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Use of telemedicine ‘exploded’ during pandemic

32nd IHCA AGM, Saturday 10 October 2020, Virtual Annual General Meeting and Conference

The use of telemedicine has “exploded” during the Covid-19 crisis and more training for doctors is required, the IHCA annual conference was told. Dr Graham Billingham, Chief Medical Officer, MedPro, Berkshire Hathaway, told attendees that “it is forecast that this will be a US$29 billion industry going forward and that between 10 and 20 per cent of all office visits in the future may be from telemedicine”.

Dr Billingham presented research from the experience in the United States. It was noted at the conference that the recent trend towards telemedicine use has also been reflected in other developed nations, including Ireland. In the US, during the current crisis, hospital and clinic visits dropped and telemedicine consultations increased.

“It wasn’t one for one, they didn’t completely displace hospital visits and as hospital visits have come back over the last four months, telemedicine has dropped back down, to currently between 10-20 per cent,” said Dr Billingham.

He noted that recent months have exposed how 10 per cent of the US population has limited access to Wi-Fi “so we had a digital divide… we [are also] very concerned about doing adequate physical exams through telemedicine”.

Telemedicine’s limitations where there are language barriers, and in delivering consultations for people with an intellectual or cognitive disability, was also referenced.

“We have seen a marked increase in patient volume,” continued Dr Billingham.

“Patients are more complex, almost every speciality was involved with telemedicine. There is a marked increase in the use of this technology and we all know that technology has learning curves associated with it and we have been struggling with those in order to meet the needs of our patients.

“We don’t think telemedicine is going away and we expect to see more development in this area and it should be easier in the future for practitioners to deliver the service.”

The experience during the pandemic was that telemedicine seemed to work better for GPs with established patients rather than new patients. Also addressing the conference, Dr Rob Hendry, Medical Director, Medical Protection Society, said telemedicine has pros and cons.

“But as we get used to it, probably through the training side I think we can get the good bits as well as the limitations.”

“Doctors have almost been on a self-taught crash course during this [pandemic],” he said.

“There is going to be a lot more training. We certainly have been producing a series of training webinars and so forth. A lot of specialities have adopted it and come at it in different ways.

“I think GPs probably have been more used to assessing people remotely. I was speaking to one person who was running a fracture clinic and using video, and that is perhaps where they were not used to doing it. Training is important. Technology will be improving, there is huge investment going into new platforms.

“I think for some specialities it may well become mainstream. For example, certainly speaking to a number of rheumatologists, a number of them have found that really positive and we have also had some good feedback from psychiatrists on its use.”

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