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(NewsOK)   The American Medical Association has not approved the use of Skype for treating patients; however, leeches and blood letting are still considered cutting edge   (newsok.com) divider line 21
    More: Fail, Skype, Medical associations, Oklahoma, northern Texas, patients  
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1050 clicks; posted to Main » on 13 Sep 2013 at 9:49 AM (30 weeks ago)   |  Favorite    |   share:  Share on Twitter share via Email Share on Facebook   more»



21 Comments   (+0 »)
   
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2013-09-13 09:51:13 AM
THANKS OBAMA!
 
2013-09-13 09:57:49 AM
Is it that Skype is not secure enough to meet HIPPA rules?
 
2013-09-13 09:58:53 AM
submitard, there are important reasons why you can't diagnose someone over the phone ( or even video skype sessions). You lose a great deal of information about your patient by not being able to observe them more accurately.

The guy was treating mental health patients remotely from a public forum and he was "prescribing (controlled dangerous drugs) without ever seeing the patients in person for an initial evaluation" ( according to TFA )

He absolutely deserves that penalty.
 
2013-09-13 10:08:13 AM
Actually...  Leeches and maggots are quite handy and still in use in today's medicine.
 
2013-09-13 10:16:01 AM
Medical board documents show that Skype is not approved as a telemedicine communication system.

I don't want to say the medical board is behind the times, but AT&T is still waiting on approval for the Picturephone.

/telemedicine
 
2013-09-13 10:19:34 AM

Vodka Zombie: Actually...  Leeches and maggots are quite handy and still in use in today's medicine.


Don't forget bloodletting. An essential treatment for some diseases.
 
2013-09-13 10:37:37 AM

huntercr: The guy was treating mental health patients remotely from a public forum and he was "prescribing (controlled dangerous drugs) without ever seeing the patients in person for an initial evaluation" ( according to TFA )

He absolutely deserves that penalty.


But in some areas, telemedicine is just about the only means to get a medical (chemical) abortion.

I'm glad that the issue with this case was the technology used, not so much that telemedicine was used.
 
2013-09-13 10:39:27 AM

fireclown: Is it that Skype is not secure enough to meet HIPPA HIPAA rules?


FTFY

There are many doctors that use Skype, and I have seen a few RFPs from the VA for mental health services that designate Skype and one of the systems used, which always surprised me as how notoriously the VA's IT (archaic) systems are required to be locked down.  That being said, there are secure, approved, video conference systems.

/10 years in telemedicine
//regulations need to catch up
 
2013-09-13 10:45:34 AM
What's the problem?  It clearly worked for Bill Frist and Terry Schiavo.
 
2013-09-13 10:46:32 AM
We have a telemedicine system thru the Arkansas Department of Health and we can't find any doctors who want to use it. Sucks being a critical access hospital.
 
2013-09-13 11:03:09 AM

Vodka Zombie: Actually... Leeches and maggots are quite handy and still in use in today's medicine.


I wouldn't say "quite handy" as the number of situations they are used for is low.

Bloodletting is also still used.  It's the standard (and only) treatment for hemochromatosis.

Misch: huntercr: The guy was treating mental health patients remotely from a public forum and he was "prescribing (controlled dangerous drugs) without ever seeing the patients in person for an initial evaluation" ( according to TFA )

He absolutely deserves that penalty.

But in some areas, telemedicine is just about the only means to get a medical (chemical) abortion.

I'm glad that the issue with this case was the technology used, not so much that telemedicine was used.


Yeah, that's how I see it also.  The guy was being careless in prescribing drugs that can be abused.  Skype might actually have had something to do with that as the low framerate means you don't get as good an impression of the person as you would in person.
 
2013-09-13 11:27:50 AM
When I was a resident in the 90s, I sometimes would get sent to the telemedicine suite, which I despised. I don't know what carried the signal, but I think it was pre-internet.  Piles of high end (for the time) AV equipment everywhere but very frustrating to pretend that you were doing anything close to a physical exam, even with a nurse holding an amplified stethoscope on site.

Everyone  the telemedicine dept was always excited when you used their facility. I'd report back to my dept that it would have been cheaper, faster and easier to buy us a Ferrari and drive out to the country to see these patients than fumble around doing half arsed work using telemedicine.

I understand that telemedicine has gotten better in the intervening years. While I don't approve of the practice of soliciting strangers for skype evaluations, I can see it being a valid way to do follow up and med checks with psyche patients.
 
2013-09-13 12:03:08 PM

mjones71822: We have a telemedicine system thru the Arkansas Department of Health and we can't find any doctors who want to use it. Sucks being a critical access hospital.


If you need radiology services, let me know!
 
2013-09-13 12:22:13 PM

dywed88: Vodka Zombie: Actually...  Leeches and maggots are quite handy and still in use in today's medicine.

Don't forget bloodletting. An essential treatment for some diseases.


Bloodletting is a great prophylactic for heart disease.

http://www.sciencedaily.com/releases/1997/09/970901072035.htm
 
2013-09-13 01:01:29 PM

Infobahn: fireclown: Is it that Skype is not secure enough to meet HIPPA HIPAA rules?

FTFY

There are many doctors that use Skype, and I have seen a few RFPs from the VA for mental health services that designate Skype and one of the systems used, which always surprised me as how notoriously the VA's IT (archaic) systems are required to be locked down.  That being said, there are secure, approved, video conference systems.

/10 years in telemedicine
//regulations need to catch up


Telemedicine certainly has its uses, but it will always be inferior to an in person meeting. You can learn so much by observing people, which is very limited on something like Skype.

Especially for an initial consult that results in the doctor prescribing powerful narcotics that are commonly abused.
 
2013-09-13 01:36:31 PM
I'm pretty sure the problem was not was the telemedicine component of this story, but that (at least in Texas) an initial face-to-face, in-person exam is required before prescribing any "dangerous medicine," which here means any medication that requires an actual Rx....not just controlled substances. After that initial exam, telemedicine is fine though you put yourself up for liability issues if you miss something, just as if you do a half-ass physical exam in person.
 
2013-09-13 02:52:26 PM

voodoomedic: I'm pretty sure the problem was not was the telemedicine component of this story, but that (at least in Texas) an initial face-to-face, in-person exam is required before prescribing any "dangerous medicine," which here means any medication that requires an actual Rx....not just controlled substances. After that initial exam, telemedicine is fine though you put yourself up for liability issues if you miss something, just as if you do a half-ass physical exam in person.


Telemedicine has its place.  Certainly better than what this guy is doing (also in Texas BTW):
http://www.victoriaadvocate.com/news/2013/jun/01/jo_drivet hrudoc_06021 3_210800/
 
2013-09-13 03:29:16 PM
hotoffpress.files.wordpress.com
 
2013-09-13 05:41:48 PM
I wouldn't want to blab my diseases over Skype.

The back-doors left by Microsoft at the NSA's request/command violate the doctor-patient confidentiality laws.
 
2013-09-13 10:07:07 PM

dywed88: Infobahn: fireclown: Is it that Skype is not secure enough to meet HIPPA HIPAA rules?

FTFY

There are many doctors that use Skype, and I have seen a few RFPs from the VA for mental health services that designate Skype and one of the systems used, which always surprised me as how notoriously the VA's IT (archaic) systems are required to be locked down.  That being said, there are secure, approved, video conference systems.

/10 years in telemedicine
//regulations need to catch up

Telemedicine certainly has its uses, but it will always be inferior to an in person meeting. You can learn so much by observing people, which is very limited on something like Skype.

Especially for an initial consult that results in the doctor prescribing powerful narcotics that are commonly abused.


Surely the fact you can't smell a patient is (at least) an issue?  Scent is a diagnostic factor for some diseases.  And it can tell you basic things like if the person is failing at basic hygiene.

How can you tell if someone can't or won't make eye contact on Skype?

I'm pretty sure a lot of skin and hair cover changes would be difficult or impossible to see on Skype too.

Some of the best medical reports I've read are being with doctors trying to find a diplomatic way to call a patient "fat, dirty, and smelly".

/That biatch be overmass and odiferous
 
2013-09-14 01:36:37 AM
Telemedicine isn't for every specialty.  Millions of patients are diagnosed through Teleradiology a year in the US.  Teledermatology, telepathology and telepsychology are coming up quickly, and are an efficient way to provide patient care to areas that don't have access to doctors 24/7.

/ATA Member
 
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