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 and contrasts their generally positive experiences and patient benefits of virtual visits/house calls in immediacy and lowering of stress. He adds these caveats: patients should sign consent, Skype’s claims they are encrypted (but the TeleMental Health Institute disagrees in Psychiatric News–TTA 11 May, and there are many other HIPAA-compliant video providers), and that visits should be follow up only. News OK, the CHealthBlog.
A better example was highlighted at the Epic EHR User Conference last week with Stanford (University) Hospital and Clinics. Epic has developed a software add-in for video consults which integrates three ways: 1) with the patient’s EHR, 2) with scheduling and keeping the appointments into the physician workflow and 3) with third-party identity verification services. The ease of use demonstrated in the Epic video is a real pointer to the future. An earlier telemedicine test was done with Stanford Dermatology and the Cisco HealthPresence platform. InformationWeek, ScienceRoll.
Previously in TTA: Telemedicine in the TIME Swampland, HealthSpot, Netsmart ally for telemedicine kiosks
The Oklahoma Medical Board disciplinary action taken doesn’t even mention Skype as an issue but focuses on his “dishonorable/immoral conduct, prescribing violations, narcotic law violations, medical records violations, and dishonorable or immoral conduct likely to
deceive/defraud/harm the public” The board minutes with this information is at http://www.okmedicalboard.org/meetings/rs201309.pdf
Kenneth, thank you for the clarification and the link to the documentation. Interesting that the unapproved telemedicine platform was not cited and his other failures in practice were. If you look at the original local coverage and the follow ons by Dr. Kvedar and others, it’s all about the Skype and increasingly they paint the situation backwards. It is not like they don’t use telemedicine in OK–just that Skype is a problematic platform. I would believe that Skype was the least of the problems with this particular physician!