SECOND OPINION – A NEW OPPORTUNITY FOR PATIENTS AND DOCTORS

 

Telemedicine is one of the youngest branches in medicine. It stands for transmitting and exchanging medical knowledge by distance using high technology telecommunication devices. It all started in 1968 when Kenneth Byrd and his colleagues reinstated a video connection between the Massachusetts Hospital and Boston Airport. But, there was very little progress made during 1970-1980. Great interest in telemedicine has been shown in the 90's due to evolution of communication technology.

The usage of telemedicine exists in almost all branches of medicine. It is most oftenly used in teleradiology, which is the queen of telemedicine, followed by cardiology, dermatology, pshycology, urgent medicine, patology and oncology. Teleradiology along with telenuclear medicine is currently the most specialized form of telemedicine.

 The task of the telemedicine network, established in USA two years ago is to ensure acquirement of a second medical opinion with the assistance of specialists from the leading Health Care Centers in the States. The project is called Second Opinion and with it, a second opinion of top specialists is attainable to patients from all over the world. The Project uses the latest achievements of telemedicine.

 Slovenia joined the network in May 1998. Other European countries, joined in the project are: The Netherlands (managing center), England, France and Hungary. Second Opinion Slovenia operates under the professional guidance and supervision of the largest health care center in Slovenia, the Clinical Center in Ljubljana. The members of the Slovenian Second Opinion committee are significant experts from all medical departments.

 Ensuring patients and doctors a rapidly gained specialized opinion on a diagnosys of a disease and its treatment is the main goal of the Second Opinion project.

 Most doctors have probably asked themselves whether their diagnosys was correct, whether they should have had other examinations done or whether they are having in mind the correct method of treatment. And their patients keep asking themselves: is the diagnosys correct, can anything new be done in search of new diagnosys, do I really need to have surgery or irradiation. In all these cases we now have an opportunity to ask foreign specialists for their opinion.

 With the intention of gaining a second medical opinion, Second Opinion Slovenia has connected to the University of San Francisco (UCSF-University of California San Francisco) through the international telemedicine network. UCSF was established in 1864 and is with two thousand beds one of the largest organisation in the territory of San Francisco. It's one of the top ten health care centers in USA and one of the top five according to the number of doctors from the »Best doctors« list employed there. Two of their researchers have achieved a Nobel prize in 1989 and according to the ratings of the American National Institute of Health Research, the Medical University of UCSF has been on first place for over ten years. Along with UCSF also other medical foundations collaborate in the telemedicine consultation network, such as: Bowman Gray School of Medicine of Wake Forest University – Winston Salem, The Brigham Radiology Foundation – Boston, Emory University Hospital – Atlanta, University of Pennsylvania Medical Center – Philadelphia. 

 How the system works.

 If a patient or doctor wishes to have a second opinion, we first study the documention he/she has and the first opinion of the family doctor or specialist. A short summary of the disease, diagnosys and treatment is written and sent to UCSF along with the questions we wish to have answered. We can also suggest a specialist if we know him by name. X-rays, CTs and NMRs are sent by the help of teleradiology, that is a specialized computer system with which a picture is digitalised, then compressed and transmitted. The digitalized pictures appears on the monitor at UCSF in a few minutes. All films, like ultrasound, angiology pictures and films, citology and histology slides may also be sent on tape by express mail and in less time as possible also by telemedicine equipment. This way all documention arrives to UCSF the same day it's sent. A specialist or more of them study the documentation and send their opinion within 48-72 hours. Notice of consultations is regulary sent by e-mail. As soon as we receive the second opinion, the doctor or patient who asked for it is immediately informed. In case of any kind of indistinctness or if the second opinion is totally different from the first, a video-conference is held with the presence of the pacient, the doctor who gave the first opinion and the one who gave the second opinion and if necessary also a doctor from the Second Opinion committee.

 The pacient's documention is lead accurately and each patient has his record with an identification number which is also put into a computer so we have access to his data at any time.

Larger companies have joined the Slovenian Second Opinion Project, which enable their users inexpensive access to a second opinion. Currently there are around 125.000 individuals part of the project. We wish all patients to have such a possibilty when they need it. 

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