EMR in the Age of Skype

The physician community has something of a split persona. Doctors are probably the only community still dedicated to using pagers to communicate with their offices. And yet, it’s no secret that the medical establishment is among the fastest growing segment among smartphone and tablet users. A widely quoted statistic from Manhattan Research stated that 81 percent of doctors would own a smartphone. Manhattan now states that the 81 percent rate has already been reached in 2011, while average America is at 40 percent adoption, according to Nielsen.

So, the medical establishment is clearly ahead of the curve in some ways.

But you just have to juxtapose pagers and smartphones against each other to understand the real advantages of the smartphone. If you have an iPhone and your doctor has one too, you’re going to probably take it to the next level, right? Yeah, FaceTime. (Surprisingly enough, that’s not what the statistics show. A full 78 percent of respondents said they didn’t want to chat or IM with their doctors, according to this recent article on Technology Review.)

For this kind of face to face interaction to work, it really depends on how good a rapport you have with your doctor, but if there’s a good doctor-patient relationship, you might just consider making the move. Let’s be clear, doctors are not taking to video-conferencing via Skype or Face-Time in droves (or rather, there are no published statistics from the bean-counting firms about the trend), but there are some anecdotal stories on blogs like Dr. Brian Goldman’s on CBC.ca. But it’s interesting to think ahead to how video consultations might change EMR.

The Pros:
Direct connection with your doctor, in an instant: Great for the patient, furthers doctor-patient relationship but could be something of a double-edged sword.
Show, don’t tell: For those times, when you don’t know whether a symptom needs an in-office visit, or when you’re not in town and some conference magic and ePrescribing can save the day.
No more Lost in Translation: The paging process has that additional office staff layer in between, who convey your message to the doctor. It’s tempting to think that you can axe the middleman with Skype.

The Cons:
Direct connection with your doctor, in an instant: How long before patients are calling at all hours of the night demanding FaceTime? Blackberries and iPhones might simply be another way to tether yourself to your business (Next time you see 24-7 IT support, know that there is a person dreading the Blackberry ping somewhere in the world)
Too many interruptions spoil the day: Pagers let the doc put off calling till she’s done with the task at hand, not when the patient demands.
Privacy issues: From an EMR perspective, this is the big kahuna. There are several nuances to consider. The doctor-patient line has to be securely done, with HIPAA in mind. For CYA purposes, video-cons will probably need to be recorded.

Microsoft’s main intent behind its purchase of Skype might be its conferencing features for business, but wouldn’t it be awesome if Skype also showed up in HealthVault (which only has image saving capabilities so far, according to this Q&A on MSDN forums)? Or if any advice dispensed via Skype could be saved into your doc’s EMR system and become part of your health profile. There are several possibilities out there when you throw video into the mix, and they seem quite interesting.

About the author


Priya Ramachandran

Priya Ramachandran is a Maryland based freelance writer. In a former life, she wrote software code and managed Sarbanes Oxley related audits for IT departments. She now enjoys writing about healthcare, science and technology.


  • As a family doctor that doesn’t take insurance, i’m free to use any form of electronic communication and i see the biggest demand for email, text, twitter, facebook, skype (skype is way last). Patients prefer convenience over face to face time so i see the digital use only growing as technology improves its quality and access.

  • Dr. Josh, thank you for your comment. It’s interesting what you say about Skype. I would have thought the Skype trend would be reverse for a practice like yours, where the emphasis is more on doctor-patient interaction. I too see digital use expanding, but I also worry that it means overworked doctors and demanding patients (been there, done that with IT support. Blackberries simply meant a 24X7 tethering to work)

  • Hello

    I am researching the use of Skype or EMR Facetime for online doctor consulations with remote mine sites in the Pibara region of western australia. Is anyone aware of a medical practitioners who can offer a diagnostics service in conjunction with site based paramedics.
    My tel 0061 400 140898

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