By Jenn Riggle
Not only did Microsoft recently purchase the Internet telephone and video calling service for $8.5 billion, but new research reports that 7 percent of physicians are using videoconferencing technology like Skype to chat with their patients.
And while videoconferencing has been around since the 1960s (longer than most of the GenXers and Millennials who use it), health care providers are turning to this technology for a variety of telehealth initiatives, from remote radiology readings and remote monitoring by off-site specialists, to e-visits between patient and physician.
With the increasing availability of applications like Skype and FaceTime, people no longer need expensive videoconferencing systems or special cameras, but can video-chat from their smartphones or iPad 2.
Physicians are also becoming more comfortable using this technology and are using it to check on their patients, have an online consultation, or transmit images, such as x-rays.
Videoconferencing also may play an important role as hospitals work to reduce their readmission rates. The Patient Protection and Affordable Care Act (PPACA), which goes into effect next year, has established benchmarks for hospital readmission rates. Hospitals that don’t meet these rates will see a decrease in reimbursement. So it only makes sense that hospitals will be placing more emphasis on home care and follow-up with homebound patients or patients who have been discharged with a chronic illness.
Barbara Duck, author of The Medical Quack blog, wrote about how a friend was working overseas and got an outbreak of gout. Since this doctor was in the U.S. and he was getting ready to board a plane, he resorted to using “redneck telehealth” and called his doctor using Skype to show him his foot. While not a perfect situation for a real diagnosis, necessity is the mother of invention.
And unfortunately, this is not an uncommon occurrence. According to an article in eWeek, the majority of U.S. physicians have embraced iPhones, even though they’re not supported by the hospital’s IT department. This means they aren’t integrated with the hospital’s IT systems or electronic health records.
Dr. Brian Goldman’s wrote a great blog post entitled “Take Two Pills and Skype Me in the Morning” that stated how physicians are very comfortable using their cell phones to talk to patients, but have been more hesitant to use email, texting and social media to communicate with patients. Why? It’s the all-popular concerns about HIPAA and privacy violations. Now, they’re also concerned about making a misdiagnosis from an image seen on smartphone.
Dr. Brian advises that physicians should reserve electronic communications for patients with whom they already have an established relationship. “You don’t give advice by phone to a patient unless you know them or you’re on call for your colleague and have access to their chart.”
While webcam technology will not replace real-life appointments, it helps restore face-to-face communications that is missing from email or a phone call. However, it also raises new concerns, such as:
- How can these chats be integrated into the patient’s medical record?
- Can the actual video be captured and inserted into the record or should a summary of the call suffice?
- How should physicians be reimbursed for the time they spend using social media?
There currently aren’t any guidelines for electronic communication between physicians and patients, but it’s clear that it’s here to stay.
With the recent Microsoft acquisition, we can look forward them unveiling a strategy for integrating Skype videos into its HealthVault personal health record system.
The question is whether hospitals are going to put aside their HIPAA fears and make it easier for physicians to videoconference with their patients. My guess is that it will happen, but it will take time.