Tag: Telehealth

Doctorology: Communication. It’s All Good

“Doctor’s office; please hold.”

You’ll never hear that when you call me. Never. You’ll also never get an automated answering system (I’m just referring to office hours, of course. Evenings and weekends the phone goes to Google Voice. More on

that below.) We are also in the middle of a communication revolution. There are now so many other ways patients can contact me other than the telephone, the silly thing is almost becoming obsolete. I took amoment the other day just to go through all the various ways patients contact me.


Still the most reliable fallback. Most synchronous form of communication: both parties willing and able to talk in real time. After hours, Google Voice (free) transcribes messages and texts them to my smart phone. As a rule, patients do not call my cell phone, although I’m not shy about giving out the number. Then again, those who have my cell number usually use it for…


At the moment, it’s just a few patients, but I anticipate more and more of them will partake as time goes on. It doesn’t happen very often, and so far it’s never been inappropriate. Med refill requests and pictures of kids’ rashes have been the mainstay so far. I like it. By it’s very nature, the people choosing to text me understand the limitations of synchronicity, ie, they don’t get bent out of shape if I don’t answer them right away, and they understand that it’s just for relatively minor issues. I also use it to communicate simple quick questions to specialists with all the same mutual understandings (minor issues only; response time unimportant).

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Safe Skyping: The Evolving Doctor-Patient Relationship

Skype and videoconferencing have surpassed the tipping point of consumer adoption. Grandparents Skype with grandchildren living far, far away. Soldiers converse daily with families from Afghanistan and Iraq war theatres. Workers streamline telecommuting by videoconferencing with colleagues in geographically distributed offices.

In the era of DIY’ing all aspects of life, more health citizens are taking to DIY’ing health — and, increasingly, looking beyond physical health for convenient access to mental and behavioral health services.

The Online Couch: Mental Health Care on the Web is my latest paper for the California HealthCare Foundation. Among a range of emerging tech-enabled mental health services is videoconferencing, for which there is a growing roster of choices for platforms that market a variety of features beyond pure communications.

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Frances Dare, Cisco: Global Health Leaders’ Survey

Cisco’s Frances Dare is an occasional but regular and welcome guest on THCB. Frances spends a lot of time looking at the environment for Cisco’s products and services in health care both in the US and internationally–think demand and readiness bandwidth and live video! Earlier this year Cisco released the results of a survey done with numerous international leaders in health care about their problems in general and their readiness for telehealth solutions in particular. The overall verdict? It’s getting pretty close, especially outside of the US. For the longer story, grab a cup of coffee and watch this interview in which I bring chat and Frances brings data!

Advances in Online Care and Telehealth

At a recent symposium on Online Care in Hawaii, two Family Physicians and a primary care Internist participated in a panel in which they described their experiences with Online Care and Telehealth.

– Ron Dixon, MD is the Director of Massachusetts General Hospital’s Virtual Practice Project. He talked about his practice using videoconferencing for patient visits, and discussed results of his research on e-visits, which includes the largest randomized comparative trial to date of videoconferenced medical visits versus face-to-face visits.

– Peggy Latare, MD is Chief of Family Medicine at the Hawaii Kaiser Permanente Medical Group, and the physician lead charged with the implementation of KP HealthConnect in the Hawaii region.  For over two years she has used Kaiser’s online tools on a daily basis for communicating with and caring for her patients.

– Dr. Michele Shimizu, a native Hawaiian, is a family physician in private practice on the Big Island, and uses the American Well platform for Online Care to maintain relationships with her former patients on Oahu, despite being separated by more than 100 miles of Pacific Ocean, and to treat new patients as well.  She uses the web-based Telehealth system made available through HMSA, the Blue Cross Blue Shield of Hawaii ,  on average three times a day, mostly in the evenings.

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