Monday, 8 July 2013

Home visits via the internet: webcam-based neurological exams

Cyberspace neurology consultations. Are you ready for them? #MSBlog #MSResearch

Wood et al. Can a Low-Cost Webcam be Used for a Remote Neurological  Health Technol Inform. 2013;190:30-32.

Background: MS is the most common progressive neurological disorder of young adults affecting over 1 million persons worldwide. Despite the increased use of neuroimaging and other tools to measure MS morbidity, the neurological examination remains the primary method to document relapses and progression in disease.

Objectives: The goal of this study was to demonstrate the feasibility and validity of using a low-cost webcam for remote neurological examination in home-setting for MSers. 

Methods: Using cross-over design, 20 MSers were evaluated in-person and via remote televisit and results of the neurological evaluation were compared. 

Findings: Overall, the investigators found that agreement between face-to-face and remote EDSS evaluation was sufficient to provide clinically valid information. Another important finding of this study was high acceptance of MSers and their providers of using remote televisits for conducting neurological examinations at MSers homes.

Conclusions: The results of this study demonstrated potential of using low-cost webcams for remote neurological exam in MSers.


"This study shows that there is no original ideas. I have been wanting to do this exact study for several years. Unfortunately, the NHS IT and privacy rules and the EU data protection act prevent you using off the shelf free software for this type of study, for example Skype and Google Hangouts. You have to use very expensive proprietary software that only runs on the NHS servers. In other words you need to be shackled to your NHS computer. NHS rules in my opinion block innovation; any attempt to test or try adapting existing innovations for healthcare are trampled and killed by red tape. Most of us are so fatigued by NHS red tape that we don't bother trying new things. I am therefore not surprised that NHS is less productive that it was 20 years ago. The NHS needs a revolution; a new regulatory framework to allow its staff to innovate."

"Would you be prepared to see your neurologist  in cyberspace?"

8 comments:

  1. could it be done through a third party to overcome the NHS?

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    Replies
    1. Yes it is called private pratice.
      Thin end pf the wedge.

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    2. If you look at some clinics in USA you can book an online consultation, if you are a thousand or two miles away, the cost of a flight and hotels make it a sensible option.

      I am surprised the NHS has not started selling off its doctors...maybe they should and take the money rather that letting them have time to stuff their pockets with private pratice cash.

      If I could have done this with my doctors appointment today it would have been great. I could have saved about 1.5 hours of my time travelling from my work for a 5-10 minute appointment that ended in frustration. They would spend the same amount of time, telling me something you probably know already.

      This way we would not be sending people to A&E ER for a scratch on a knee or gone to GPS when a baby coughs.

      Delete
    3. Oh an next thing.....Docotors call centres...but we know it will get exported offshore to save costs.

      We know how much we like them. We can employ from Far East, half of the western Universities have outposts in these countries anyway

      Delete
  2. Last week I walked to the bus stop, took a bus then a cab for a 10 minute bi-annual meeting with my neurologist and thought there must be a better way. There is, so lets use it!.

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  3. It's feasible for me to get transport from Watford to the National on the NHS at whatever ridiculous cost. Something is definitely wrong somewhere. An appointment by Skype or a similar app with NHS levels of security(!) must be better when face to face contact is not needed.

    We could roll this app out to GP's and make everyone's life easier!

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  4. It is the way to go but rather than dive in at the deep end and do a full online examination why no use just find a way for the patient to keep in touch electronically. Find out how they are feeling. you can then gauge the requirement.

    I do not believe you can get the answer to your requirement in one hit, just build up the computer system slowly. That is why these big expensive projects like the NHS system failed to deliver and are canned. Look at how your blog has evolved over a number of years

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  5. As a teacher in universities since 2000 (including at one point of your very own Alison T) I know my workload has incredibly as a result of the rapid increase in "virtual working" I have experienced in the last 5 years or so. Am I better teacher as a result? Yes I think so. Am I more effective? Yes I think so. Has it cut my workload? No not at all. Do my students benefit? Yes?

    I'm in the middle of a fairly hard hitting relapse. I am not currently in hospital due to a combination of an amazing MS nurse, a great deal of email and phone support and a small amount of home support. That nurse has probably saved the NHS thousands. She's certainly kept me in the very best place for recovery.

    The problem though is getting this into the NHS - a system that seemed to have been purposely designed to be as slow moving, unadaptive and un-innovative as possible.

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