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Patientinvolvering på DSKT’s årsmøde

Under DSKTs Årsmøde blev patientens stilling i digitaliseringen af sundhedsvæsenet berørt på flere forskellige måder. Mødet, der havde telemedicinens påvirkning eller rolle i det fremtidig velfærdssamfund som tema, havde selvfølgelig også fokus på de patienter, som gerne skulle have gavn af alverden nye tiltag i sundhedsvæsenet.

Selvom Ivan Pedersen fra National Sundheds-IT blev spurgt, om han ikke havde glemt at tage højde for netop patienterne i sin status over telemedicin i Danmark 2012, havde han slået hovedet på sømmet kort forinden, ved at sige, at ”hvis vi er dygtige, kan vi endda få dem til at kunne lide det” (frit efter hukommelsen).

Udtalelsen faldt efter Ivan Pedersen havde fastslået, at også patienterne skal ændre deres indstilling til behandlingen. Patienterne skal acceptere mere ”prevention, selfcare og selfservice”.

Der er flere årsager til at patienterne – uanset om de vil det eller ej – er nødt til at acceptere ændringer i forholdet mellem patient og sundhedsvæsen. Der kan være økonomiske, strukturelle eller videnskabelige grunde til at ændringer er nødvendige, men nødvendige er de i hvert fald.

Mange telemedicinske løsninger er tænkt til at kunne løse problemer af strukturel art, f.eks med centralisering af speciale – ligesom de ofte har til formål at afhjælpe økonomiske problemer. Telemedicinen og det digitaliserede sundhedsvæsen er altså både en konsekvens af ændringer i velfærdssamfundet, ligesom det i sig selv er med til at ændre sundhedsvæsenet og samfundet.

Disse ændringer har selvfølgelig betydning for patienterne, og der vil være stor forskel på, hvordan forskellige patienter føler omkring den nye situation.
Nogle patienter vil kræve større selvbestemmelse og derved også tvinge lægerne til at ændre deres indstilling til sundhedsvæsenet, behandling og telemedicin.

Som professor Stanton Newmann rigtig nok pointerede, vil andre patienter føle, at de får mindre kontakt med lægen – og dermed en dårligere behandling – i takt med, at de får højere grad af hjemmemonitorering, call centerkontakt eller andre telemedicinske tiltag.
En af de helt store udfordringer i fremtidens telemedicin bliver derfor at forberede patienterne på de nye behandlingsmetoder – og at vurdere hvilke patienter, der ønsker højere grad af involvering, og hvilke der ikke er så begejstret for den nye udvikling.

Identifikationen af de mindre begejstrede patienter skal ske på et mere informeret grundlag end blot at antage, at ældre patienter er mere modvillige end yngre. Der skal tages højde for at patientens tilgang til behandlingen, og sig selv som patient, kan ændre sig - både med tiden, med behandlingen og på grund af personlige forhold.

Når man har afklaret patientens indstilling til behandlingen, er det ikke nødvendigvis muligt at tilbyde forskellige typer af behandling, men man kan tilgå patienten efter patientens ønsker og behov. Det kan skabe et mere trygt sundhedsvæsen, hvor patienternes IT-kundskaber, sociale kompetencer og andre faktorer ikke bliver afgørende for kvaliteten af den behandling de får.


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