More Patients Meeting With Doctors Via Web Programs Such as Skype

Patients increasingly are making appointments to meet with physicians online via web cameras, MyHealthNewsDaily/Yahoo! News reports.

Online chat services such as Skype allow doctors to meet with patients in a quick and convenient capacity, according to MyHealthNewsDaily/Yahoo! News. The services also allow for specialty physicians, such as plastic surgeons, to interact with patients in distant cities.

In addition, the technology helps patients with illnesses confine their germs to the home.

Trend Growing

According to Gary Capistrant -- senior director of public policy at the American Telemedicine Association -- there are limited data on how many doctors use webcams at their practices because no agency tracks or requires doctors to report when they use webcams.

However, he said the number is "absolutely increasing" as patients gain more ways to access video chat programs, such as through smart phones.

Potential Problems

Physicians using webcams to consult with patients soon could see significant obstacles, as state laws likely will grow more restrictive as technology advances, according to Capistrant.

Physicians must be licensed in the state where their practice is located and in any state where they see patients through videoconferencing. However, Capistrant said that some states have agreements with others to accommodate doctors who see patients across state lines.

In addition, Capistrant said doctors must make sure their communication with patients meets HIPAA security requirements.

Physicians also might be forced to reconsider how they bill patients as the practice of using webcams becomes more common. Most doctors charge patients the same price for in-person visits as they do for a web-based appointment. However, technology could shorten the length of many appointments -- perhaps even reducing certain exchanges to a text message, according to Capistrant.

Finding a Balance

Doctors say that in-person visits still are preferable because they often can pick up on nuances not obvious through video.

Certain physicians will agree to use webcams only if they already have seen the patient several times in person (Chan, MyHealthNewsDaily/Yahoo! News, 1/2).

John Bierma
All system are subject to failure. Unless you have a back up generator as do skilled nursing homes and hospitals for emergencies, you are going to lose access to the Internet. We had surge protectors with built in batteries at our clinic to keep us going but when a contractor cut the cable going to our town, we lost access to the Internet anyway. Nothing is forcing providers to use Skype or other IP based communication, audio or video. Storms can cause the loss of land line telephone service as well. I have used both big box polycom/tandberg type IP systems and Skype for telemedicine. In my experience Skype is FAR more reliable and uses the same AES encryption and user ID security. I used Skype for 3 years with only one day of loss of service. Both IP systems and Skype can be unsecure if used improperly. IP systems used with laptops or servers that do not have their virus and malware updated daily or more often are as risky as using Skype under the same circumstances.
Shea Steinberg
This is a huge improvement in mobile healthcare. Imagine being so sick you can barely get out of bed, let alone drive to the doctor where you are exposed to even more sickness. Electronic health records ( EHR ) make it possible for doctors to have virtual appointments with their patients. It's also a incentive for doctors who want to reach out to people in rural areas. Practice Fusion EMR: http://www.practicefusion.com
Lew Mills
Roger, I understand your point with respect to VOIP to replace a landline. But Skype video doesn't have a cheap alternative. When I've looked at "telepresence" solutions, they typically cost more per minute than my fee. I also understand that it would be preferable to have military grade encryption on my conversations, but I wonder if that isn't overkill. If somebody has the resources to hack Skype, they probably have the resources to know more about my patient than I or the patient knows. So, Skype video seems worth considering.
Roger Downey
It's "good enough" for polite conversation, but not for confidential, private communication between physician and patient, so why take the chance just to save a buck or two because Skype is free? The people who thought their social security information was safe on various providers' computers had that same naivete until they lost their laptops or someone hacked their system.
Lew Mills
Patricia, I believe that Skype is encrypted and probably "good enough" security for HIPAA. Do you have some other information on that?

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