Monday, November 26, 2012

Just talk to each other!

@Lucienengelen at Radboud University Nijmegen Medical Center @umcn is passionate about how to apply the tools of social media to help patients participate in their care, and also about how to enable doctors to work better together to help make that happen.  A recent advance from his REshape Center carries out the convergence of those functions in an elegant and simple manner.

It's called FaceTalk, and you can find a description here.  It might be simplest to think about this as Skype on steroids.  First, several people can join in a conversation simultaneously and see and hear each other.  But the discussion can be supplemented by the visual presentation of test results, images, electrocardiograms, and the like.  Further, the images can be manipulated by any of the participants.  Want a closeup view of a CT scan that has been been presented by your colleague across town (or across the country)?  Just spread it wide like a photo on your iPhone.

The whole thing also has significant privacy protections and meets US HIPAA standards and the equivalent European standards.

FaceTalk is offered on a subscription basis to doctors for a modest fixed fee per month.  Any subscribing doctor can invite anyone else to be part of his video exchanges.  The whole thing works on any platform on any computer or smart phone.  Lucien has negotiated with the Dutch insurance companies to consider FaceTalk visits reimbursable, just like office visits would be.

Here's a short video of a news story on the project.  (Click here if you cannot see the video.)

FaceTalk kort EN from UMC St Radboud on Vimeo.

Read this story about treatment of children with cleft lips or palates.  Previously, they had to travel many hours to visit the hospital for periodic checkups.  Now they, are sent an inexpensive webcam and are able to present the doctor with a view of their physical features.  Doctor Stefaan BergĂ© explains:

Our patients come from every corner of the Netherlands. An online consultation via FaceTalk saves them a lot of time. They no longer need to travel to Nijmegen for a check-up. There are various stages to treating children with a cleft lip or palate. It starts between birth and four years old, and continues between the ages of ten and thirteen years. They need several surgical procedures, so the children have to come to hospital on a regular basis. These are the periods when we really need to see them.

But between four and ten-years-old and twelve and eighteen-years-old, we only need to check their progress. These consultations only take a couple of minutes and can be carried out perfectly well via FaceTalk. The webcam allows us to look into the patient´s mouth and if we are in any doubt, we ask them to come to the hospital.

Another doctor in the Netherlands helped a patient in Egypt:

The diagnosis of my patient had previously been made in Egypt. The mother wanted to consult with me about whether additional treatment would be required for her child and whether she would have to come to the Netherlands for this treatment. They are Dutch, but are living in Egypt as ex-pats. At that point, I thought about FaceTalk; I had heard about it previously and wanted to try it myself. I told the mother that we would be able to have a video consultation, but if this was unsatisfactory then she would still have to purchase the airline tickets. However, the video consultation worked very well, so this was unnecessary.

Lucien demonstrated the system to me recently when I was in Nijmegen.  It is as easy as Skype and Facebook combined.  Within seconds, we had a three-way conversation going on around a conference table:  One of us on one computer, and the other on two!
There are a lot of people working on complicated inventions to improve health care.  This one is elegant and inexpensive and works.  It can truly be transformative in the delivery of care.


Anonymous said...

what happened to the post about the phones at Logan hotel?

Paul Levy said...

Back tomorrow.

Anonymous said...

This is truly remarkable. I am in a Medicine and Media class at my university and we have spent a considerable amount of time talking about the effects of new mediums through which patients and physicians can engage. “FaceTalk” are products like it are going to reshape how medicine is practiced. The examples of the doctors in the Netherlands performing consultations through this computer application epitomize how technology is shaping medicine and ultimately how it will lead to the globalization of medicine. In our class, we discussed the importance of collaboration between patients and physicians and I truly believe that “FaceTalk” is a step in the right direction. The ability for multiple parties to take part in a video consultation further enhances the ability to collaborate and fully equip patients with multiple perspectives without having to make individual appointments with each of the physicians. Furthermore, it provides physicians the ability to securely collaborate on patients, even if they are on opposite sides of the world.

Now, my question is whether the virtual doctor’s appointment can truly replace a visit to the doctor’s office. Where does the physical exam and data collected through this medium fit in to the picture? Or is this a way for doctors to follow up with patients after initial visits?