Who is afraid of an online examination? – maybe let’s just try…

Some of the sentence sentences I’ve heard last week regarding online exam:

” Online clinic is a truly an amazing idea”

“Interesting idea, though it concerns me greatly that you consider a neurological examination by telehealth to be of any value”

” We are looking for people who can help us with online examinations for hospitalized patients “(on- stage)… Later “it is not possible to perform neurological examination online ” (face-to-face conversation)

 Who said what?

The first sentence was sent to a parent after an online examination for his child with a complex motor disability. The clinic was performed in the child’s special education school with his therapists.

The second comment was written by a pediatrician without experience in neurology or telemedicine.

The third was presented by a physician form a hospital management team seeking for digital health partners.

What are the hurdles for implementing telemedicine?

Main issue is not technology- the challenge is implementing telemedicine service within the medical system. Of course it’s always difficult promoting innovative ideas within big systems. New things are intimidating. In the medical world there’s a great fear from legal aspects, patient satisfaction, ineffectiveness and costs. People who use telemedicine do not tend to sue the medical system mainly because they choose the service and sign a disclaimer acknowledging advantages and disadvantages. Patient satisfaction is usually high because parents patients choose this service. The studies demonstrate that online treatment is as effective and sometimes is even more effective than from face to face clinic. So we are left with the cost… Telemedicine does not reduce the physician’s time and sometimes it is actually more demanding. It is interesting to see where  telemedicine is expanding. In systems where the HMO pay for patient travel (such as Canada) telemedicine reduces the cost. In areas where cost related issues have not resolved telemedicine is still not used and it’s full capacity (such as in dermatology). Implementing telemedicine in large systems is really a separate project that is a startup. Leaders would need an innovative approach with high abilities to test several projects. Some will succeed and some will fail. Only medical systems who will try to implement telemedicine in a start-up approach will eventually succeed.