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Background: Lithuania started to implement its own National eHealth Service System (NESS) in 2005. In May 2007, an eHealth system development strategy for the period 2007-2015 was prepared. In general, it is expected that these processes will lead to a higher level of citizens' awareness and involvement in protecting their health, as well as more effective use of available resources for provision and expansion of healthcare services, based on modern IT technologies. However, the implementation of the system is very slow and difficult. We aimed to assess competence and willingness of healthcare institutions (HCIs) to implement the NESS in primary care healthcare institutions in Lithuania., Methods: A cross-sectional study design was used. Questionnaires with letters of invitation to participate in the study were sent to 150 Lithuanian HCIs by mail. Only one questionnaire per HCI was sent. HCI head administrative staff (e.g., director, medical director, head of administration) was asked to answer the questionnaires., Results: A total of 68 replies from all HCIs were received. Response rate to the survey was 45.3%. The eHealth system implementation was mostly expected in eAdministration (77.9%), eReimbursement (47.1%) and Institutional EPR systems (47.1%). There was a lower willingness to start implementing ePrescriptions (4.4%), a picture archiving and communication system (PACS, 8.8%), eLaboratory (11.8%) and Telemedicine (13.2%) services. A lack of competence and knowledge in eHealth system implementation was recorded in the following: digital data protection (p=0.006), IT (p=0.028), health technology (p=0.032) and National eHealth Strategy (p=0.036)., Conclusions: Most Lithuanian HCIs are planning to participate in the implementation of NESS. HCIs are mostly willing to use eAdministration, eReimbursement and Institutional electronic patient record systems. HCIs highlighted a lack of key competences in eHealth system implementation.

Ischemic heart disease in European countries over decades causes up to 55% of all cases of sudden death and also has a high rate of mortality, morbidity, and hospital admission. Patients with such chronic diseases also require intensive home care facilities from community nurses. The aim was to establish international multilingual platform for transtelephonic ECG system as an alternative solution for home care and assess its performance. METHODS. During this pilot study, the international toll-free line between Lithuania and Germany was established, and practical applicability of the tele-ECG device was tested. Transtelephonic ECG system was implemented between Telemedicine Center in Bad Segeberg (Bad Segeberg Clinic, Germany), the Call Center in Kaunas at the Hospital of Kaunas University of Medicine, and a patient residence. RESULTS. Over a 6-month follow-up period, 34 patients were recruited. Following the ECG transmission, 86 teleconsultations were done. During the study, a total of 329 ECGs were sent by the patients; out of them, 14 ECGs were with clinical changes. Technical problems due to insufficient patient training, telecommunication systems, acoustic data transmission, and device itself were reported. Up to 23% of ECGs sent by patients were unreadable and not applicable for further clinical analysis. CONCLUSIONS. Our study showed the potential of telemedicine facilities to overcome the problems of access that makes the technique so potentially useful, but for telemonitoring application at patient homes in a wider population, it needs to be improved in terms of technical performance, transmission and analysis automatization.

The effective use of cardiology hospital services could improve patient safety while shortening pre- and in-hospital stay periods using modern transtelephonic technologies and consultations by phone to follow up electrocardiograph (ECG) changes of the patients on a waiting list. The aim of this study was to assess clinical-technical performance and satisfaction with application of an international telephonic ECG system. A transnational telephonic ECG system was established between Lithuania and Germany. A follow-up study design was used to assess clinical-technical performance and user satisfaction with the system. According to inclusion and exclusion criteria, 34 patients were enrolled who transmitted 329 ECG's, of which 14 ECGs showed clinical changes. Of the ECGs sent 254/329 (77%) were of good quality, 9 (3%) were of moderate quality, and 66 (20%) were of bad quality. Among physicians surveyed, 77.6% were satisfied or very satisfied with telemedicine services. A telecardiology service can help to identify patients with urgent problems requiring rapid assessment at the hospital. The service has high acceptance from physicians but needs to be improved in terms of technical performance and patient compliance expectations.

Telecardiology can identify patients with urgent problems requiring rapid assessment at the hospital or even emergency admission. Telemedicine applications in cardiology must identify factors that make the service most beneficial to the patients. The aim of the study was to analyze factors affecting relevance and benefits of telephonic electrocardiography (ECG) consultations. A transnational telephonic ECG system was established between Lithuania and Germany. Using a follow-up study design, clinical performance and beneficial factors for telecardiology were assessed. According to inclusion and exclusion criteria, 34 patients sent 329 ECGs with 14 ECG showing important clinical changes. Of the 329 ECGs only 263 (80%) ECGs were of acceptable quality for clinical interpretation. Most important factors associated with benefits from tele-ECG service were gender, Thrombolysis in Myocardial Infarction (TIMI), Systematic Coronary Risk Evaluation (SCORE) risk stratification, and chest pain in previous month. Tele-ECG service of routine ECGs can be useful in recognition of silent ischemia or arrhythmias, and facilitating diagnosis. However, other factors such as chest pain in the previous month, gender, TIMI, and SCORE risk stratifications are important in planning tele-ECG services.