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Biomedical subjects

Kari Harno

Publications and source records attributed to Kari Harno.

7 recordsLinked to original sources
PubMed2006

Managing diabetes care using an integrated regional e-health approach.

A total of 175 patients with Types 1 and 2 diabetes in primary care and university hospital outpatient departments were randomized into a study group (n = 101) or usual care (n = 74). The study group used an e-health application with a diabetes management system and a home care link. Usual care did not involve e-health, i.e. the patients made regular general practitioner visits about every three months. After 12 months HbA1c decreased significantly in both groups of patients. The differences were small, but HbA1c was significantly lower in the study group than the controls. Diastolic blood pressure, fasting plasma glucose, serum total cholesterol, serum LDL-cholesterol and serum triglycerides were significantly lower in the study than in the control group. This was achieved with fewer visits by study patients to doctors and nurses. Use of e-health in diabetes care for 12 months was able to provide equivalent diabetic control to usual care, and improved cardiovascular risk factors.

Blood Glucose↗
PubMed2006

Sharable EHR systems in Finland.

In Finland, the shared record is a virtual electronic health record (EHR). It consists of health data generated, maintained and preserved by different health care service providers. Two different kinds of technologies for integrating regional EHR-systems are applied, but mainly by using a common middleware. Services provided by this middleware are EHR location services using a link repository and combining EHR-viewing services with security management services including consent management and identification services for health professionals. The Regional Health Information Organization (UUMA) approach is based on a stepwise implementation of integrated regional healthcare services to create a virtually borderless healthcare organization--a patient centered virtual workspace. In the virtual workspace multi-professional teams and patients collaborate and share information regardless of time and place. Presently the regional health information network (RHIN) is comprised of three integrated services between primary, secondary and tertiary care within the county of Uusimaa. The regional healthcare modules consist of an (1) eReferral network, (2) integrated EHR service between health care professionals and (3) PACS system. The eReferral between primary and secondary care not only speeds up the transfer, but also offers an option for communication in the form of eConsultation between general practitioners and hospital specialists. By sharing information and knowledge remote eConsultations create a new working environment for integrated delivery of eServices between the health care providers. Over 100,000 eReferral messages (40 %) were transferred between health care providers. Interactive eConsultations enable supervised care leading to the reduction of outpatient visits and more timely appointments. One third (10/31) of the municipal health centers are connected to the clinics in the Helsinki University Central Hospital by the eReferral system. The link directory service extends the dimensions of networking between organizations by combining legacy systems within regional primary and secondary care. The link directory is an interface to diverse patient information systems, like HUSpacs, containing links pointing to the actual patient data located in remote information systems. The original data including images can be viewed with a web browser, but data can be accessed only with the patient's informed consent. Currently the reference data base includes 9.5 million links from 1.4 million patients with over 2.000 daily users. We aim to create a new working environment for professionals by incorporation of innovative information and communication technology, new organization of work and re-engineering of workflows. In the near-future, the citizen will have an active role participating in decisions on his care, carrying out guided self-care and taking steps of pro-active prevention.

Computer Communication Networks↗
PubMed2004

UUMA. Regional eHealth services in the hospital district of Helsinki and Uusimaa (HUS).

The UUMA approach is based on a stepwise implementation of integrated regional healthcare services to create a virtually borderless healthcare organisation--a patient centred virtual workspace. In the virtual workspace multi-professional teams and patients collaborate and share information regardless of time and place. Presently the regional ehealth network is comprised of four different integrated services between primary, secondary and tertiary care within the county of Uusimaa. The strategic healthcare modules consist of an (1) ereferral and econsultation network, (2) a knowledge-based disease management platform, (3) PACS system and (4) a universal model for integrated regional services between professionals and patients by a link directory service. The ereferral between primary and secondary care not only speeds up the transfer, but also offers an option for communication in the form of econsultation between general practitioners and hospital specialists. By sharing information and knowledge remote econsultations create a new working environment for integrated delivery of eServices between the health care providers. Last year over 60,000 eReferrals were transferred between health care providers. When associated with viewing of patient data through the link directory, interactive econsultations enable supervised care leading to the reduction of outpatient visits and more timely appointments. The link directory service extends the dimensions of networking between organizations by combining legacy systems within regional primary and secondary care. The link directory is an interface to diverse patient information systems, like HUSpacs, containing links pointing to the actual patient data located in remote information systems. The original data including images can be viewed with a web browser, but data can be accessed only with the patient's informed consent. The chronic disease management system is disease specific: information is utilised in parallel to viewing other relevant medical data through the link directory. We aim to create a new working environment for professionals by incorporation of innovative information and communication technology, new organisation of work and re-engineering of workflows. The citizen has an active role in deciding on the use of his medical information, participating in decisions on his care, carrying out guided self-care and taking steps of pro-active prevention.

Computer Communication Networks↗
PubMed2003

Realtime teleconsultations versus face-to-face consultations in dermatology: immediate and six-month outcome.

We evaluated the outcome of both realtime teleconsultations and face-to-face consultations in dermatology. Forty-six patients were enrolled in an open controlled study. Twenty-nine patients (60%) answered the questionnaire sent to them after six months. Over the six-month follow-up, similar proportions of the two patient groups had visited a general practitioner or a specialist in the consulting hospital. At follow-up, overall patient satisfaction with the consultation, measured on a linear analogue scale (0-10), had fallen only slightly and to the same extent after both types of consultation, that is by 1.2 (SD 3.7) after realtime teleconsultations and by 1.4 (SD 4.5) after face-to-face consultations. The proportions of patients who would prefer the same mode of consultation for their next appointment had decreased from 83% to 50% in the realtime teleconsultation group and from 83% to 62% in the face-to-face consultation group. However, in neither group was the change significant. The study suggests that patient satisfaction with teleconsultation is well preserved after six months.

Adult↗
PubMed2002

Integrated regional services: are working process changes desirable and achievable?

In the hospital district of Helsinki and Uusimaa, 32 municipalities with one or more health centres provide primary care to their residents. Legal and organizational barriers between primary care and hospital care impede the continuity of patient care. Integrating primary and secondary care with the aid of information technology may facilitate a virtual electronic patient record, in which the viewing of images and other patient data is possible regardless of the organization that produced them. For example, in one trial, diabetic patients sent their home blood glucose measurements by modem to their health centre. Preliminary observations suggest that they could increase their glucose testing largely because they were able to transmit the results to the database and receive teleconsultations. Also, a picture archiving and communication system (PACS) has been in operation in two clinics of the Helsinki University Central Hospital for over two years and seven hospitals had become filmless by the end of 2001. A regional PACS is planned to be completed by the year 2004.

Journal Article↗
PubMed2002

Integrated regional services: are working process changes desirable and achievable?

In the hospital district of Helsinki and Uusimaa, 32 municipalities with one or more health centres provide primary care to their residents. Legal and organizational barriers between primary care and hospital care impede the continuity of patient care. Integrating primary and secondary care with the aid of information technology may facilitate a virtual electronic patient record, in which the viewing of images and other patient data is possible regardless of the organization that produced them. For example, in one trial, diabetic patients sent their home blood glucose measurements by modem to their health centre. Preliminary observations suggest that they could increase their glucose testing largely because they were able to transmit the results to the database and receive teleconsultations. Also, a picture archiving and communication system (PACS) has been in operation in two clinics of the Helsinki University Central Hospital for over two years and seven hospitals had become filmless by the end of 2001. A regional PACS is planned to be completed by the year 2004.

Adolescent↗