Doctor, patients in touch by video

More care in less time via e-mail connection

By ANNETTE WELLS
LAS VEGAS REVIEW-JOURNAL
January 14, 2008

Walk into the medical office Dr. Loring Jacobs shares with his colleagues along Maryland Parkway and it's bustling with patients, even after 5 p.m.

The receptionist has left for the day, and patients are still awaiting a physician's exam, filling out paperwork, or speaking with nurses about medications.

Most of those patients will wait days, if not weeks, before getting simple test results or answers to questions, said Jacobs, a Las Vegas internist.

In an effort to speed up that process, Jacobs has combined his medical knowledge with that of video e-mail technology. His patients don't have to wait for a nurse or physician to become available, or for one of Jacobs' staffers to make contact with them.

That's because medical test results are sent by video e-mail to patients.

Using his laptop and the video e-mailing system, Jacobs talks into a small camera and records a video message. That message is sent to his patient for review, just as a regular e-mail would be.

Patients who have the technology can respond to Jacobs' e-mail through their own video e-mail. Some may even have a live discussion with him.

Though Jacobs is unaware of any other physicians using video e-mails, electronic communication between patients and physicians is growing, according to the American Medical Association.

Larry Matheis, executive director of the Nevada State Medical Association, said Nevada physicians are increasingly sending e-mails to their patients, "but selectively.'' However, he said, the use of video e-mails in medicine is new to him.

"We get about 30,000 patients a year coming through this office," Jacobs said. "It has become very difficult to get patients their test results in a timely manner, much less establish good relationships with them. Sometimes they have to wait a month or two just to hear that everything's OK.''

Jacobs believes this form of communication is not just for tweens or teens, but the "way of the future" for physicians.

He says having the ability to communicate with his patients allows him to answer more questions and educate them a little better about a condition, medication or overall health care issues.

"For me, this is an opportunity to be more personable with my patients,'' Jacobs said.

"And, if you have a sore throat or runny nose and not something serious, we can talk about this through e-mail instead of you having to wait hours or days for someone to tell you about the common cold.''

Jacobs uses a video e-mailing system developed by VM Direct, a Las Vegas-based Internet technology company. Video e-mails are sent only to patients who consent to the process.

If a test result comes back positive for a disease or condition, Jacobs asks the patient to make an appointment.

Jacobs started using the service about seven months ago after one of his patients mentioned it to him. So far, he is the only one in his office using it.

Jacobs typically sends the video e-mails after 5 p.m.

Though Matheis sees this as part of medicine's future, like most forms of communication between a physician and patient there are confidentiality issues.

"You have to have a system that protects against that,'' Matheis said. "If you can get over that hurdle, then the potential for an e-mail to get to someone it is not intended for declines. But, for the most part, there are a lot of advantages to e-mailing patients, especially with younger patients who are Internet savvy.''

Jacobs said he has introduced video e-mailing to some of his patients. Most of them have given consent.

Robert Gomez, one of Jacobs' patients, can respond to his video e-mails through live streaming video, which can make for an interesting back and forth.

On Wednesday afternoon, Jacobs spoke with Gomez about his annual exam through live video e-mail. During the conversation, Jacobs told Gomez, "Your treadmill today was normal.''

Gomez, who appeared to be sitting in a kitchen or dining room area of a home, didn't respond, nor was there any movement on Jacobs' screen.

The screen had frozen.

After a few minutes, Jacobs was able to resume the live Web conversation with Gomez.

"I'm in the pharmaceutical industry, so I know how important it is to speak with physicians,'' Gomez said through his video feed. "This is very convenient.''

According to the AMA, new communication technologies should never replace interpersonal contacts between physician and patients; rather they should be used to enhance them.

Jacobs made similar comments. One-on-one interaction is still a crucial part of medicine, he said.

However, as the population grows, physicians take on more patients, and people's schedules become more crunched, there is going to be a need to utilize electronic communication methods more.

"It can be more convenient for both the patient and the physician on small issues because patients have the ability to check their e-mails on the go,'' Jacobs said. "And, we can get an answer to them.''