One in 10 surgeries are to offer patients the choice of seeing a GP at evenings and weekends, receiving electronic prescriptions and having checkups over Skype. The Prime Minister David Cameron recently unveiled the £50m scheme amid fears that too many people are turning up to A&E when they cannot get appointments with their GP, putting too much pressure on emergency departments.
But how realistic is the use of Skype to treat patients?
There is little doubt that telemedicine has the potential to serve at least 5 functions:
1) Increases access to care
2) Offers efficiency
3) Improves overall health status
4) Decreases cost
5) Brings care to the patient (patient-centric medicine)
Telemedicine use has grown 10% annually in recent years and has become a $4 billion per year industry in the United States. (1,2)
In the USA it is now an option for doctors to care for patients via Skype. Dr. Gregory Smith, who treats prescription drug abuse and patients with chronic pain turns to a webcam to see patients. Dr. Michael Escobedo, in Austin, Texas, says it serves as a means to save out-of-state patients the long trip to his office. Gary Capistrant, senior director of public policy at the American Telemedicine Association (ATA), while “it’s absolutely increasing, and now that you’ve got those 4G phones where you can videoconference from your cell phone, it’s going to be much more common.”
Dr Murdoch works at Birmingham’s Vitality Partnership and consults on Channel 4’s Embarrassing Bodies thinks it may help people consult their doctor. “For some people I think having that slight distance knowing that there’s someone at the end of the camera, but not having another person in the room with you, does encourage people perhaps to show things that perhaps they otherwise wouldn’t,” he added.
Another project recently announced in the UK at The University Hospital of North Staffordshire could be the first in Europe to use such a service. It is claimed that Skype could reduce outpatient appointments by 35 per cent, would therefore ease pressure on many struggling hospitals and 180,000 patients could benefit from online consultations.
3G Doctor is a service providing the public with documented mobile video consultations since 2006. Director David Doherty said “Video calls are great because they can fix the access problems we all experience with healthcare but it’s very important that we don’t just try to replicate office visits with video calls. Access to the internet means that Patients and Carers now also have the ability to interact with Doctors before the consultation ever takes place and we’ve found that by enabling the sharing of information with interactive medical history taking questionnaire tools we’ve quickly proven that the Healthcare Professional can be much more effective when they realise they’re not in the business of just providing office consultations. We need to move on from this 2000 year old model of healthcare because there are today many other ways of helping Patients manage their healthcare needs e.g. providing them with a direct documented referral to a specialist, sharing with them a Youtube video that’s been produced by a clinician who is an expert on their particular needs, sharing a link to a recommended smartphone app that can help the Patient to better self manage their illness, providing a referral to a Pharmacist for a treatment that’s available over the counter.
Peter Mas-Mollinedo MRPharmS, MPSI, MBS can be contacted on +353 872464977, @PeteMas, firstname.lastname@example.org he is also author of the blog “Pete The Pill”
References and Links
(1) Hilty DM, Yellowlees PM, Cobb HC, et al. Models of telepsychiatric consultation—liaison service to rural primary care. Psychosomatics. 2006;47(2):152-157.
(2) Freudenheim M. The doctor will see you now. Please logon. New York Times. May 29, 2010:BU1.
Peter Mas-Mollinedo MRPharmS, MPSI, MBS
Managing Director, IMI International Medical Information, MyMedicines.ie