Telemedical Discharge Conferences for Patients with Complex Challenges

20th May 2021

Patients with complex challenges that demand increased coordination with partners beyond the hospital can benefit from telemedical discharge

Safe settings and secure communication add value during discharges

Patients who have been through a complex and long-term process at the hospital demand increased coordination across hospital, municipality and general practice when they are discharged.

These patients can greatly benefit from a so-called telemedical discharge conference where the healthcare professionals from the hospital have a video conference with e.g. municipal homecare and perhaps the patient’s general practitioner in order to plan and arrange the discharge. The patients and relatives are also included.

– It was our experience that after we started using the video conferencing equipment more, our patients felt more safe in their discharge because they had already met some of the people they would meet when returning to their home, says Ward Nurse at Neurorehabilitation, Odense University Hospital Svendborg.

Telemedical discharge conferences add great value for these patients and their relatives because the patient feels safe through being involved in the discharge and subsequently the plan and agreements regarding further care and treatment.

The personal contact in particular, as well as the opportunity to clarify any doubts before the discharge, make the patient feel safe. A municipal nurse explains that the patients actually experience a personal contact with the municipality, even if the contact is virtual through video:

– When we did not have telemedical discharge conferences, there was no personal contact. You could say: how personal is it, when it is behind a screen? But the citizens actually experience it as personal contact.

The healthcare professionals at the hospital also experience added value from telemedical discharge conferences because any potential doubts or disagreements are handled much faster.

– It improves the collaboration, and I actually think it is easier for us because we address everything in one go instead of making calls back and forth.

Telemedical Discharge Conferences via video can lead to fewer readmissions

Telemedical discharge conferences improve the communication and reduce misunderstandings between the healthcare staff across hospital, municipality and general practice. And because patients and relatives are involved in the discharge, the expectation is that telemedical discharge conferences can reduce the number of readmissions, which are harmful for both patients and relatives. At the same time, reduced readmissions are also beneficial for healthcare sector expenses.

This is the conclusion from an analysis project in the Region of Southern Denmark, which aimed to uncover barriers for implementation of telemedical discharge conferences. The analysis is based on existing experiences and statements from the healthcare professionals at all regional hospital units.

– The analysis project was carried out in 2020 during the COVID-19 lock-down, and all meetings and most interviews were done via video, which in itself underlines the added value of video communication. And it has been very positive to experience the support and goodwill in sharing and collaborating. It is our hope that the analysis, and especially the more action-based telemedical discharge concept can help implement more telemedical discharge conferences, explains Emil Høstrup, Project Manager, Health Innovation Centre of Southern Denmark.

Telemedical Discharge Conference Concept for Clinicians

For more than 10 years telemedical discharge conferences have been discussed without achieving a significant increased use of them.

In order to support the upscaling of telemedical discharge, the Health Innovation Centre carried out the above-mentioned analysis with a focus on barriers for implementation. As a part of the analysis, the project developed a Telemedical Discharge Concept.

The analysis clarifies the notion of ’telemedical discharge conferences’ and illustrates some of the most frequently experienced barriers for using video in connection with patient discharges, and not least the implementation.

The Telemedical Discharge Concept addresses these barriers and provides actionable knowledge and tools for the clinicians, so that they can implement and start using telemedical discharge via video.

The tools are aimed at departments that intend to test and implement virtual discharge conferences, and the concept and tools are co-created in an ongoing collaboration with healthcare professionals who have concrete experience with telemedical discharge conferences.

The Challenge of Implementation

The project has had a strong focus on implementation because implementation of concepts such as telemedical discharge conferences are challenging and demand detailed planning, execution and follow-up.

Some of the central points when it comes to implementation of this particular concept are;

  1. The magnitude of the task is often underestimated, as it is considered ”just” a digitalisation of existing workflows. The central point is that this is not the case. The workflows are different and they call for more time to implement new ways of doing things.
  2. A new initiative like this one can seem very complex, particularly in the beginning. Developing skills, coordinating with secretaries, local guides and good IT support can contribute to reducing the experience of complexity.

There is a strong interest in using telemedical discharges more in the regional hospitals but the complexity of the task ahead has been daunting for them. The Telemedical Discharge Concept tackles the complexity and includes specific tools and activities for 3 phases: Preparation, Testing, Operations, and by far the most activities are in the preparation phase.

Future initiatives for further upscaling will include continued efforts to anchor the concept and workflows within the municipalities and general practice in the region.

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