Are you ready to dispense of face-to-face consultations with your neurologist? #MSBlog #ClinicSpeak #PoliticalSpeak
“As a follow-on to our group clinic posts, here is another one on a major disruptor to the antiquated Victorian model of healthcare delivery, Telemedicine. The state of the art review in this week’s NEJM is very good read and tell us where we are heading with telemedicine.”
“We are in the process of setting-up our own telemedicine clinics and I see no reason why once we get the format of the group clinics sorted out we can’t take them online and deliver them via a telemedicine format. For example, last night I did an MS education webinar to Latin American neurologists via the internet using Adobe’s webex platform. Although there were a few glitches the software has matured enormously and we were able to have a very good question and answer session at the end of my talk. I see no reason why a group clinic can’t be run using the same platform.”
“The one thing the article below addresses is the so called ‘digital divide‘, i.e. the group of people who are disenfranchised and don’t have access to the internet. What do we do about those people? I think this needs a political solution and the government should enact legislation defining internet access as an essential utility and mandating local authorities to set-up digital access and training programmes for all British citizens. This legislation should also ensure that the whole country has high-speed broadband. If healthcare in the UK is meant to free at point of access and equitable and healthcare is increasingly being delivered via the internet then everyone needs access to the internet.”
“The biggest challenge we face in teleneurology is replacing the laying on of hands, or the clinical examination, with a remote examination. I am sure this can be done, we simply need to think laterally. Can we assess the functioning, or malfunctioning, of the nervous system using telemedicine? We have started to develop apps to just this. We have recently been awarded a priming digital health grant to develop an app to assess visual function. This one of the most exciting projects I am involved in at the moment and we will need to come back to you for help us assess the utility of the app when we go into beta testing mode.”
“We have entered a brave new world of telemedicine and teleneurology. Those of us who don’t adopt telemedicine may find ourselves becoming a dinosaur.”
|an old-school clinician
Dorsey & Topol. State of Telehealth. N Engl J Med 2016; 375:154-161.
Telehealth is the provision of health care remotely by means of a variety of telecommunication tools, including telephones, smartphones, and mobile wireless devices, with or without a video connection. Telehealth is growing rapidly and has the potential to transform the delivery of health care for millions of persons. Although several reviews have examined the historical use and effects of telehealth,1-3 few articles have characterized its current status. Here we examine the trends of telehealth, its limitations, and the possibilities for future adoption.