NYHETER 2019-10-02

Centre for Rural Medicine in Storuman

Region Västerbotten invested early in research and development in rural areas and formed the Centre for Rural Medicine in Storuman in 2014. The centre is dedicated to research, development and innovation in the fields of health and medical care in rural areas, Sami health, skills provision and education.

Pia Kristiansson is Head of Clinic at Centre for Rural Medicine in Storuman. Foto: Patrick Degerman

På svenska/In Swedish

– In northern Sweden's inland, we have extremely sparsely populated areas with a large proportion of elderly people. It gives us a unique opportunity to test medical technology and new ways of working in a population structure will exist in many densely populated cities in 25 years, says Pia Kristiansson, acting Operations Manager of the Centre for Rural Medicine. 

The demographic development, where fewer people of working age must meet the increased health needs of an aging population with a reduced tax base, can be solved by, among other things, offering health care as close to the patient as possible.

Storuman is a distinctly rural municipality where the nearest hospital is 100 km away. For some patients, the distance might be two or three times as large. Storuman's cottage hospital has worked with distance technology since the mid-1990s, when the first consultations using telemedicine started. A number of development projects, such as remote heart ultrasonography, have reduced travel for patients with an average of 460 km, and have resulted in higher quality and more satisfied patients.

Research on inhabitants of sparsely populated areas

– Our research focuses on those living in sparsely populated areas and takes place in collaboration with national and international regions, municipalities, universities and businesses. Some examples of studies are remote dietitians, terminal care for Sami residents, the cottage hospital model, and continuity of care, says Pia Kristiansson.

In its efforts to develop good health care for the Sami population, the centre works primarily in the northern regions and in close cooperation with the Sami Parliament and other Sami organizations. In 2017, the Knowledge Network for Sami Health was initiated with the aim to increase access to culture- and language-adapted health care services.

The Nordic Council of Ministers' priority project, Healthcare and Care with Distance-spanning Technologies, is led from the centre. By mapping Nordic distance-spanning solutions and identifying tools to implement them, development can be accelerated. Many solutions increase patient safety and reduce hospital time

SOS 1.0 is an Interreg project within Botnia-Atlantica where the Centre for Rural Medicine, together with care providers and patients in specialist, primary and home health care in Sweden and Finland, build simulated models of the continuity of care to make the health care more needs-oriented. The project seeks to identify where limited resources create the greatest value for the individual and caregivers, and provide suggestions for working models that will make the health care even better.

Drones handle transportation

Other projects focus on future healthcare transport. Electrically powered drones can transport samples and medicines, reducing travel by car and increasing accessibility.

– The first real-life flights are supposed to go between the cottage hospital in Storuman and the health room in Slussfors, a distance of 60 km. In the long term, the drones will also be able to provide first aid equipment to injured people in roadless terrain, says Pia Kristiansson.

With self-driving vehicles, chronically ill and multi-sick patients can be picked up at home for tests, joint lunches or other care appointments. Health care gets better and closer regardless of where you live and loneliness decreases, as well as carbon dioxide emissions and transport costs.

Storuman can receive companies that want to test health care or aviation in the testbed being built, where they expect to remotely control vehicles and health rooms. One of the world's best-developed broadband networks and cohesive patient record systems provide excellent conditions for testing new innovative solutions.

– We have been working for several years to develop health rooms and today there are eight in Västerbotten. In the health rooms, the residents can manage their own check-ups and follow-ups, says Pia Kristiansson.

Health rooms provide local care

The residents can take a variety of blood tests, including glucose, haemoglobin and INR value, and check their weight and blood pressure. All results are immediately available in the patient’s medical record. The patient can also connect with a doctor, or another health care professional, by video link. Staff from the municipality’s home care service are on site certain hours of the day to assist with wound dressing, holding stethoscopes to transmit heart and lung sounds in real time, and more.

The health care come closer to the residents, who are spared unnecessary travel. It also leads to financial benefits, increased level of service, reduced impact on the climate and increased safety.

Patients are positive to digital solutions if they lead to continuity. Another effect is that the home service staff has felt an increased level of trust when they are given tasks with more variety and responsibility.

One obstacle to development is that the technology is adapted to the care staff's level of competence and not the patient's. Therefore, more patient-friendly diagnostics are now being developed. New working methods mean that the healthcare processes must be changed.

The hope is that the rooms will be used by more companies and agencies, and become meeting places that fill an important social function and contribute to a healthier population.

Investing in education

– We also invest in education. Emergency medical care in extremely sparsely populated areas (AXG) is aimed at people who work in roadless country, and we provide an SK course for emergency care in sparsely populated areas where the medical resources are limited. Among other things, you learn how to identify and treat injured or severely ill patients with the help of patient-close and distance-spanning technology, says Pia Kristiansson.

Ultrasound courses are given at regular intervals. The course provides basic knowledge of ultrasound technology and interpretation and is the first step to a certification from the Royal College of Radiology. The course is adapted to the specific needs of Swedish rural areas.

– Our strategy for building sustainable rural research is to make students interested in our work. Both medical students during semester 10 and nurses who are writing their bachelor’s or master's theses. This builds knowledge and promotes recruitment in the area, says Pia Kristiansson.

 

The cottage hospital model

In Lapland's sparsely populated areas there have been cottage hospitals, mini hospitals, for more than 100 years. General practitioners, nurses, ambulance staff, midwives and paramedical staff work here. In a cottage hospital, there is generally X-ray and laboratory equipment, ambulance and telemedicine technology to receive virtually all patient categories. Almost all cottage hospitals have a well-developed collaboration with the municipal health care services. They are often grouped together with elderly residents and cooperate on staffing, storage and more. All types of patients are cared for simultaneously in the wards. This model, combined with large investments in e-health and digital technology, means that health care has come closer to the population.

 

Contact:

Pia Kristiansson, Operations Manager at the Centre for Rural Medicine, +46 70-600 73 02

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