Day by Day

I wasn’t well last week and had a video appointment with my GP while waiting for the power company’s contractor to arrive at my new home to reconnect the power that the previous owner had disconnected. After the appointment, I reflected on some myths about telehealth.

1. Telehealth overcomes time and geographical constraints for all types of health issues.

No true. It was hard to do the video appointment in my car. I had to hold my phone still, concentrate on what we were talking about, and also look out for the contractor. It felt like I was being rude to the doctor. He wanted to know if I had a fever but I couldn’t tell him – it would have been good if my thermometer’s battery hadn’t been flat when I tried to take my temperature that morning. In the end, we came to a consensus about what was wrong with me and he prescribed an antibiotic for me to collect from the pharmacy without having to pop into the practice first to get the prescription.

Generally speaking, the best way to do a diagnostic process is in-person, when your doctor can do a physical examination. There are circumstances when a physical examination is not necessary – follow up appointments; check up appointments for long term health issues; appointments where the doctor and patient know one another; meeting a specialist to discuss a referral that doesn’t need a physical examination because there will be a second appointment; mental health appointments, discussions and interactions; and appointments where a discussion is the focus of an interaction with your doctor or nurse.

2. Young people find it easy to use telehealth for interacting with their doctor or nurse.

It depends. There is a belief that young people automatically know how to best use technologies for communication because they grew up using them. Not all young people have had this opportunity. On the other hand, there is so much variety for interacting with others via technology that young people choose which tech to use according to their preferences and what their interaction is about. When given a choice of technologies for interacting with their doctor or nurse, they will select the tech that best meets their need, e.g. a message via patient portal with a question, or a phone appointment via Whatsapp to discuss a long term health issue, or an in-person appointment when they want to show their doctor or nurse something they are concerned about.

3. Old people tend not to use technology for communication purposes.

It depends. They have used the phone all their lives, so talking to their doctor or nurse on the phone is something they don’t even think of as telehealth. On the other hand, the fastest growing video and social media technology adoption recently has been among grandparents so that they can keep in touch as their distant grandchildren grow up. It is more true to say that families and people with friends who live far away are likely to use video tools than those who live a short drive or walk away from one another. While old people may not be as confident as young people are with technology (other than the phone), they also have preferences according to their reasons for interacting with others via tech. They use video to talk to their grandchildren, the phone to talk to friends, and don’t be surprised when you find them on Facebook or equivalent for social interaction, e.g. as members of a quilting group.

Telehealth is, therefore, not a ‘one size fits all’ solution for health care at a distance. Once the myths are out of the way, telehealth choices become about why and not how. Telehealth becomes part of the in-person diagnostic and treatment process, rather than replacing it. Hi-touch (in person, face to face) becomes blended with hi-tech (via telehealth). If you know your GP or nurse (hi-touch) and you don’t need a physical examination to solve your health problem, your why determines how (hi-tech or hi-touch or combination of both) you get a solution.

Tell us about your observations and experiences. To complete our surveys follow these links:
Consumer and whanau (if you’ve had a video or phone appointment with your GP or nurse in the last year)
Provider survey (if you’re a general practice doctor or nurse)

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