Journey to the Teledactyl?

In the wake of COVID-19, we have all adjusted our ways of working. Some Health & Social Care Professional (HSCP) services were in a position to turn to Telehealth using telephone and video to maintain service levels, keep up with demand for services and keep themselves and service users safe.

So is the concept of Telehealth new?

No, in fact as early as 1879, a Lancet article talked about using the telephone to reduce unnecessary visits to the doctor’s office.  In the 1920s, a magazine Science and Invention put forward the idea that doctors would use television and microphone and look after their patients via a “teledactyl” “a device with appendages that would respond to remote manipulation by the physician, allowing the doctor to feel his patient, as it were, at a distance.”

One of the most famous uses of hospital-based telemedicine took place in the late 1950s where a closed circuit television link was established between the Nebraska Psychiatric Institute and Norfolk State Hospital to facilitate psychiatric consults. No surprise that it was space research that made improvements and NASA first began performing physiologic monitoring over a distance in the ‘70s.

HSCP use of Telehealth – HSCP TH Survey

What you told us in a snapshot in time in April this year

• In April, 18% of HSCP had no experience of using telephone or video as part of their clinical work

– It is hoped that with access to supports such as webinars, training, communities of practice, equipment & licence roll out, HSCP will be empowered to give video enabled care a go!

• Only 3% of HSCP were using video enabled care pre COVID-19

– We anticipate that this will have increased by now and look forward to hear information from the Video Enabled Care Healthcare Professional Survey

• Just 21% of HSCP felt very or completely confident in using video consultations as part of their work.

– It would be interesting to take a snapshot at this point, six months on to assess any change … Supporting materials are under development.

So why does it matter?

HSCP who took up video enabled care were impressive in their ability to adapt at speed. Perhaps what amazed us even more, though, was how well service users embraced this new approach. Patient choice must be key going forward. Users of services cannot be expected to travel and leave work for every health problem when they manage most of their daily lives digitally. Service users deserve to have a choice.

In the recent physiotherapy webinar , it was heartening to hear colleagues say they will definitely keep this mode of delivery in their arsenal and how one of the many benefits of video enabled care is patient empowerment towards self-management – all done while keeping patients and frontline workers safe through reduced community contact and transmission.

https://www.ehealthireland.ie/National-Virtual-Health-Team/Video-Enabled-Care-Webinars/

---

Indeed, perhaps the most endearing benefit from telehealth is how it strengthens rapport with our patients – seeing them in their pyjamas, “meeting” dogs and cats, and feeling amazed after a successful video consult session with a 90-year old.

Some of the benefits to the Health Services and by extension, to the populations identified are:

So we urge HSCP to seek out opportunities for video enabled care, access training, link with colleagues and join the community of practice that is emerging. Sustaining this new way of working will need to be underpinned by HSCP feeling competent and confident in use of Telehealth. Let’s keep abreast of the changes that are happening in so far as possible and avoid a Foil Arms and Hog “The Online Doctor” scenario!

Will we ever reach the Teledactyl?

Perhaps not but do we need to?

Surely, the measure of success will be when telehealth is simply seen as one way of delivering care, instead of separate from other interventions, and when it is embedded into workflow with service user choice and HSCP confidence & competence as central components.

We cannot underestimate the value in the ongoing surveys being completed by universities, professional bodies and our HSE colleagues. We need you, the HSCP voice, to continue engaging in these forums so that you can help us understand clinicians’ and service users’ experience and feedback in order to shape the future design of services.

One thing is certain – Telehealth is here to stay. The only thing we as HSCP need to figure out is how to continue to improve telehealth services for our patients and ourselves.

If you would like to share your work in Telehealth, please join the conversation below.

This Blog post was written by Marie Byrne and Siobhán Keohane, Telehealth Project Officers in the National HSCP Office.