Following our previous item on the topic, on January 16th, Tim Kelsey made it very clear to this editor at a PICTFOR event that the £1b promised to GPs for premises improvement included a strong requirement that GPs also invest in electronic support, including remote consultation technology.
It is therefore particularly pleasing to see in yesterday’s Pulse Today, an item on a Skype trial in Central London that both patients and GPs seem to love. Some key quotes:
Almost all patients surveyed about their experience of the remote consultation service said they ‘would use it again’ (95%).
Although patients were warned that ‘the security of Skype isn’t 100%’, 83% also said (more…)
Here are three items that are each important and have hit my screen in the past couple of days – sadly, try as I may, I’m struggling with a common linking theme.
The first, that the 3G Doctor alerted me to, is a simply brilliant talk by Telcare‘s CEO Dr Jonathan Javitt at the Technion Social-Mobile-Cloud Meets Medicine Conference on the 17th December 2013. We’ve all made the arguments that technology enables the genuinely continuing care that long term conditions require, rather than the episodic care our health service is set up to provide, and that technology ensures that patients have clinical support 24/7 rather than in the brief period the doctor or nurse sees them. However Dr Javitt brings all the arguments together to make such a powerful case that the only sensible way to treat long term conditions is to use technology to help the patient that anyone opposing it might as well try to argue that the earth is flat. As a result I have decided that my New Year’s resolution this year will be no longer to rise to the challenges of the naysayers. (I wonder how long I can keep it.)
The second item is a new take on monitoring activities of daily living (ADLs). For those new into telecare, continuous ADL monitoring looks a brilliant way of picking up an early decline in cognitive or physical decline, often well before symptoms show up in a change of vital signs or response to questions. The challenge though is whether the computer analysing the ADLs is smart enough to cope with activities such as the invasion of the grandchildren, or can cope with multiple occupancy. So it’ll be interesting to see how well CarePredict’s service is received. This uses a bracelet to track someone being cared for, rather than relying on PIRs or similar sensors as many other ADL systems do. Of course, like falls detectors, the problem with wearables is that people take them off, although the mHealth News item claims that ‘seniors’ like the bracelets.
The third item is a BBC item on the attractions of care homes in countries where the cost of living is lower, such as Thailand, which does feel a tad mercenary, although where there is genuine reverence for older people the quality of care can be excellent, and recent revelations suggest that care for older people in the UK is hardly without its problems. A combination of Skype and cheap flights certainly means that it is possible to keep in touch regularly. If it gets to be considered a viable option, it will certainly complicate the economics of technology to stay at home vs care home.
Hat tip to Prof Mike Short for alerting me to the BBC item.
A family practice physician in eastern Oklahoma was disciplined by the state medical board for using Skype on initial mental health consults. Skype is not approved by the board for telemedicine; other factors were that the patients were not physically seen at any point and that they were prescribed controlled substances (including narcotics). Three of the patients died while under care but the deaths were not attributable to Dr. Trow. It is easy to score the doctor for what could be seen as bad practice in telemedicine, but a mitigating factor is his practice in a remote area of the state and the distance of the patients. Joseph Kvedar, MD of the Center for Connected Health/Partners HealthCare reviews the situation (more…)