Vol.5, No 1, 2008 pp. 71 - 81
UDC 616-07:621.39(497.11)
INFORMATION TECHNOLOGY FOR IMPROVEMENT OF PATIENT REFERRAL SYSTEM FROM PRIMARY CARE TO SECONDARY 
AND TERTIARY CARE IN SERBIA: "THYRONET"- ELECTRONIC THYROID CONSULTATION NETWORK
Jane Paunkovic1*, Robert Doktor2, Nebojsa Paunkovic1,
Robert Whitton3, Victoria Garshnek4, Nenad Crncevic5
1Faculty of Management, Zajecar, Megatrend University, Serbia
2College of Business Administration, University of Hawaii, USA
3Technical Innovations, Inc., Ka'a'awa, Hawaii, USA,
4Telehealth Research Institute, University of Hawaii, USA
5Special Hospital for Thyroid Gland and metabolism, Zlatibor, Serbia
*E-mail: jane@fmz.edu.yu
Estimated 80% of all referrals to Tertiary Care for Thyroid disease in Serbia are deemed unnecessary or ill-timed by the specialty care providers, and detract from time and effort available to treat the remaining appropriate referrals. Documentation on patient treatment rarely is delivered from Primary Care to the Specialty Care center, necessitating costly duplication of laboratory and radiology testing. Documentation from the Specialty Care center often does not return to the Primary Care center, rendering follow up care more difficult, and denying Primary Care clinicians the opportunity to learn from each case. A deployed web-based electronic consultation system is proposed to alleviate the problems noted above. Appropriate organizational interventions will be designed into the pilot project to overcome inertial resistance to change, monitor utilization, and proactively ensure cost-effective systems implementation. The use of an electronic system will optimize the time a specialist spends with a referred patient, as complete diagnostic workups will have been completed and this needy patient will not be competing for specialist time with inappropriately referred patients. Additionally, modern database information supports detailed data analysis to observe clinical patterns and treatment effectiveness.
Key Words: electronic consultation system, organizational change, telemedicine, thyroid disease
PRIMENA INFORMACIONE TEHNOLOGIJE U POBOLJŠANJU SISTEMA UPUĆIVANJA PACIJENATA IZ PRIMARNE ZDRAVSTVENE ZAŠTITE U SEKUNDARNU I TERCIJARNU ZDRAVSTVENU ZAŠTITU U SRBIJI : "THYRONET"- ELEKTRONSKA MREŽA KONSULTACIJA O TIROIDEJI
Procenjuje se da je 80% korisnika tercijarne zdravstvene zaštite za bolesti tiroideje u Srbiji nepotrebno upućeno od strane lekara specijalista čime se oduzima i vreme i napor potreban za tretman korisnika kojima je ona zaista potrebna. Dokumentacija o tretmanu pacijenta retko biva poslata specijalizovanom zdravstvenom centru od strane primarne zaštite što zahteva ponovno izvođenje skupih laboratorijskih i radioloških testova. Dokumentacija iz specijalizovanog zdravstvenog centra se često ne vraća centru za primarnu zaštitu što otežava dalje praćenje i lečenje pacijenata. Za prevazilaženje prethodno navedenih problema predlaže se primena konsultativnog sistema putem elektronske mreže. U pilot projektu će biti data odgovarajuća organizaciona rešenja kako bi se prevazišao početni otpor i vršio monitoring primene ovakvog sistema. Korišćenje elektronskog sistema će optimalizovati vreme koje jedan lekar provede sa pacijentima kojima je tercijarna zaštita zaista potrebna. Savremena baza podataka omogućava detaljnu analizu kliničkih podataka i efikasno lečenje pacijenata.
Ključne reči:  elektronski konsultativni sistem, organizaciona promena, telemedicina, bolest tiroideje