engleski

Development of Informatic's System and Telemedicine in Croatian Primary Healthcare

DEVELOPMENT OF INFORMATIC SYSTEM AND TELEMEDICINE IN CROATIAN PRIMARY HEALTH CARE R. Stevanovic1, A. Stanic2, G.Galijaševic3, M. Mauher3 1Croatian National Institute of Public Health ; 2Orthopedic Clinics Lovran Croatia, 3Consultant, Zagreb, Croatia ranko.stevanovic@hzjz.hr Croatian ICT Primary Health Care Project Croatia's health ministry has started a health care system internetisation project aimed at strengthening collaboration between health care institutions, expert groups and individuals providing health care. Some of the important reasons for undertaking the project are rationalisation of drug utilisation, and potential savings owing to a reduced use of specialists, consultants and hospitalization. Achieving the goals of better cooperation, division of labour, result networking, data quality improvements (via standardisation), and ensuring proper information-based decision making are additional reasons. For the PHC team, it is too time consuming to keep the non standardised and thus hard to process data. The fact that a vast portion of the data collected relates to only a few indicators could lead to the uncovering of important information. Although health authority decisions should rely on evidence and processed information, most of the time these bodies work with the raw data from which their decisions ultimately stem. The system permits bi-directional data exchange between a central database and sources on different levels, across a spectrum from basic PHC teams to local authorities. This will enable the data collection control, comparisons with national averages and prompt distribution of information over the Internet. Telemedicine in Croatian Primary Health Care As a diagnostic tool, telemedicine offers primary health care teams great opportunities. The telemedicine project conducted on the Adriatic islands was an excellent pilot effort for including all primary health care teams in a single ICT and telemedicine system. Today, the recording and reading of relevant diagnostic study findings (ECG, EEG, EMG, ultrasound, X ray scans, CT, color Doppler, MR, etc.) is largely digital. Croatia has an impressive network of specialists, polyclinics and hospitals with experts in the fields routinely using digital records and diagnostic messages. Distant consultation and on line consultations are a reality now. Many examples show the usefulness of telemedicine in primary health care, primarily in Emergency Medical Service (portable biochemistry analyzer, remote ECG, emergency coordination, out-of-hospital thrombolytic for A.M.I. attended by emergency teams). In family medicine service, when checking on tests done and in diagnosis setting, telemedicine is useful in the form of on-line urgent examinations, consultant organised examinations, or off-line care. Today, electrocardiography, diagnostic imaging, digital photo transmission and reception, and portable analysers are also simple, inexpensive and welcome aids saving the health fund money by producing results that favour health more. Communication between a primary health centre and first, second and third level hospitals, as well as establishing a special coordination centre are today’ s reality and need. An evaluation of diagnostic correlation between the consulted and consulting physician found the quality of teleassistance to be superior to the traditional assistance in more than 95% of the cases. The investment into IT is a strategic one and having no alternative. A cost/benefit analysis has shown that its operation in the primary health care system will give a return on investment in two years. Key words: Internetisation, Primary Health Care, Informatic Sistem

Informatic's System; Telemedicine; Croatia; Primary Healthcare

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