The Doctor Will Skype You Now

Parkinsons patients benefit from virtual house calls

(RxWiki News) A doctor’s appointment without even leaving the house? Virtual house calls could be an important alternative for patients limited by distance or disability.

A recent small study looked at the use of doctor’s appointments for Parkinson's patients held through web-based video like Skype.

The study found that web-based teleconferencing – or “virtual house calls” – were comparable to in-person office visits without the added time and travel costs. 

Each virtual house call saved the participants and their caregivers an average of 100 miles of travel and three hours of time.

"Attend all scheduled appointments."

Ray Dorsey, MD, of Johns Hopkins University School of Medicine, and colleagues conducted a small study with 20 Parkinson's disease patients. All patients had home internet access and received care for seven months.

Nine of the study participants received three virtual house calls and 11 traveled to a physician’s office three times.

Researchers evaluated the number of visits completed, time and travel savings and quality of life as defined by a 39-item Parkinson Disease Questionnaire.

Both groups averaged a similar number of missed appointments. Quality of life was also similar in both groups.

The savings became more apparent when it came to time and travel.

The researchers pointed out that these savings may be of particular importance to those who live far from specialists.

The authors noted that there were a couple obstacles to implementing doctor appointments via teleconferencing. Medicare rules do not allow for remote care and there may be issues with doctors practicing outside their licensed state.

Steven Kussin, MD, FACP, patient advocate and author of Doctor, Your Patient Will See You Now expressed additional concerns to the dailyRx. According to Dr. Kussin, medicine is too complex and individual needs are too unique to be explored through video conferencing alone.

"Medical care today is characterized by problems with communication, continuity and coordination," said Dr. Kussin. "Patients are already experiencing an increasingly a disembodied, impersonal experience when they are actually in the same room with their doctors, let alone hundreds of miles away."

While Dr. Kussin acknowledged that the researchers intended that the virtual house calls be used for those who have difficulties attending appointments, he expects that the method would be overused.

 "As so often is the case in an overloaded system, short cuts become institutionalized and the exceptions become the rules," said Dr. Kussin.

Dr. Kussin added that telemedicine was appropriate for viewing X-rays and physician to physician consultations. He stressed the importance of it being used selectively.

The study authors noted that larger studies are needed to confirm the effectiveness of virtual house calls. 

The study was published in the March issue of JAMA Neurology.

Funding for the study was provided by grants from Google and Excellus Blue Cross Blue Shield, the Paul Beeson Career Development Award Program and the Parkinson’s Disease Foundation Summer Student Fellowship.

The authors reported links to ConsultingMD, Medtronic, Presbyterian Home for Central New York, Verizon, Lundbeck, Google, Blue Cross Blue Shield and the Susquehanna Nursing and Rehabilitation Center. Several authors are also developing a patent application related to telemedicine.

Reviewed by: 
Review Date: 
March 13, 2013
Last Updated:
December 30, 2013