Integrated transnational strategy paper to attract health professionals to remote primary care - Executive Summary

When looking into current approaches and agendas of European health care systems described by WHO's Health 2020 or the NDPHS's main goals , the importance of strong primary health care provision cannot be neglected. But equal primary health care provision especially in remote regions all around the Baltic Sea is not that easy considering on the one hand the growing share of elderly in the population and on the other hand the unwillingness of young health professionals to take over the work or practice of retiring medical professionals.

Since this is not only a problem in one or the other country, but in most of the Baltic Sea region, partners from the seven countries Belarus, Estonia, Finland, Germany, Latvia, Lithuania and Sweden built a consortium together in PrimCareIT to develop ICT-based approaches to provide professional exchange between health professionals of either different specialties or different educational levels. The overall idea is to enhance the working environment of health professionals in remote regions through the provision of specialist contact via ICT solutions, such as video-conferences, forum discussions or portals. The different approaches are focused on tele-consultation and tele-mentoring, while the first describes an exchange between health professionals of different specialties and the latter between more experienced and less experienced of the same profession. Enabling this exchange is targeting at health professionals, who feel professionally isolated in remote regions and who might even think about moving away or not settling there at all. Tele-consultation and tele-mentoring are therefore tools to enhance the working environment for health professionals in order to make it more attractive.

To develop well working solutions for tele-consultation and tele-mentoring to counter-act brain drain and professional isolation, the PrimCareIT partners split up into different groups, of which one concentrated on the theoretical background, while others established pilot regions for tele-consultation and tele-mentoring. The target was to generate best practice examples for tele-consultation and tele-mentoring as well as show the challenges and issues that should be considered when planning the implementation of those solutions in daily practice.

Tele-consultation was realised by using video-conference software that was mainly installed on PCs or tablets. It required internet or 3G connections and well working audio and webcam equipment. Additionally, forums and chat rooms were used to support a good exchange between the health care professionals. A similar setup was used by the tele-mentoring participants. Apart from the tele-consultation equipment it also included an eLearning platform and a calendar with hints to important professional development seminars in the regions. The eLearning platform enhanced the possibilities of single mentoring via video-conferences.

The main hindering factors were seen in missing IT infrastructures, financial incentives, less health professionals are willing to use something new, the impossibility to get financial reimbursement for providing or using tele-consultation/tele-mentoring or the missing time in the care processes to provide or participate in tele-consultation or tele-mentoring. Apart from directing activities to counter act those issues pilot owners and experts in the PrimCareIT interview study emphasised that an easy usability, good training opportunities and well working technical equipment build among others are the main requirements for a successful implementation of tele-consultation and tele-mentoring.

The overall finding of the expert interviews as well as the pilot regions was that although the health care systems in the Baltic Sea Region are very country-specific, the issues of brain drain and professional isolation of health professionals in remote regions are relevant in all countries. That is why the aim of counter-acting those challenges and the issues and recommendations when implementing tele-consultation or tele-mentoring are similar in all countries.

It was very well shown in all carried out studies that participants were regarding tele-consultation and tele-mentoring as highly interesting and useful tools. They also think that these tools can successfully support health professionals in remote regions, when implemented according to the recommendations derived from the PrimCareIT studies.

Find here the integrated transnational strategy paper.

For more information, contact Prof Bosco Lehr, Flensburg University of Applied Sciences, Germany.

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