Telemedicine: critical massing or déjà vu, dear Humans, too?

A veritable blitz of telemedicine advocacy articles have appeared in the past week in leading healthcare and business publications. All of them promote telemedicine as a mix of consumer friendly (rapid care from anywhere at relatively low cost), a solution to the paucity of primary and specialty care in rural America, and contributing to quality affordable care. They both point out the increasing acceptability of the online consult (75 percent of consumers favor in a recent Cisco survey) and by doctors (60 percent). The writers are former Senator, Majority Leader and practicing surgeon Dr Bill Frist, and Dr Boxer is the chief telehealth officer of Pager and chief medical officer of Well Via. Health Affairs (Frist) and Wall Street Journal (Boxer).

Of course, do you need a human doctor at the other end, or will Humans do? The University of Southern California has tested Ellie, a virtual human,who’s been successful at getting patients to report honestly to her–more honestly than to real people. Computer Expression Recognition Toolbox (CERT) which automatically detects facial actions, including expression of basic emotions like sadness, can make interactions seem almost real. In fact, the more automation, the better as far as patients were concerned. Getting the full story from patients, whether telemedicine or on a visit, is difficult in sensitive areas ranging from food consumption to sexual problems to medication compliance and of course, feelings of sadness and depression. A 2009 study found this was true to up of 29 percent of adults. EHR hacking has also entered the frame, with 13 percent of adults reluctant to give a doctor full information due to the logical fear of hacked hospital records. When given the chance, nearly half of patients chose to limit access to their EHRs. Perhaps more empathetic anonymity is just what the doctor ordered. So, be honest. Have you lied to your doctor? (Washington Post) It’s only a computer: Virtual humans increase willingness to disclose (Computers in Human Behavior)

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