Service innovation from the edges: enhanced by telemedicine decision support

Abstract Increased prevalence of diabetes creates a need for improved care. Diabetes, as a chronic disease in which the patient is a central asset for effective care, is relevant as an illustrative example for also other chronic diseases that are on the rise globally. Such diseases demand localised co-produced healthcare services that respond to the need for integrated health care. The aim of the current paper was to investigate how telemedicine may facilitate patient consultations that improve quality, efficiency and patient involvement. Patient consultations facilitated by telemedicine were evaluated by the means of qualitative questionnaires to specialist, general practitioner and patients. The questionnaires revealed that the patient consultations improved quality of health care and saved time and cost. Findings suggest that such tripartite consultations may lead to outcomes where patients are empowered to take a more active role, the general practitioner increases his knowledge and competence, and the specialist is able to have a more holistic approach grounded in an understanding of patient history and local context. The support of telemedicine strengthens the consultations in terms of synchronous communication with visual clues and reduces time spent on the consultation by the specialist and travel time and cost for the patient. The contribution of this paper is to demonstrate how telemedicine can provide improved patient consultations by altering the established system of healthcare delivery.