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Video conferencing (VC) and other telemedicine tools may help to improve the quality and availability of care in remote, sparsely populated areas. The transnational "eHealth Services for Child and Adolescent Psychiatry (eCAP), 2015-2018" project aims at developing new solutions for mental health care for children and adolescents in remote communities. In Finland, the Department of Child Psychiatry at Kuopio University Hospital (KUH) launched in early 2017 an online booking system and a browser-based VC solution to support the primary healthcare and other professionals working with children in Pohjois-Savo region by facilitating video-based consultations, supervision and support for treatment. Over 200 professionals in the region were trained to use the service.
For evaluating the provided training and gaining insight for the revealed non-use of the service, an online survey was administered to the trained persons in December 2017-January 2018. The respondents (n=89, response rate 45 %) demonstrated high satisfaction with the provided training, yet majority of them had not used the service and could not assess its functionality. They embraced the idea of video consultations, but there had been no need for that in practice yet, or more training or reminding about the service was desired. Some had faced technical problems preventing them from using the service. However, nearly 90 % of the respondents said that they will or might use the service in the future – often conditionally, "if there will be a need".
The results clearly demonstrate the importance of customer-orientation, training, constant promotion and reinforcement when introducing new telemedicine services.

Abstract
Purpose Early detection and timely treatment of child psychiatric problems require multi-professional collaboration and interaction between primary and specialized health care. The "eHealth Services for Child and Adolescent Psychiatry (eCAP), 2015-2018" project aims at improving child psychiatric services in peripheral areas by developing eHealth tools facilitating better cooperation between professionals working with children with mental health problems.
Methods The online booking system allows the primary healthcare professionals in Pohjois-Savo region to book a video conference (VC) with experts in child psychiatry for consultation, supervision or follow-up of care. Background information gathered from the parents, teacher and the child by online forms helps the consult to prepare for the meeting, which can be carried out on computer, laptop, table or smartphone. The developed services will be evaluated based on the log data and user experiences from the pilot phase.
Results The services will improve the quality, availability and cost-effectiveness of child psychiatric outpatient services in the region. Increased multi-professional collaboration among professionals will support preventive work, early identification and treatment in natural developmental environments of children. The travel needs for families are expected to decrease.
Conclusions eHealth can help to meet the global challenge of providing sufficient, timely child psychiatric services in remote, sparsely populated areas with limited resources, but information security and compatibility of different technical applications require innovative solutions. Furthermore, the people-related factors are crucial in introducing a sustainable change: the users must understand the benefits and receive training to adopt the new tools and routines for their work.