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Health services The organisation of health services is an important cue for telemedicine. Whether it concerns special cases or total strategies where telemedicine is involved as part of the working tools for the health services to farsund singeltreff its objectives, quality control, economy, and legal conditions must be considered.

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Quality control is to a high degree related to the question of whether telebased applications, e. Telebased applications imply changes in the work routines, e.

Another example is that the pathologist must examine the microscope pictures on an image display and not directly through the eye piece of the microscope. Another question is whether telebased transmission results in loss of details in the transmitted information, details that are lakselv single speed for the diagnosing. It is, of course, a basic condition for telemedicine from a medical point of view that the health services shall not be reduced in quality.

In the case of some medical applications it is important to clarify the responsibility towards diagnosis and treatment.

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A concrete example is when a patient together with a general practitioner call on a specialist via telecommunication. Thereby the specialist has the responsibility.

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The same will be the case by telebased specialist consultations, but this has not been tried before a court of justice. Another question is the responsibility of the supplier of the communication service in case of e.

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In the latter case it might be a question of replacing an existing arrangement with another one, based on telemedicine. A typical example is the arrangement with travelling medical specialists in areas where it is difficult to establish permanent specialist services.

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Around such arrangements is usually built up a system of economic transfer which keeps the balance for all parts involved. If this arrangement is replaced by a telebased service, the economic arrangement will not balance.

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Thereby clear-cut winners and losers will emerge. In the perspective of social economics the problem might be related to efficiency and effectiveness of the health services. The starting point is a steadily increasing gap between the expectations of the population to the health services and what the community can make accessible for health purposes. The question becomes partly how telemedicine can contribute to optimum production of health services from a given amount of 5 resources, and partly how telemedicine can contribute to fulfil central healthpolitical objectives.

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This perspective reaches far into the way of organising health services, and not least of all how co-operation and sharing of labour should be arranged. The superior goal of the health services is to fight sickness and promote health. Considerable resources are used for health purposes.

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The health trade is characterised by a rapid development of medical technology. This applies to advanced instruments for diagnosing and treatment, drugs, technical remedies for nursing and biotechnology. One of the greatest challenges for the health services is to match the expectation of lakselv single speed population to the health services to the services which can be delivered on a large scale.

Another characteristic feature is singel i midsund large production of knowledge through research and practical clinical work. The classical medical field is steadily divided into more specialised fields.

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At the same time the contact with other fields is extended. The health services will change character, partly because, in addition to the curative and preventive medicine, there will be more emphasis on predictive medicine based on the development in biochemistry and molecular In organising health services these development trends point towards a larger division of work duties and a centralisation of specialised functions.

New professional environments and new equipment require comprehensive efforts of as well economic as organisational character.

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In the first place this will be important on a national level by the fact that some institutions will have nationwide responsibility for certain specialities imposed on them. In the long run we can se a need for greater international sharing of labour.

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Another challenge for the public health services is that the population during the next ten years will be changed with regard to composition of age groups. Older people, who are the major users of health services, will considerably increase in number.

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In Norway the num- ber of persons over the age of 80 has doubled since Sagvåg dating the year this number will increase further.

The part of the population over the age of 90 will increase considerably. In general, there will be more heavy users of the health services at the same time as there will be fewer persons in the age group which can produce health services and contribute to the economic resources needed by the health services.

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In addition, an increased number of handicapped and chronically sick persons is expected St. White Paper No. As an answer to the increasing cost of running the institutions of the health services hospitals, nursing homeswe will have a change towards greater emphasis on primary health service. In Norway we are already phasing lakselv single speed to more day care activity where staying time in hospital is reduced and in the nursing sector a transition to homebased care. In light of these challenges telemedicine must be assessed as a tool for more efficient exploitation of available resources.

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Instead, it gives a possibility of increasing the integration between various health services and in this way single eidskog to better care directed towards the patient.