Telemedicine in primary care in the Istrian county (Croatia)

Nicol Kolar Istarski Domovi Zdravlja

Keywords: Telemedicine, Endocrinology, Cardiology, Urology, Neurosurgery, A5 form referral


The telemedicine is widely implemented in many healthcare domains during the latest progress in medicine. Goal of this study was to determine what general practitioners consider to be appropriate consultations with other speciality experts in secondary care medical institutions.

Research question(s):

Analysis of a form of referral named „A5“, which is reffered by GP (general practitioner) or FP (family physician) to the secondary care specialists of General hospital in Pula. A5 form is a new-founded vector in telemedicine with direct impact on the treatment for most common chronic diseasses and provides better quality of care for patients.


Evaluation of the impact of telemedical consultations in primary care with other specialists in General hospital of Pula using referral form called „A5“. A questionnaire form was designed which included most common chronic diseasses (diabetes mellitus type 2, atrial fibrilation, prostate patology, vertebral patology, ...). The form was answered by GP/FP doctors in the Istrian county (Croatia).


Impact of 'A5 form' usage was analysed in various fields; most frequent endocrinology consultation was the dose titration of oral antidiabetics (62,2 %). In cardiology, the telemedicine form was often used in prescribing an oral anticoagulant therapy in atrial firbilation with a usage rate of 83,8%. In urology consultations, the telemedicine form was often used in prescribing tamsulosin with a usage rate of 62,2% and for the neurosurgery, A5 form was often used for interpretation of magnetic resonance imaging with usage rate of 83,8%.


Overall, A5 form consultations can improve a clinical outcomes in patients with cardiac, endocrine, urologic and neurosurgery conditions.

Points for discussion:

Can we improve our knowledge through the impact of referral form of "A5" in some specific fields?

Can we prescribe a medication like tamsulosin without consultation with urologist if we diagnose benign prostatic hyperplasia?

"A5" form in neurosurgery was often used for interpretation of magnetic resonance imaging with usage rate of 83,8% - do we have to change this habits?


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