Two years ago at the Irish healthcare awards in 2013 John Carey and I were involved with colleagues from Roscommon. We received an award for setting up a Telemedicine service for rheumatology patients in the Roscommon area. In spite of its success as a service for patients it has not been extended in rheumatology nor have other services used to the template for delivering a clinical service to areas remote from the hospital.
I recently came across a presentation from the Mayo Clinic on YouTube extolling the virtues of telemedicine in primary care. And the experience recounted in that presentation is very much my own.
An article in January by Skip Fleshman in Forbes / Pharma & Healthcare entitled “Why Telemedicine’s Time Has Finally Come” suggested a combination of factors are driving this growth, profit, technology and convenience are all playing a part. Oh! And patient acceptance. He predicts it is going to be the biggest trend in digital health.
In September the American College of Physicians produced a position paper “Policy Recommendations to Guide the Use of Telemedicine in Primary Care Settings” in it they deal with issues such as the physician- patient relationship online and in office. They advocate that the patient and the physician should have a real ongoing doctor-patient relationship. They warn against “one off” encounters that would lack that depth.
We started off four years ago developing a telemedicine service in the West of Ireland to deliver rheumatology expertise to patients close to their community. The service was effective, accepted, efficient and cost/time saving.
I can see potential for a telemedicine service to extend specialist medical care to remoter parts of the country. (in the case of ”National Services” that means outside the Pale).
It could be a suitable way for family doctors to link with their patients at a time that is convenient. Maybe sometimes to work from home.
Telemedicine can link nursing homes or homes for the elderly to specialist services in hospital thereby avoiding the need for the patient to travel to the OPD or A&E. This may reduce the demand on trollies.
Indeed one could see a potential for A&E services to be rolled out from their “centres of excellence” to the community thus avoiding many unnecessary wasteful and expensive trips to the hospital.
To date what has happened in Roscommon has stayed in Roscommon.