Saturday, December 16, 2017


Is it a good idea?


Mark Fraser

Today, it is possible to receive specialist advice without ever having to leave your home as long as you have access to a computer with high speed internet access and a webcam. The process is referred to as an electronic consultation or E-consult. Electronic consultation systems use the Internet to deliver health services to people all around the world and has been shown to reduce unnecessary visits to specialists, with a meaningful percentage of cases being resolved without a face-to-face visit. As a result, wait times are less for those who really do need to see a specialist. Skype is one method that is popular among health-care providers today.

“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 Brian Parker, medical adviser for the Medical and Dental Defence Union of Scotland (MDDUS), an independent mutual organisation offering expert medico-legal advice, dento-legal advice and professional indemnity for doctors, dentists and other healthcare professionals throughout the UK. ‘‘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.” If you are not familiar with Skype, just go to for more information.

E-consultations and E-referrals have been well integrated into the practice of medicine for many years in countries such as Holland and in US organisations that include the Department of Veterans Affairs. Early evidence shows online doctor-patient consults can be good for your health.

Researchers at the Mayo Clinic estimated that their e-health system could avoid 1,800 specialty consultations and subsequently reduce direct costs by $450,000 annually, if each provider orders e-consultations two to three times every month. One Canadian organisation reports successfully developing and implementing an e-consultation service which has now processed over 800 consultations with an overwhelmingly positive response from both PCPs (primary care providers) and specialists. In over 40% of cases, a face-to-face consultation would have been necessary had their e-consultation system not been available. This system improved access to care and increased PCP-specialist communication among participating specialists in the region tested.

Requesting an online consultation is fast and easy. Most companies have an e-consult request booking system or just require you send them an e-mail requesting a consultation and some possible times that work best for you. You are then contacted with instructions regarding how you prepare for your consult. The healthcare provider will generally initiate a video call to you using Skype at your agreed time. Payment for an E-consult is usually done online via PayPal or another secure system. For individuals who have problems with mobility, who live very far from health services, or who cannot get adequate transportation to visit their doctor, this may be an appropriate choice.

A 2014 report stated that by providing e-consults for patients who do not require a face-to-face visit and improving access to specialty clinics for those who do costs may also go down. The feeling is even if the time commitment of the specialist completing an e-consult is identical to that which would be expended during a live visit, use of the facility, support staff, and travel would all be reduced. E–consultations have been shown to significantly reduce emergency visits and hospitalisations.