From a Green Field to a Telemedicine Service Supporting 400 Patients in One Year: The Slovenian Experience

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Until 2014 no home telemedicine (business-to-patient) service was available in Slovenia. Slovenian partners in an European R&D CIP PSP project United4Health (U4H), namely GH Slovenj Gradec (GH-SG) and Healthcare Centre (HC-Ravne) have been pioneering in the area by providing telemedical support to patients with Diabetes Mellitus type 2 (DM2) and/or patients having Congestive Heart Failure (CHF) in Carinthia region (100.000 inhabitants, 300 km2) covered by GH-SG. The project partners set-up technological and organisational infrastructure with a support of a subcontractor (MKS Ltd.) having expertise in telecare service provision. The U4H project service model was adopted as well as patient inclusion/exclusion criteria. The first patients were enrolled in April 2014 and their number has been increasing to 120 CHF and 280 DM2 patients at the end of 2014. 

The patients receive telemedical support as a part of the existing healthcare system. The CHF patients measure daily their weight, blood pressure, heart rate and blood oxygen saturation. The DM2 patients measure weekly their whole blood sugar profile. Data are automatically sent from each measuring device to the patient’s mobile phone over Blue-tooth and further to a telemedicine centre in GH-SG hospital using mobile network. 

The existing workflow process of patient treatment in the GH-SG hospital has been minimally adjusted to integrate the new telemedicine service. A new medical response scheme has been introduced that responds to requests for intervention generated by the telemedicine system that monitors the received data measured. Patients whose data exceeds their personalised threshold values are contacted by the telemedicine centre staff to assure that data provided relate to their health condition. In case that an intervention is required the centre contacts a medical specialists that decides on further action – that is a change in therapy or an invitation for a visit to the hospital. Those patients receive by post a report on every change in the therapy. 

The patients receiving the telemedical support are not charged for the service as it is a part of the U4H project. The national health (compulsory) insurance system is charged for the medical interventions and for glucometers strips. 

The project partners have been working on establishing conditions to provide the service beyond the U4H project end in 2016.