Introduction of telespecialist services into the telemedicine program of the Hungarian Charity Service of the Order of Malta

Abstract

Residents of disadvantaged areas are in significantly poorer health compared to the national average. Their access to healthcare is often hindered by shortages in medical services due to unfilled general practitioner positions, low consciousness, as well as physical distance and other barriers making specialist clinics difficult to reach. In the fall of 2022, the Hungarian Charity Service of the Order of Malta launched the Naszlady Attila Health Development Program (Program) with the goal of improving access to healthcare for residents in disadvantaged areas.
This study aims to identify the most common specialty-specific referral patterns and track the associated patient pathways during the same periods of consecutive years (March-May, 2023 and March-May, 2024). Additionally, the study seeks to demonstrate the need for and feasibility of telemedicine-supported healthcare activities within the Program. Furthermore, it presents the initial practical experiences and service capacity of a new type of care model – a mobile, virtual specialist clinic – and briefly highlights the key lessons from the pilot program.
By July 2024, the Program delivered regular telemedicinal healthcare services in 35 municipalities, providing healthcare support to nearly 40 000 patients. As part of the Program launched in March 2023, a virtual specialist clinic was established, where besides basic diagnostic possibilities, tele-specialists (cardiologists, dermatologists, pulmonologists, and endocrinologists) support the activities of primary care providers, such as general practitioners and internists by both online and offline consultations. The care process is also supported by two mobile ultrasound clinics offering ultrasound services, alongside on-site laboratory diagnostic services. Involvement of the telecardiologist led to a nearly 50% reduction in the utilization of regional cardiology services (from 11% to 5%), while ultrasound examinations were effectively replaced (from 5% to 0%) by those performed in the mobile ultrasound clinic.
The implementation of a tele-specialist system in healthcare can offer significant added value in improving the quality of patient care. It may also help to reduce healthcare access difficulties due to regional disparities and in addition, it may decrease unnecessary referrals to regional specialist clinics.

Keywords: mobil health clinic, telemedicine, virtual consultation, disadvantaged population, remote consultation, digital healthcare