system will use thin clients, which means a system architecture where almost all computations are done at a central server and basically only input and output is transferred between the server and the clients. The result of this is that the doctors can work from anywhere they want in the world, through a VPN, using only a laptop.
There will be no paper in the new system. Currently, some of the referrals are in paper form which means that sometimes double work is necessary. To work in a non-paper environment will speed things up.
There will be several benefits with the new system:
1. The new systems will allow for multiplanar reconstructions, which is a way of making a 3D picture from a lot of 2D pictures. Another improvement is the display protocol for the scans. Both of these will improve the doctors' speed and ability to diagnose the patients.
2. Aside from these major functionality improvements a lot of minor improvements will be made.
The new system has the potential to become a great tool for the staff at the hospital. The system is being developed in cooperation between staff at the hospital and developers at the company delivering the system. 


Telecounselling, Electronic referral and Telelaboratory for Neurophysiology

Neurophysiologic examinations aim to map out functions in the central and peripheral nervous system. They are considered a medical consultation and is designed individually depending on symptoms and modified conditionally on acquired results.
One examination method used at the Department of Neurophysiology at UUH is electroencephalography (EEG).
Patients are only referred to the Department of Neurophysiology at UUH when they can not be diagnosed at the satellite lab.
Current satellite laboratories:

• Gävle (Hudiksvall)
• Falun (Säter, Mora)
• Karlstad
• Örebro
• Västerås
• Eskilstuna
• Stockholm
• Mariehamn

The new project will evaluate the use of embedding video with the EEG in order to address this issue. All EEG registrations with embedded video are analysed at the Department of Neurophysiology at UUH.
Expectations are that the project will result in better diagnostics and fewer patients brought back for the complementary registrations needed to distinguish artefacts from real epileptic activity.
This leads to faster results from the examiner and less travelling for the patients, making them more satisfied. It also helps the specialist to diagnose the patients more rapidly, enabling for faster treatment. 


Telecounselling, Electronic referral, Shared medical record for Dermatology

At present, when a doctor at a GP Surgery has a case of dermatology and has doubts what diagnosis to set, the patient is referred to UUH. The idea of this project is that a GP Surgery in the Primary Care, in this case Heby Care Centre (HCC), will use a digital camera to photograph patients. These photographs will be discussed one our, once a month, during a video conference, .A digital camera capable of taking macro shots will be used. The doctors will, more or less, continue to work as before. The difference is that if a patient has skin alterations of unknown type the doctor can consult a specialist. During these video conferences the doctors also get the opportunity to ask for a second opinion in cases of uncertainty.
The specialist at the Department of Dermatology gives a rough estimate that ten percent of the referrals could be avoided, because of the collaboration.
One big benefit is that doctors at the Care Centre will learn from the specialist in cases they discuss. This will probably lead to a decreasing need for video conferences in the future.


Telecounselling, Telelaboratory and Shared medical record for Discharge teleconference

When a patients' treatment has been finalized at the Uppsala University Hospital (UUH) they are to be transferred to their home municipality. If the discharged patient currently have, or in the future will have, home-help service, a discharge conference will take place. This is to ensure that the patient will get the correct care in their home municipality. When the doctor considers the patient to be fully treated, the home municipality and the corresponding GP Surgery in the home municipality are contacted.
The Participants at the conference are the patient, the nurse responsible for the patient at UUH, an occupational therapist, and the district nurse from the patient's home municipality. Other participants are the next of kin and a technician.
The users at HCC are satisfied with the use of video conferences and the technologies. However, they also believe improvement can be found regarding how the technology is used. 


Telecounselling and Shared medical record for Oral and Maxillofacial Surgery

As this discipline came under consideration at a rather late stage, is the basket of services not fully completed yet.
However, the HO project are discussing with the excellence unit how to best and most efficient perform consultations as well as spreading of excellence in this discipline. The consultations will be performed both in planned as in acute situations.