The case offers the possibility to merge an anonymous medical information service in the mobile phone (iDoc24) to the regional personal health portal ("Mina VÃ¥rdkontakter").
With a stressful everyday life there is less time to handle unexpected health conditions. In the Swedish National Health Service (SNHS), a referral from a general practitioner (GP) is needed to visit a specialist. 300 000 calls are made to the SNHS public telephone advice service about skin related problems. If 10% of all skin related visits can be self treated using iDoc24 there is an estimated €5 million saving to the SNHS.
iDoc24 is a Telemedicine service that can be used from a mobile telephone with a digital camera or an internet web form, anywhere and at all times. Today's mobile phone cameras have excellent optics and can take good quality pictures, which are so good that a doctor can make a sound medical judgement from the Media Messaging Service (MMS). The client receives a reply by MMS and on our web page within 24 hours with medical information which includes a probable diagnosis, general information and treatment information or if a doctors appointment is needed.
"Mina VÃ¥rdkontakter" is the regional personal health portal where a citizen can see his medical diagnosis, medical contacts, book appointments, find medical information and e-prescription.
Combining the two solutions empowers the citizens to make their anonymous case personal (un anonymous) by logging on to their personal account. The citizen can then use the advice for further treatment and follow up with his local general practitioner (GP) if needed. The GP can see the case in the citizen's health portal online.
Policy Context
The European Union (EU) in cooperation with The World Health Organization (WHO) have established an IT health program called eHealth. They have drawn up guidelines that aim to support countries to further develop their health systems, by improving: access, quality and efficiency through the use of information and communication technologies. The eHealth program encourages the prevention and management of diseases through research on ‘‘Personal Health Systems''. The hallmark of this concept is to empower citizens to adopt an active role in managing their own health status and, in addition, facilitating early diagnosis of disease. It is estimated that 15% of consultations in primary care are diagnosis of visual medical concerns.
The iDoc24 service is not intended to substitute the "doctor patient relationship", nor will it treat and follow up patients, but give a probable diagnosis and treatment information, or if needed, the advice to seek a doctor. If the citizen wishes to make the errand personal he can do so by connecting to his personal health portal called "Mina Vårdkontakter" at Vården på Webben with e-identification. This empowers the citizen on his own health.
Description of target users and groups
General public
Research and Internet trends indicate that people are using the Internet to help diagnose skin related diseases.
Women
The public 24 hour telephone advice service called 1177 has around 3 million phone calls per year and their webpage has 1 million visits per year, increasing by 20% per year. Eight out of ten who use the service are women between 18 to 45 years including those with small children.
Skin cancer
From a MMS one can not diagnose skin cancer. Skin cancer can be fatal and costly for society if diagnosed late, early diagnosis can save lives & treatment costs. Men over 50 years are the most prone to develop spread disease due to patients delay.
Genital worries
The service has sofar received queries about genital worries and informed on possible relief and if a personal visit to health care worker is needed, with satisfying citizen results.
Users of health portals
An infrastructure is in place in Denmark (Sundhed) and in Sweden (Mina VÃ¥rdkontakter) for citizens to manage their own health over the internet. A health portal makes it possible to develop so called "plug in" health services to promote a citizens health and easy access to health care.
Users of health advice services
In Sweden you can use www.1177.se (Sjukvårdsrådgivningen) or call 1177 and in the UK one can use www.NHSDirect.co.uk or call 0845 4647. This public service is good and citizen friendly. iDoc24 makes it possible to use skin doctors looking at images with text, delivering telephone health advice at a specialist standard.
Description of the way to implement the initiative
The service needs partnerships with governmental and private health care institutions to achieve the citizen's trust.
From spring 2009 the client can "personalize" the consultation by logging on with an e-identification card to "Mina Vårdkontakter", which is the Västra Götalands regional health portal for the citizen.
iDoc24 has a professional relationship with "Vården på Webben" in Västra Götalands region. More regions in Sweden and the national medical telephone advice service, Sjukvårdsrådgivningen (www.1177.se) are interested. Future plans is to springboard into other EU countries with a similar health service as Sweden. We believe that Sweden is a perfect launch pad to other markets, because of the good reputation it has on high health care standard and IT standard. Many Swedish and Scandinavian eHealth projects have received ePractice awards. Legitimizing the service in the eyes of the citizen and politician will ease partnerships abroad. The service is linked from the region health portal web page http://vard.vgregion.se/sv/
Technology solution
If the citizen wants to personalise the case, he can logg onto his regional personal health portal with an e-identification constructed by the region, called "Vården på webben" http://vard.vgregion.se/sv/. There the citizen can retrieve his case from iDoc24 making it personal and can further communicate with his personal doctor for prescriptions, further tests or book an appointment.
Technology choice: Standards-based technology, Mainly (or only) open standardsMain results, benefits and impacts
Results:
As of present 150 MMS and web formula queries have been received and answered within a day.
Benefits
Citizen
Skin doctor advice within 24 hours. The client can "personalize" the consultation by logging on with an e-identification card to "Mina Vårdkontakter", which is the Västra Götalands region health portal for the citizen and have possibilities for e-prescription, further tests and book an appointment.
iDoc24 is a flexible service and can be used on boating trips, travelling abroad, in a lodge or anywhere where there is no doctor.
Regions with personal health portals
Empower the citizen and encourages the use the health portals, which in turn should save money in the long run.
To the stake holders
A fruitful and innovative international eHealth company that has the possibility to build on new innovative eHealth solutions that can reduce future tax increases due to savings to the National Health Service budget.
Return on investment
Return on investment: Larger than €10,000,000Track record of sharing
iDoc24 is active in the process of sharing and partnering.
Vården på Webben uses open source and is shared between other regions in Sweden.
Lessons learnt
Lesson 1 - Using e-services can facilitate contact between the health care sector and the citizens.
Lesson 2 - E-service can substantially reduce the cost of health care