As our population ages, society faces new challenges. Demand for primary health care services is rising: with the retirement of older professionals and an unwillingness amongst younger professionals to re-locate to remote areas, there is a shortage of physicians, especially in rural areas. The regions round the Baltic Sea are more or less in similar situations. Each of them already pursued separately diverse approaches. One of the reasons could be the called “professional isolation” of health professionals working in remote primary health care that influences on the attractiveness of their jobs and working conditions compared to cities and urban areas. It was to study conjointly how to overcome this professional isolation that the project “PrimCareIT – Counteracting brain drain and professional isolation of health professionals in remote primary health care through tele-consultation and tele-mentoring to strengthen social conditions in remote Baltic Sea Region”, was initiated.
Professional isolation refers to the circumstance that health professionals such as family doctors, specialised doctors, health workers or nurses are to some extent isolated from their professional peers. The project partners decided to test two tools in order to reduce this isolation: tele-consultation and tele-mentoring. The first one enables the virtual communication between doctors of different disciplines or with specialists in other health care institutions like hospitals for a second opinion. Tele-mentoring is a form of virtual mentoring. It should be included in existing medical e-learning programs. Teaching practices in these medical e-learning programs have to be analysed or, where applicable, developed and tested. Good practices will be published in a handbook to promote tele-mentoring in remote areas.
Thus, the project partners analyse existing barriers for large scale deployment of tele-consultation and tele-mentoring such as technology acceptance, work flows, daily routines or legal uncertainties. They elaborate on strategic opportunities for better use of such tele-health to overcome brain drain of health professionals in remote primary care. They implement jointly developed tele-consultation and tele-mentoring solutions between health workers, general practitioners and medical specialists in pilot sites in Finland, Sweden, Lithuania, Estonia, Latvia and Belarus preparing their large scale implementation.
The partnership involves health workers, medical doctors associations, hospitals, planning and financing authorities, regional development administrations, and eHealth research organisations. Thus, the consortium represents the relevant sectors in the implementing regions for successful goal achievement.
The last project period was dedicated to elaborating the lessons learned from the pilots in tele-consultation and tele-mentoring. For this, the project partners finalised their reports on fully implemented infrastructure and running processes in the pilot sites in tele-consultation and tele-mentoring. All involved partners came together for a transnational workshop in Karlskrona, Sweden, in order to exchange their experiences and to synchronise further proceeding. The result was a common structure for the “Guidelines for implementing tele-consultation and tele-mentoring”.
Afterwards all data was gathered from every pilot site by questionnaires, interviews and analysis of documents. The handbook focuses on the qualitative content analysis of the data and identifies the indicators for success: preparation, involvement, communication, technology, implementation, training, assessment, health economy.
Organisations and institutions intending to implement eHealth can read about good practices and follow the guidelines.
The reports on successful implementation of the pilots facilitate the discussion and further activities for large-scale deployment of tele-consultation and tele-mentoring in the partner regions and in Europe. Decision makers can clearly see the obstacles and hindering factors and how to overcome them. The diffuse prejudice ‘eHealth is good but difficult to realise’ will be answered by well-structured arguments and clearly defined procedural steps.
The Final Conference “Connecting health care professionals via ICT - tele-mentoring and tele-consultation in primary health care” was held on 14th of February 2014 in Tallinn, Estonia. The results of the PrimCareIT project and its consequences for the future health care provision in rural areas were presented.
The conference was a platform for more than 120 health care workers, academics and political decision makers to share their ideas and views about the remote primary care challenge all of Europe is facing.
The summary of the – mainly positive – statements made during the Final Conference were integrated in the report on “Joint transnational conclusions and political statements” underlining the role and importance of tele-health to attract health workers to primary care in remote areas. The report also contains more than 20 written agreements for ongoing cooperation and letters of intent to promote the eHealth activities signed by stakeholders, decision makers, professionals and politicians in primary health care in participating countries. This should be an effective support to promote the aim of the project.
In the future the project partners will work on the deployment of the tested IT solutions: Almost all involved pilot organisations will continue the implemented structures.