THE LAST WEBINAR OF THE AUTUMN

This week’s webinar in the Rheumatology Toolbox series is entitled “Osteoporosis- questions I get asked “. The webinar will start at 7 PM. Last year’s webinar on the same topic with the same speaker, Dr Ronan Kavanagh prompted the following comments: ‘Brilliant and extremely useful presentation. Suggest this becomes a regular , annual part of the excellent Rheumatology toolbox presentations,’ ‘excellent presentation, very practical areas covered in a comprehensive manner’, ‘Very clear logical well presented  webinar with all the latest research and thinking  on osteoporosis’, ‘excellent overview and many practical tips for everyday use in practice, thank you’ 
You are invited to register through the following link: Registration for Free Webinars.
These webinars are approved by the ICGP for CME purposes. You are encouraged to invite colleagues to register and attend by forwarding this email to them. You can send in questions before, during or after the webinar.

Back in response to popular demand

Wednesday 8th November
Great turnout last week, thank you for the favourable comments and suggestions, the feedback is appreciated. the next webinar in the series on the ‘Painful Red Eye’ takes place at 7pm on Wednesday 8th November, this is a response to requests for a repeat of a topic that was so well received last year.
You are invited to register through the following link: Registration for Free Webinars
These webinars are approved by the ICGP for CME purposes. You are encouraged to invite colleagues to register and attend by forwarding this email to them.You can send in questions before, during or after the webinar.
 

RJCoughlan

THE AUTUMN SERIES GOES ON

The next of the Autumn webinars in the Rheumatology Toolbox Series -“The Painful Red Eye ” will take place on Wednesday 8th November at 7pm. You are invited to register through the following link: Registration for Free Webinars.
These webinars are approved by the ICGP for CME purposes. You are encouraged to invite colleagues to register and attend by forwarding this message to them.

next webinar

Those who attended last Wednesday’s webinar and completed the survey should have received their CME certificates by email.Now we look to next week. 
What plan have you for a patient with Gout? What education do they need ? What targets for treatment have you? Find out more next Wednesday at the webinar.

You are invited to register through the following link: Registration for Free Webinars
These webinars are approved by the ICGP for CME purposes. You are encouraged to invite collegues to register and attend by forwarding this email to them.You can send in questions before, during or after the webinar.
 

Our experience of video consultations

In recent days there have been discussions as to the value of telephone consultation in primary care. Let me add to the discussion with an account of my experience. In the early days of developing Rheumatology Toolbox we used another strategy to try and reduce the workload in Rheumatology outpatient clinic. By workload I mean the time and effort involved in attending a rheumatology clinic this included time off work, travel time, carbon footprint and the cost in time and effort for the accompanying persons.

 

We set up a small study comparing the quality and quantity of clinical data obtained via an online system and the direct face-to-face consultation. The quality of the information using the two methods was broadly comparable, our study concluded that one could get very useful information via telemedicine.  This of course is in keeping with other findings that up to 70 or 80% of diagnostically useful information is obtained by talking to the patient the implication being that physical examination will provide a lesser amount of clinically useful information. Clearly physical examination often confirms the clinicians impression following the questioning of the patient. This stands to reason, the patient is the best witness of their own illness over time, the clinicians skill is essentially in distilling this information, gleaning it from the patient and formulating a diagnostic hypothesis.

 

At the end of our study we concluded that telemedicine in the form of a video consultation was most useful in seeing patients for review after their initial consultation had been done face-to-face in a conventional clinical setting. Subsequently we set up a very useful rheumatology telemedicine clinic that was well received by the patients and clinicians.

Spring series of webinars

This evening we have the penultimate in the spring series, to date it has been very well attended. There is exceptional interest in tonight’s topic, skin cancer and Hidradenitis suppurativa.

We will welcome many of those who have attended webinars the past and we expect some new visitors. There has been increased interest in our webinars in other countries. Quality of presentation, relevance to primary-care and ease of access all contribute to our success thus far.

 

What happens in Roscommon Stays in Roscommon

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.