The Doctor Will Skype You Now 97
amkkhan writes Next time you need to go to the doctor, instead of making an appointment, why not just fire up your smartphone? New programs by companies such as Doctor on Demand and the University of Pittsburgh's AnywhereCare offer one-on-one conferencing with doctors, either over the phone or through video on your phone or computer – giving you all the medical advice you need without having to set foot in a doctor's office. This new breed of checkup, known as telemedicine, has the opportunity to revolutionize personal health, says Pat Basu, chief medical officer of Doctor on Demand and a former Stanford University physician. "Two of the most important skills we use as physicians are looking and listening," he says. "Video conferencing lets me use those skills and diagnose things like colds, coughs and even sprains in a manner more convenient for you."
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It won't fix shit doctors.
I had a skype consult with a doctor on Monday and it went very well. Only problem is waiting for the prescription to come in the mail.
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A lot of pharmacies nowadays use e-scripts, or another internet-based service. My doctor usually submits the prescription while he's still talking to me (person to person), and I can pick it up from the pharmacy on my way home.
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That's a requirement under either ACA or a previous law. Not all doctors are up to date on it, but they are supposed to be. Most insurance companies insist, too.
Didn't we just see... (Score:2)
...an article saying Microsoft had broken Skype for some platform(s) or something? Did I imagine that?
We still need a true peer to peer video conferencing application that doesn't depend on third party servers, or embed in a browser, or otherwise embody great fragility. Seems like it shouldn't be all that difficult, unless OS webcam APIs are horrid. Displaying moving graphics and moving them over the net is so simple as to be no barrier at all. Is that the problem? OS Webcam APIs?
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The major problem probably is people behind corporate or private firewalls, or on NATs, or behind proxies, or other things that prevent them from being a "server" that the other side can see directly over the internet.
So network-wise a "third party server" that has no such restrictions might always be necessary for those www-but-not-really-internet connected people so that their machines can talk to another. Of course if one of the participants is "really" on the internet that participant could run the serv
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Thanks. So. If you hang behind a firewall/OtherWare you can't control, you lose a lot of choices overall. Protocols, ports, etc. But for the rest of us, the ones who are actually free to choose our options, no reason, then?
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It won't fix shit doctors.
At least the NSA etc will have a list of all the shit doctors and your conversations with them.
If something goes wrong you'll be able to submit FOI requests to get evidence and win your malpractice suit.
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Maybe he's only asking for/demanding prescriptions for narcotic painkillers. After all, people tend to see in others what they see in themselves, and what he sees in doctors is a desire to commit crimes for profit (though dead patients don't pay well, but hey, never expect logic from an addict).
Pain management (Score:2)
I assume that the visit during which you were declined pain medication, wasn't the visit to the ER room right after the accident, but a visit sometime afterward because the pain was still there.
Two things:
- Some doctors are very suspicious of patient asking for pain medication regarding an old accident. Lots of pain meds are addictive and should not be taken long term. You might have been an addict simply trying to persuade the doctor to prescribe your next hit.
- Pain management is complicated. What works i
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You're doing something wrong. You sure you haven't been visiting Chiropractors?
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I would imagine these are for the case where the patient can't get to the doctor's office frequently.
Doctors' offices are full of germs. You are almost as likely to catch something else, as you are to be cured of what you have. Most health problems are routine, and a doctor should be able to diagnose them over the internet. Since there is no need for the doctor to be local, or even on the same continent, you can quickly be referred to a specialist if you have something complicated, This could replace 80-90% of doctor visits, saving people time, making better use of doctors, and preventing nosocomial inf
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And the privacy concern: someone else may look over your shoulders for Skype calls? Like your estranged spouse/offsprings...
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Or for follow-ups. I had an appointment with a specialist this last Monday. She prescribed some stuff, said to call back or come in (if necessary) in two weeks. What if I could Skype for five minutes and say how things are going, maybe show the affected area of my body on the camera for a quick look. Saves time all around. Then if I really
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won't listen to me in person or try to help me, why would Skype be any better? I haven't had a prescription in over thirty years.
I think if you're still alive after 30 years, you probably didn't really need those meds after all.
There's a reason some medication needs a prescription from a doctor. They aren't supposed to give you what you ask for.
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I'm more worried about the rectal exam.
Re:Butt (Score:5, Funny)
How big is your camera?
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Well, if you fork the feed then you may just be able to pay for the medical exam while performing it.
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That'll be a common excuse, when caught.
*walks into room*.. *sees person with fingers in butt*.. "I'm in the middle of a medical exam, get out!"
Oh, yes, of course.
Or perhaps tomorrow or yesterday (Score:2)
But the last I knew The Doctor preferred/will prefer to use cell phones. It probably isn't important the device use Skype. It may not even be important that the device be turned on.
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"You've got leprosy, goodbye." (Score:2)
"You've got leprosy, goodbye."
You have been billed no refund for unused time
Artificial Intelligence (Score:1)
HIPAA Compliant? (Score:5, Insightful)
Mr. Snowden begs to differ. Yet another benefit the NSA/Microsoft conjoined twins have fucked up.
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I'm an software development intern at a health care software company. My internship project has been developing a WebRTC platform for telemedicine instead of the third party vendor we've tested so far. Open source and encrypted by default, so hopefully all the parties play nice and WebRTC won't be compromised.
Bullshit medicine and antibiotics (Score:3)
Usually telemedicine is bogus, for hypochondriacs, helicopter parents and women with bladder infections.
Prescriptions are limited to antibiotics for those with compelling easy diagnosis like the aforementioned women with bladder infection histories.
The ones I've seen advertised on HR bulletin boards at companies I've visited always say they won't prescribe any narcotics or other "controlled substances" (gee, aren't all prescription drugs controlled substances if you need a prescription?).
While this makes sense it also doesn't, since there are plenty of conditions that are extremely painful but neither life threatening nor worth a trip to an emergency room on a weekend. A 2-3 day supply of Percocet to ameliorate the pain of a back injury until you can see your regular clinician won't create or enable anyone's addiction.
Until telemedicine gets over its paranoia about drugs its just not worth the effort.
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(gee, aren't all prescription drugs controlled substances if you need a prescription?)
The difference is whether or not you can give some to your friends and not have to worry about being arrested if the police find out. E.g., you can share your antibiotics, or your blood pressure medicine, even most antipsychotics. It isn't a good idea, but there's no law against it. On the other hand, those pain relievers, and most anti-anxiety and ADD medications are controlled substances, and sharing them will get you in trouble. It's a similar big deal for the doctors, as there's a lot more oversight
Nacrotics (Score:2)
A 2-3 day supply of Percocet to ameliorate the pain of a back injury until you can see your regular clinician won't create or enable anyone's addiction
Actually, it's a nice example of something that would help the addiction:
the drug you mention, Percocet, contains a substance called oxycodon. This one is an opioid. A morphine-class substance. It *is* a narcotic. [wikipedia.org]
So you see the scheme:
- call some tele-doc. pretend to have an episode of intense backpain, pretend to be on a work trip in this city, and being in a hurry. you just need 2-3 days supply of percocet, until you go back home and see your family doctor for an appointment.
- get a presciption. get it fr
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My working assumption is that, at least in the US, you're limited to the telemedicine providers your insurance company provides, so you'd be calling the same one who would have access to your medical history.
Unless.... (Score:3)
You're on a Mac [slashdot.org] that is...
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People on old Macs deserve what they get.
Promising... (Score:2)
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Depending on where you are of course...
But in many places your Doctor can only bill your insurance if they actually see you in the office. They cannot bill or can only bill less if they talk to you over the phone.
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Depending on where you are of course...
But in many places your Doctor can only bill your insurance if they actually see you in the office. They cannot bill or can only bill less if they talk to you over the phone.
Indeed! Our insurance company which costs a mighty fortune has made it clear they will cover no such "remote visits"
"convenience" (Score:1)
So, without commenting on accuracy, precision, completion, mis-diagnoses, missed symptoms, bias, colour correctness, nor smell, I think convenience is the all-time most important part of a doctor's check-up.
Oh yeah, house-calls. Remember? That's where we started. We are where we are because we made it convenient for the doctors, not for the patients. Remember? The guy with the expertise gets the convenience. Remember? The guy getting paid gets to make the rules. Remember?
Another excuse to reduce care levels, and costs (Score:4, Insightful)
While continuing to raise premiums.
I have never, ever, ever been to a doctor's appointment, and not had my blood pressure, pulse and temperature taken, even for the most routine visit. Nor should I, ever, in the future. Yes, I could, in theory, do those things myself and tell him, but none of the home kits can hold a candle to the gear they use, even if used correctly by the patient.
If I go in for something specific, physical contact becomes more specific. How can a doctor palpitate my chest, or listen to my lungs, over Skype? Some doctors will favor this because it will let them spend even less time with each patient, and insurance companies will push it because it will cost them less, but I won't put up with it. And neither, I think, will my doctor, who is very good.
Not the target audience... (Score:5, Interesting)
If I go in for something specific, physical contact becomes more specific. How can a doctor palpitate my chest, or listen to my lungs, over Skype?
Then you're not the target audience for this service.
It's targeting:
- The anxious people ("Doctor, the tip of my nose is itchy a bit, am I gonna die ?!") where 99% of the time all you need is to ask them and make sure that there are no other worrying symptoms and reassure them and ask them to come to the office if it persists longer than a week ("Has half of you face melted? No? Then it's definitely *not* Noma, no need to panic. Come see me if next week if it still does persist").
- The very simply common disease that are basically just about renewing the supply of self-medications ("Why do you bother coming here for a common cold?", "But doctor, I'm out of acetaminophene.", "ah, okay. here's your prescription.")
- The recurring simple infection that are actually damn easy to diagnose (e.g.: women who have often bladder infections can very easily recognise them. No new alarming symptom that wasn't there last time? It will probably go away with a simple drug) (e.g.: boyfriend has some bacterial STD? girlfriend needs a prescription to protect her too, and if she doesn't have any symptoms at all, she doesn't require an actual visit to the doctor beyond a few question about allergies).
If you break your leg in an accident, there's no way that a skype conversation will help you.
Well, actually speaking about what you said (needing to listening the lungs, etc) it might work the other way around: there are some people (call them "hyper"-chondriacs if you will) that tend to downplay symptoms because they don't want to bother loosing time going to the doctor's and think that the symptoms will wear of. If you provide them with a phone-line maybe some of them will think giving a call isn't that much bothersome, and will at least call the doctor. That also means that doctor can take the opportunity to explain to them that the thing is a little bit more serious than they've taught and persuade them that maybe it would be good to drop by the office for a more thorough check (or directly rush to the ER).
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The problem I see with this service, at least in the US with the litigious nature of its society, is that it's almost to the point that if you say a common housefly landed on your arm and you are worried they will tell you to come in to the ER or urgent care. I know of no one who has called any level of their heath provider with any concern who has not been told to come in.
The last thing they want is for someone to call in with something seemly trivial and have it turn out to be something quite serious. Tha
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I have never, ever, ever been to a doctor's appointment, and not had my blood pressure, pulse and temperature taken, even for the most routine visit. Nor should I, ever, in the future.
And that is actually part of the problem. There are many people out there who go to the doctor, get the whole 9 yards when all they really need is for someone to tell them they are fine. We have a service hear called 1300HEALTH. You call the number explain what you're seeing / what has happened and a qualified nurse will tell you if you actually need to see a doctor.
There are people who go to the doctor because they have a pimple, a stubbed toe, or in the case in our country need a medical certificate becau
Doctor.... (Score:1)
...who?
nope (Score:3)
No. I like keeping my medical information private and I don't want people listening in on my the conversion like they can do with Skype.
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If someone wants your medical information, do you really think they'd have a harder time getting it from your doctor's office than say, eavesdropping your encrypted skype chat?
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Street smart? How about technologically outdated and lacking any sort of insight into how the world actually works? I never said B&E. If you are *targetting* someone's medical records, what's more likely: find their/their doctors skype IDs, find the systems or networks they connect from, and somehow track/decrypt their encrypted skype conversations...and listen to what they are *talking about at the time*, which ultimately means a very small amount of insight to what you're obviously trying to get ahold
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All well and good (Score:3, Insightful)
But it was a random blood sugar test that diagnosed me T1 diabetes and a random blood pressure check that diagnosed me high blood pressure (and saved my life, if the 240/160 reading was anything to go by).
So no, I would have to say phoning it in would be as terrible an idea as... phoning it in.
There have been Skype Doctors in Canada already (Score:2)
mostly ones that sign for medical canabis.
Value of physical examination (Score:2)
A classical article on the subject, quite old now, has concluded that approximately 80% of diagnoses can be made from the history (ie a structured interview) with a further maybe 10% from physical examination and maybe 5% from additional investigations (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1673456/). Obviously, the requirements for modern medicine and the available means are a bit different. Nevertheless, any serious doctor will tell you that the history taking and the physical examination are the mo
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The physical examination should never be dispensed with in the long run. But in the case of a routine checkup for someone like myself, mid 20's non-smoking male, it seems like one of those things that is done just because I happen to be there anyway. Maybe the frequency of a physical visit could be cut down to once a year, or every 18 months with this system. It would mean one less potential scheduling conflict for the both of use without completely ignoring my health and if I could double book and have a c
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You are correct. Thanks for the citation.
Kevin Pho wrote about this on his blog.
http://www.kevinmd.com/blog/20... [kevinmd.com]
A virtual office visit for your cold is not a good idea
Kevin Pho, MD | Kevin's Take | February 10, 2013
But something is lost through these virtual connections. There is value to face-to-face interaction, where a provider talks to and examines a patient in person. For example, I’ve seen a patient convinced that he had a sinus infection only to find that he had a tumor inside his nose. Another complained of minor ear pain, but after examining her, I saw that it had spread to the point where she needed to be hospitalized for intravenous antibiotics. Both of these diagnoses would have been missed had I only treated them over the Internet.
Without the ability to talk to and examine patients in the exam room, many doctors play it safe and reflexively prescribe drugs, whether patients need them or not. A recent study from the Journal of the American Medical Association http://www.medpagetoday.com/Pr... [medpagetoday.com] found that patients who were treated through Internet-based virtual visits had higher antibiotic prescription rates for their sinus infections, compared to patients whom were seen in the office.
That's actually Archives of Internal Medicine (now JAMA IM).
"Physicians ordered fewer tests, but prescribed antibiotics more often, when they evaluated patients for sinusitis and urinary tract infections (UTIs) via Internet-based virtual office visits versus in-person visits, a study of four primary care practices showed," as MedPage Today put it. Mehrotra A, et al "A comparison of care at e-visits and physician offices visits f
Easily stopped. (Score:3)
1. Use telemedicine to handle chemical abortion, in states where there are few or no clinics left that will carry out elective abortion due to intimidation and harassment.
2. Watch as those states pass bills (Some already have) to ban telemed abortion, while claiming that they are just trying to outlaw a dangerous procedure that kills women.
3. Watch as courts strike down those laws as placing an undue burden and thus violating Wade, pointing out that the claimed reason is clearly only a pretext as non-abortion telemedicine is not prohibited.
4. Watch as states pass new bills to outlaw telemedicine completly.
Prehospital Paramedicine (Score:2)
This is going to be commonplace in the next few years in the field of Community Paramedicine. I'm an EMT and work on a 911 ambulance. A very large percent of our calls are for patients that can easily be treated in place, but our scope of practice does not allow us to "treat and release". So we use the most expensive method of transportation (an ambulance) to take a non critical patient (with a problem not an emergency) to the most expensive destination, an emergency room.
A very common example (like DA
What I would like to ask these doctors: (Score:1)
Dumb Profit Seekers (Score:2)
Can doctors get any idler?
Anyways, stupid idea. Sick people want to share with a real person. Hard enough to do with a flesh and blood arse giving you 12 minutes of his/her time, let alone a 'remote presence' (as if that even makes sense). The only circumstance where the scenario is a necessary evil, is true remoteness eg. medical advice for people in very remote locations like the Arctic.
Next profit idea: don't even use a real doctor, instead, an avatar with AI that is 'really good at listening and loo
HIPAA will have a major cow ... (Score:2)
... and what about the sleeze buckets?
"Yes, dear, I have been assigned to you. Now, if you'll just slip out of the robe ..."
Better than Nothing (Score:1)
I tried it a couple days ago; I liked it (Score:3)
I saw a notice on my company's intranet last week advertising this program. As a pilot, it was offering free "visits" (PCP visits are free under the regular program.) Tuesday morning, I needed to leave on a business trip just after lunch, and I had my colon acting up (nothing disgusting, just inconvenient.) Several years ago, the same thing happened and an Rx for Hyocyamine fixed the issue. I didn't have time to see even a Doc-in-a-box, much less my PCP.
In a few minutes, I registered for the program, picked one of the four physicians currently online, and after about a five minute wait, she popped onto the screen. She went through a quick history, had me prod various parts of my abdomen to make sure it wasn't some serious organ problem causing my colon issue, and sent the Rx to the K-Mart across the street. She reminded me that she was no substitute for regular physical exams, and that if the problem continued I should see my regular doctor. I cannot imagine a doc-in-a-box visit for the issue would have been very different.
In short, this is exactly the sort of issue telemedicne works for. It saved me the hassle and time of a doctor's visit, it worked for my employer since I didn't have to cancel my business trip, and it worked for my primary doctor, who didn't have to work me in at the last-second.
Really, I think it's best for the sort of issues that you'd handle yourself if the drugs you need to treat it were OTC, but for whatever reason, are not. It ain't going to make a whole lot of sense for most problems.
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The Doctor? (Score:2)
Symbian. (Score:1)