Momentum telemedicine service descriptions

KSYOS TeleConsultation (NL)

At the dermatologist…

Objectives, expected outcomes, main beneficiaries

With KSYOS TeleConsultation a general practitioner can refer a patient digitally to a medical specialist in order to replace a physical referral. In the case of TeleDermatology, the general practitioner sends digital images of the skin and the patient’s medical history to the dermatologist to whom the practitioner would usually otherwise refer the patient physically. The dermatologist will answer the TeleConsult and will include diagnostic considerations and therapeutic advice in the response.

The general practitioner benefits from the action as he or she learns from TeleConsultation. The patient benefits as the answer is given within one working day instead of the several weeks generally spent waiting for a physical referral. The medical specialist benefits as he or she often likes to perform TeleConsultation so as avoid unnecessary referrals and strengthen his/her working relations with the general practitioners with the general practitioners that usually refer the patients physically. The health insurer benefits as TeleConsultation leads to a 20 – 50% cost reduction.

Targeted population, number of patients

… and on screen (click to enlarge)

TeleConsultation between primary care and secondary care clinicians has proven its efficiency in  enhancing potential in fields such as cardiology, dermatology, ophthalmology and pulmonology (i.e., conditions related to the heart, skin, eyes and lungs). However, KSYOS is expanding TeleConsultation to many other medical specialities, including ear nose and throat, psychology, and nephrology (kidney-related conditions). Patient groups come from all of these fields of condition.

The general practitioner mostly selects those cases in which he or she is in doubt as to whether to refer the patient to a specialist or not, or is in doubt about how to treat the patient.

Type of telemedicine service

Eye exam…

KSYOS TeleConsultation is an integrated service consists of all the following elements:
– A definition of the medical process, organization in the region, and the role of health workers involved.
– A KSYOS Electronic Health Record, which is integrated in the health IT infrastructure.
– Education, support and training in the general practitioners practice.
– Financial and legal support; contracting.
– Medical liability and insurance.
– Quality management and reporting.
As a health institution, KSYOS is responsible for the entire TeleConsultation service. KSYOS TeleMedical Centre is responsible for the medical and legal relations with the patient.

Set-up that was being replaced

TeleConsultation replaces physical referrals from primary care practitioners to secondary care specialists.

Outcomes and results expected after introduction

After selection of the appropriate patients by the general practitioner, TeleConsultation avoids 70% of all physical referrals. In 90% of the TeleConsultations, the general practitioner experiences a learning effect. The mean response time of the medical specialist is 4.8 hours instead of the many weeks that a patient generally spends on waiting lists otherwise. Overall, TeleConsultation leads to a minimum cost reduction of 20%. (van der Heijden JP, de Keizer NF, Bos JD, Spuls PI, Witkamp L. Teledermatology applied following patient selection by general practitioners in daily practice improves efficiency and quality of care at lower cost. Br J Dermatol. 2011 Nov;165(5):1058-65)

Detailed description

A more detailed description is available at these links:

www.ksyos.org
www.ksyos.org/english/
www.ksyos.co.uk

A bibliography of relevant scientific publications in Dutch, English and others is at

www.ksyos.org/onderzoekers/wetenschappelijke-publicaties/

Operational status

KSYOS has been considerably scaled-up since its foundation. KSYOS is part of mainstream service delivery. KSYOS started TeleDermatology Consultation in the Netherlands in 2005. Since then, KSYOS is active in TeleDiagnosis (TeleFundusScreening, TeleSpirometry, TeleECG, TeleHolter ea), TeleConsultation and TeleMonitoring in many medical fields. KSYOS has now contracted over 7,000 general practitioners, medical specialists and paramedics in various EU countries who physically or digitally will see over 100,000 patients in 2014.

Further information

For more information contact:

Prof. Dr. L. Witkamp, Director
l.witkamp@ksyos.org
+31 20 600 00 60