Pilot in Sweden: Psychogeriatric in distant rural area

Interview with Käte Alrutz, Västerbotten County Council

The Geriatric Centre at Umeå University Hospital provides psychogeriatric specialists for tele-consultations with staff at healthcare centres in the communities of Malå and Sorsele. The idea: Patients with the onset of cognitive decline and dementia disorders in rural areas will receive adequate diagnosis. Healthcare professionals will improve their medical knowledge. We asked Käte Alrutz, Speech Therapist and Healthcare Developer, who is responsible for the pilot that started one year ago.

Who is involved in the pilot?

The specialist of psychogeriatric and the specialised nurse at the University Hospital in Umeå connect to the GP, the district nurse and the occupational therapist at the local healthcare centres. If necessary, staff from the Community nursing homes take part. The pilot project's staff consists of a project manager, a project administrator, and the head of the Geriatric Centre. There's also a technician who can help out if something goes wrong before or during a meeting - a useful support.

Which technology is used and how does it work?
The Geriatrician works at the hospital using her computer with a web camera and a Jabber client, sometimes also using an iPad. Both healthcare centres have videoconference rooms. Four iPads have been bought, but the mobile network at the nursing homes is not strong enough. We are working with the community technicians to solve this problem. So far the community nurses have gone to the healthcare centres to take part in the consultations. We have bought two computers for the videoconference rooms to give the GPs easy access to patient records.

How do the colleagues involved feel about being instructed via monitor?
Everyone who is working on this project has a very positive stance, because they realise the mutual benefits they get from it, the increase in knowledge and the more qualified treatments for the patients. One person also clearly expressed that these consultations are necessary for her work; before the pilot started, she often thought of leaving her profession and doing something else, but now she feels more confident working with her patients.

Has the routines changed after tele-consultation was adapted?
The consultations via video-links have been fully implemented in the psychogeriatric healthcare programme of the Geriatric Centre. At both of the participating healthcare centres one occupational therapist and one district nurse have been appointed responsible for the dementia patients.

What are your first findings?
In 2013 an increase in correctly diagnosed patients in the two areas was recorded compared to 2012. About 75% of the staff are satisfied with the consultations, according to the survey we carried out. Furthermore, two institutions are interested in implementing this working model.