chrisI’m not a big user of Skype. I have an account, I set up a username a few years ago and I can count the number of times I have used it on one hand. Despite falling into the demographic of a typical Skype user – (between the ages of 18-35 and ‘socially engaged’), I do not find myself using it as a main communication tool. Phone calls, text messages, emails still seem to be the norm for me. But I can see how Skype is more appropriate for certain types of communication where a real time visual is a requirement.

Following David Cameron’s speech at the Conservative Party Conference, I found myself questioning Skype’s potential in improving patient experience and clinical outcomes. As part of a promise for seven-day GP access, the Prime Minister announced an extension to the ‘Challenge Fund’, a £50m pilot scheme, which includes offering Skype consultations to patients.

And David Cameron is not the only politician who believes that Skype consultations could have real merit in healthcare. Earlier this year, health secretary Jeremy Hunt announced that his “pet idea” was for GPs to be able to Skype hospital consultants before a referral, to check that the referral is appropriate, and to learn more about the condition.

Reflecting back to some follow-up GP appointments after my knee operation, I find it hard to imagine these being delivered via Skype. Firstly, there was clearly a physical requirement to check the progress of my knee’s movement and strength, plus I live very close to my local practice. I also think that there is an element of reassurance by seeing your GP face-to-face, that you have been comprehensively diagnosed or ‘checked-up’. I can imagine that had this appointment been via Skype, I would have ended up going to the doctor anyway – just to make sure.

But maybe I am not your typical candidate for Skype consultations. I would suggest clinicians should be very selective on who would qualify. Those with long-term health conditions who require regular check-ups, or those that live in remote areas are stronger candidates for the service.  But at the same time they of course, should not be discriminated against and instead offered Skype on the understanding that this is one of many options available to them.

Although it might be slow progress, demand is growing as technologies like Skype become more popular and mainstream. At the recent Healthcare Efficiency Through Technology Expo in London, Michael Seres, a long term condition patient who had a bowel transplant, talked about how he asked his transplant team if he could communicate via Skype, rather than travelling an hour an a half to the hospital. Unfortunately all bar one of the consultants and administrative staff refused to be part of the Skype call, which resulted in the clinician Skyping him from his home!

Whilst there has been some progression of the use of Skype and other VOIP (voice over internet protocol) technologies, categorised by the term ‘telehealth’, it has generally been met with mixed reactions from patients and clinicians for many years now. Questions have been raised to whether the technology can really save time for busy GPs and if telehealth is in fact a viable care model.

At the moment it seems that there are more risks than rewards to using technologies like Skype in GP practices. There are cases where Skype can offer more convenient access for patients, potentially reduce waiting times and provide a useful tool for initial consultations.

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On the flip side, how do GPs account for technology failures such as a broadband outage? Are there sufficient audit trails with videoconferencing? How are videos saved and protected? If a GP misses a vital symptom, who is liable? The people who may value this service the most, such as the elderly and infirm, may not have access or the technology skills to use such software.

As technology adoption develops, inevitably we will reach a time when using Skype in healthcare will become the norm. The extension to the ‘Challenge Fund’ outlined by David Cameron will help chosen ‘pioneer’ practices address unanswered questions and teething problems as the demand and expectation from patients rises in a time when getting an appointment with your GP is neither timely or convenient.

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