Teleradiology with satellite units - six years experience at the norwegian radium hospital.

Norway has played a leading role in Europe in applying telemedicine in health care services over the past two decades and is still in the forefront of developing telemedicine services both nationally and internationally. Today support for telemedicine comes mainly from the wish to meet the challenges of rising costs in health care. Critical obstacles for implementation of telemedicine techniques may by overcome easier by referring to the experience from other medical centers. A case in point is the six year experience of telemedicine at The Norwegian Radium Hospital, in distributing radiotherapy services to two satellite hospitals hundred kilometers far off. The main lesson learned is: the most serious obstacles are not technological but socio-psychological challenges and that staff up-dating, prior to implementation, is crucial. Case selections, routines, work flows and administrative solutions are described for the daily operations between the main clinic and the satellite units. In conclusion: radiotherapy service by telemedicine is feasible and cost effective. Standardization and quality assurance of radiotherapy at the quality level of a comprehensive cancer center can be offered to a much larger population and may play a role in improved cancer survival outcome.