Evidence still scarce on the uses of Skype in clinical practice

Anecdotal evidence would suggest that in Australia at least, Skype is the most commonly used platform for telehealth provision but exactly what it is used for – and its clinical and economic benefits – still remain unclear, new research has found.

In a literature review of international research on the uses of Skype in clinical settings, University of Queensland researchers have found that Skype was most commonly used in the management of chronic conditions such as cardiovascular diseases and diabetes, followed by educational and speech and language pathology applications.

The researchers aimed to investigate what uses Skype was being put to, for what patients and in what settings. In all but one case Skype was reported by the authors to be feasible and to have benefit, but those benefits remain unclear in the absence of formal studies, they conclude.

The research, to be published in the International Journal of Medical Informatics, follows previous research by the lead author, UQ's Nigel Armfield, on the clinical use of Skype. That 2012 research found there was no formal evidence in favour of or against the use of Skype in any clinical setting.

However, as the researchers write, Skype is very obviously being used by clinicians. Figures released last year by the Australian College of Rural and Remote Medicine (ACRRM) show that the vast majority – 89 per cent – of telehealth providers registered on its telehealth provider directory use Skype to conduct telehealth consultations.

Dr Armfield's literature review found that there were eight clinical application areas using Skype that had been formally described, with chronic disease management and clinical education representing 48 per cent of articles reviewed.

Speech and language pathology, critical illness, mental health, pathology, urology and orthopaedics were also described. Of the studies, all but one were supportive of the use of Skype.

Most of the studies were done in developed nations, despite Skype's obvious potential for use in the developing world.

“While not all studies considered the economic effects associated with using Skype, those that did agreed that Skype was more economical than face-to-face appointments with savings accruing from avoided travel,” the researchers write. “This is unsurprising since there are no initial or ongoing technology costs associated with the software.”

They also found that there is limited evidence on the technical adequacy of Skype for telemedicine with only two papers commenting on image quality.

However, only one paper described problems with internet connectivity. What was mostly raised as a concern with using Skype clinically was its security and privacy, which the researchers say is likely to remain a hindrance for its further uptake in some jurisdictions.

“Since Skype is free, easy to use and may be installed on a range of devices, its clinical use may grow,” they write. “It may be that the use coalesces around a small number of clinical application areas or settings, or that Skype is found to be more generally useful and acceptable to clinicians and patients.

“Alternatively, it may be also be found to be inadequate for some clinical work. At the moment, the picture is still unclear.”

Posted in Australian eHealth

Comments   

# Terry Hannan 2015-07-24 18:13
Telehealth-a short observational study report with an unexpected beneficial climate change findings.
J. L. do Campo MD FRACP1; C. Pava, MD FRACGP2, T.J. Hannan MBBS FRACP, Sandy Gopol , James Lutterall , Environmental Scientist. Consultant Physician, Department of Medicine, Launceston General Hospital, Charles Street, Launceston. Tasmania. 7250
Abstract
This paper reports a small observational study on Telehealth and its potential benefits in a regional health location in Tasmania, Australia. Initial findings indicate benefits from e-referrals between an individual Specialist General Physician and Primary Care Practitioners (PCP) that relate to reduced referrals to the local hospital clinics and reduced patient transportation. A surprising finding that lies outside the standard measures of inter-hospital and inter-clinician and inter-patient communications is the potential benefit to climate change factors with a reduction in significant carbon emissions relating to reduced patient transportation.
We see Telehealth as not only supporting more efficient patient care but also having direct climate change benefits.

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