Telemedicine journal and e-health : the official journal of the American Telemedicine Association
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The doctor-patient relationship is one of the most complex interpersonal relationships, in that it involves individuals who are not on the same level, it has not been sought by both individuals, it is emotionally loaded and it requires close mutual co-operation towards a shared goal. A well-managed clinical interview lays the grounds for a good doctor-patient relationship which in turn leads to further advantages. In a classical ambulatory setting the doctor-patient relationship should take into account a number of context variables: physical environment, doctor's clothing and instrumental vs. affective behavior. ⋯ The setting of a videoconferencing interview is completely different as interaction is not direct but occurs via a technological system that enables an unusual form of visual and auditory interaction that may be more or less realistic depending on the technology employed. The growing use of telemedicine and videoconferencing has led to new reflections on the doctor-patient relationship in non-conventional settings and warrants in-depth studies on the dynamics of this form of consultation so as to increase the patients' level of satisfaction in telemedicine. The next step will be to verify experimentally and with adequate tools what the demands of patients are in a videoconferencing setting.
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Telehospice (TH) utilizes telemedicine technology to provide care at the end of life. A bistate project was launched in 1998 to study the use of home-based telemedicine for routine hospice care. Videophones were deployed for telenursing visits and evaluations by social workers. ⋯ After careful review of the records, the coders also made a subjective observation regarding the suitability of each visit for telemedicine. As part of this analysis, we found that 64.5% of home hospice nursing visits could be performed by telemedicine. Using TH, it is possible to reduce the number of in-person visits, thereby significantly decreasing the cost of providing hospice care.