Can Skype offer safe alternative to face-to-face consultations?

PRESS RELEASE

For immediate release: Monday, 12 November 2012

Doctors are urged to consider the medico-legal issues of using Skype for patient consultations.

With Skype touted as a possible solution for the millions of pounds wasted from missed healthcare appointments, UK-wide medical defence organisation MDDUS looks at whether it could offer a safe alternative to face-to-face consultations.

Reports show that one in ten health appointments were missed last year which, as well as the financial implications, delays treatment for other patients.

‘‘The concept of holding consultations via Skype is an interesting development, which may have clear advantages in terms of convenience for patients and doctors.’’ says MDDUS medical adviser Dr Barry Parker.

“Seeing your doctor in a safe and convenient way in the comfort of your own home may appeal to some patients. It could be particularly beneficial in rural areas or if the patient has a disability that makes it difficult for them to attend their practice.”

With the flu season approaching and the possibility of travel disruption during adverse winter weather, Skype could be a useful way for GPs to make contact with their patients.

‘‘Skype consultations may potentially be better than telephone advice calls, in that the patient can see who they are talking to, aiding communication, and the doctor can gain an overall impression of the patient’s condition,’’ adds Dr Parker. ‘‘Not every patient has access to a computer or would feel comfortable using this new technology, but for some it may be convenient and beneficial.

“Doctors would have to avoid over reliance on this method of consulting given the limited scope for any examination of patients. Even with good picture quality, observation of skin conditions, for example, is likely in most cases to be much better at face-to-face than Skype consultations, and examination beyond superficial observation will be impossible.

“The medico-legal pitfalls of Skype consultations are not yet fully apparent as it is a recent development, but it is anticipated that some of these will be similar to telephone advice. The key issue for doctors will be to recognise when this mode of consultation is not sufficient to properly assess the patient and address the problem, and to arrange a face-to-face consultation instead.”

GMC guidance states that: “good clinical care must include adequately assessing the patient’s conditions, taking account of the history (including the symptoms, and psychological and social factors), the patient’s views, and where necessary examining the patient.”

“There are also security issues to consider, as medical confidentiality must be properly protected during Skype use,” says Dr Parker. “An encryption process is in operation when users log on, but there may be other security risks, and practices should seek expert IT advice before using this technology for consultations, so that safeguards, as far as they are possible, may be put in place.

“In addition, bandwidth availability may be an issue for users, as problems in this area could result in disruptions during the consultation.

“If a practice was to promote the use of Skype then there would need to be relevant information available to patients in the form of leaflets or posters, so they have an understanding of how it works and the process runs smoothly.

"It would be important, for example, to emphasise that the doctor would always initiate a call, allowing them to control communications and avoiding potential technical difficulties with incoming calls. Patients should also be aware of issues of confidentiality.

“Records should, of course, be kept to the same standard as other consultations.”

Ends

For further information contact Richard Hendry on 0845 270 2034 or 07976 272266, or email rihendry@mddus.com.

Note to editors

MDDUS (The Medical and Dental Defence Union of Scotland) is a medical and dental defence organisation providing access to professional indemnity and expert medico- and dento-legal advice for doctors, dentists and other healthcare professionals throughout the UK. For further information on MDDUS go to www.mddus.com.