Call for e-health to ‘permeate’ rural Scotland

E-health should permeate thinking about every aspect of remote and rural healthcare, according to a newly-published report on healthcare in remote areas of Scotland.

Scotland’s Remote and Rural Steering Group, ‘Delivering for Remote and Rural Healthcare: what it means for you’, sets out a framework to develop a sustainable care system in remote Scotland. Its findings have been accepted by the Scottish government.

The report calls for Scotland’s eHealth Strategy Board to ensure that the level and quality of connectivity is the same across Scotland and says that remote and rural communities should be supported by a “first class IT infrastructure”.

The steering group said that the principles underpinning a technological approach should be that specialist advice could be provided from a distance using videoconference, telephone or e-mail, that videoconferencing could avoid the need for traveling to a central point and that digital data such as blood tests and ECGs could be transferred from remote sites to other points, enhancing diagnosis.

However, it commented: “At the moment the gold standard depends on fixed telephone lines which are expensive and inflexible. In addition various NHS boards have different policies around the implementation of their information technology projects, leading to problems with communication across firewalls and regions.”

The group said the NHS in Scotland would need to invest in high-specification links between remote centres and larger centres that provide clinical decision support, which should include image data transfer and video-conferencing. The group said it was important that larger health economies invested in appropriately e-health.

“Anecdotally the most difficult place for R&R [remote and rural] health professionals to communicate with, using technology, is that which is most centrally located,” the report adds.

The report also recommends that the roll-out of Picture Archiving and Communication Systems (PACS) should be prioritise remote and rural areas and that NHS boards should ensure that all premises have access to a range of modern communication tools including broadband access, video-conferencing and telemedicine as a minimum. Launching the report, Nicola Sturgeon, Scottish health secretary, outlined an action plan in response to the recommendations.

She said: “The Scottish Government is committed to ensuring that access to healthcare is as local as possible to everyone in Scotland, no matter where they live. After years of uncertainty, today’s report sets out a blueprint which will secure these vital services for our remote and rural communities.”

The action plan includes investment in a range of enhanced services for Scotland’s six rural general hospitals and a pledge that NHS boards will make better use of technology such as ideoconferencing to avoid the need for patients or staff to travel.