As someone who has been waiting a decade or more for telemedicine to become more relevant to healthcare delivery, a recent article about internet video chat gave me some cause for optimism (see: Web video chats and on-line services keep patients connected to care). Below is an excerpt from it:
A new study from Manhattan Research reveals that about 7 percent of US physicians are currently doing web video chats with their patients. The practice is most common in certain specialties such as mental health or oncology where patients benefit from more frequent, and convenient contact with the physicians or other clinicians caring for them.... Combined with the impending shortage of primary care physicians, the implications of these technologies for how healthcare is delivered in our country are remarkable." Although clinicians continue to have concerns regarding reimbursement, security and HIPAA when using [internet] video chat technology, the trend in using the technology is only expected to grow. And video chatting isn’t the only way patients are getting more connected to their care and care providers.....SLaM [South London and Maudsley NHS Foundation Trust] and Microsoft are working in partnership to develop a personal online health record for people using mental health services. Using Microsoft’s privacy and security-enhanced HealthVault platform, SLaM will be able to offer an online solution that enables clinicians and patients to work collaboratively on care and treatment by providing patients secure access to their health records and the facility to contribute to them directly. According to officials at SLaM, this represents the next phase in patient choice by empowering patients to shape and influence their care and treatment plans. The aim is to encourage a more equal dialogue between patient and clinician and improve the nature of the relationship. It ultimately puts the patient in greater control of their healthcare, allowing individuals to become more engaged.
For me, there were two major lessons to be learned from this article. The first is the use of the term "video chat" instead of telemedicine. It sounds warm and inviting whereas the latter seems formal and technical. Moreover, access to video chat (e.g. Skype) is both both ubiquitous and inexpensive for physicians and patients alike. A patient could have a follow-up session with a physician with little planning. All that the physician needs is a laptop computer, most of which now come equipped with a webcam and a microphone these days.
The second important lesson from the article is the emphasis on two large categories of patients who will derive substantial benefit from video chats between doctors/healthcare professionals: mental health and oncology patients. Both groups require relatively frequent and personal interactions with physicians or allied health personnel. For reasons of both easy access, low cost, and efficiency, video chat will fill the bill.
Some people tend to emphasize the technical coldness and impersonal nature of telemedicine/video calls. This article instead emphasizes the need for a "more equal dialogue between patient and clinician and improve the nature of the relationship." Some patients tend to get overwhelmed in a formal medical setting and may not address all of their problems with the physician. They may also think that "the doctor is too busy to bother with my petty complaints." With video chat, the patient remains on his or her home turf and hence the discussion may be conducted on a more equal footing.