Managers claim that outpatient appointments – which would include email as well as Skype – could be reduced by as much as 35 percent, while improving patient satisfaction. Another benefit is allowing patients who cannot take time off from work to be seen medically, while freeing up spaces in the hospital’s parking garage. The added technology is said to reduce the number of visits by 180,000 people per year, with the potential growing to an annual reduction of 517,000 or 35 percent of patient visits.
The underlying strategy behind the change is to reduce pressure on the hospital. It is likely that the audience for Skype consultations is primarily youth (mentioned as those under 50). However, the hospital is discussing patient clientele for the new roll-out to include Baby Boomers, whom they term “silver surfers.”
The types of cases that could utilize the new Skype technology for doctor consultations would be follow-ups for those patients who had routine surgery or hospital procedures and need doctor confirmation before they are discharged. The Britain hospital acknowledges that there are many cases that would not be appropriate for Skype, such as physical exams and other visits requiring face-to-face contact.
In the U.S. Skype-like apps, such as Doctor on Demand, which allow patients to video-chat in real time, have been used by some hospitals and doctors for at least six months. It is helpful if a patient has pain with moving due to, for example, a swollen knee or ankle. They can rest at home while getting a physician consult. A pediatrician in London, England, has been doing Skype for about the same length of time. (See video below.)
In fact, in the U.S. doctors have been using Skype telemedicine long enough to have negative repercussions from its use: in September a doctor in rural Oklahoma was disciplined for treating patients remotely for mental health issues. This came to a head after a patient died due to overdosing. The challenges that arose fell into the categories of legal and regulatory, as well as privacy and security. Perhaps for this reason, the U.K. hospital is careful to express that Skype is not used for treatment of mental health issues, and is limited to follow-up visits after a doctor-patient relationship has been established.
Another technology mentioned that the hospital is trying to change is a move to electronic medical records (EMRs), something that the Institute of Medicine in the U.S. prompted healthcare institutions to do 20 years ago. U.S. hospitals have hurried to catch up and two years ago most major medical centers had EMRs in place.
Cleveland Clinic is among U.S. trailblazers in lean hospital operations that focus on value from the patient’s point of view, identifying steps that add value, and eliminating wasteful steps with efficiency as a goal. In this light, the Clinic has created guides regarding accessing recommended patient treatment plans based on what is appropriate in real time for the majority of patients. Nationwide, tools are used to track team performance measures, such as medical errors and infections. This allows strengths and vulnerabilities to be replicated or corrected.
In Britain, however, where Skype is just beginning in hospitals, patients are expressing hope and anticipation at not losing work time and getting quicker responses. Doctor consultations online for University Hospital of North Staffordshire will, for now, provide it with a competitive edge in the age of technology.
By Fern Remedi-Brown