Due to the corona crisis, doctors and patients are suddenly more dependent on digital communication. General practitioner Bart Timmers has years of experience with video calling. ‘Online contact is different, but no less good.’
He remembers as if it were yesterday when he had his first video call with a patient. That was eleven years ago. As part of a pilot project, home care organization Sensire placed cameras in clients’ homes, with the aim of maintaining contact with clients from a distance. Home care asked GP Bart Timmers from ‘s Heerenberg if he wanted to participate in the pilot. But what a pleasure, was his response. “I have always been very interested in technological innovations. It was fantastic to see a patient appear on my screen.”
However, the system never really got off the ground. It worked, but was also cumbersome. Technical problems got in the way of smooth video calling. Not so many people had a smartphone or tablet as they do now. But from that first time, Timmers was enthusiastic. “I then experienced how much more image bubbles offer than just telephone consultation. You can make real contact, see how someone reacts, see emotions. I now have a lot of experience with it and I know: an image consultation is almost as good as a personal conversation.”
Just call
Thanks to the corona crisis, remote care has gained momentum. No matter how sad the occasion, Timmers is happy with this development. ‘We can still call patients,’ many of his colleagues told Timmers for years. Because yes, they were used to working that way. He vehemently disagreed with that. “With a normal phone call, the contact is much less personal. And you certainly can’t do research. Moreover, these kinds of new forms of communication make it easier for many patients to contact us. They can do this from home or at work. On the other hand, it helps us doctors to stay even closer to our patients.”
According to Timmers, he can do more during an image consultation than many patients initially think. In addition to answering questions, for example, also performing some physical examinations. Think of assessing skin complaints. He even looks into patients’ throats through the camera. “Of course there will always be complaints that I can only assess in the doctor’s office. But I think that GPs could handle at least a third of their consultations via video calling. For example, there are many complaints or treatments where I want to see a patient again after a while in order to check how things are going. Those check-up conversations can often be done digitally.”
Online walk-in consultation hours
He mentions another example of such a convenience service, the online walk-in consultation room, which he has been offering for a few months now. He had been testing that for a long time. But when the corona crisis came, the makers of ArtsOnline accelerated the rollout of the system. As a patient, you create a one-time account on a secure website. From that moment on you can register for the online consultation hour without an appointment.
“During the corona crisis, I opened my virtual waiting room for an hour three times a day,” explains Timmers. “A maximum of six patients can ‘take a seat’ in it at the same time. They receive a text message when the last person in front of them is next. And also if it is their turn. They can then ask me written questions via a chat function. want to, I turn on the camera so that we can also talk to each other — with images. That almost always happens. For example, yesterday I was able to check the red spots under someone’s feet from a distance via the video link. And the respiratory rate of another patient counted, to assess whether he was short of breath. I also write out medicines following an image consultation.”
Digital divide
The corona crisis has therefore given digital communication a huge boost. “Healthcare has changed permanently as a result,” Timmers believes. “As far as I am concerned, in a positive way. It is really an enrichment, for patients and doctors.” In any case, he has now given the online walk-in consultation hour a permanent place in his practice. Still, there is one thing he is concerned about. “The patients I make video calls with are of all ages. But I do notice that the elderly are often more hesitant about it. There are also still people without a computer or e-mail address. They cannot, for example, use the online consultation hours. so make sure that there is a digital divide in healthcare. I myself therefore contacted the library and welfare organizations in the area. They organize all kinds of activities to make the elderly more digitally literate. I regularly tell them how useful the internet can be, including for arranging your care. Especially for the elderly, who on average need more care, there is still a lot to gain in this respect.”
Laptop out of the bag
Does that digital skill always go wrong? Certainly not. An 80-year-old lady thought it was a strange idea to talk to the doctor via a tablet. She first called him on her landline and then started the video connection with him. “While she happily continued talking, I secretly put the phone down,” he laughs. “‘You can hang up now, you know,’ I said to her through the camera. Then she looked up in surprise. ‘It’s just like you’re real, doctor’, she responded. A good example of how patients, once they have crossed the mental threshold, they often suddenly become enthusiastic.”
Another example: about six years ago, Timmers took part in a pilot project. This time, the home care organization had provided tablets to clients. They could then install a special app to make video calls with their GP. A 78-year-old patient was unable to do so. “Then come to the regular office hours,” Timmers told her. “In my office, she suddenly took her laptop out of her bag. I then showed her how the system worked. She loved it. It gave her the feeling that she still belonged.”
Privacy
Is all that remote care safe? You don’t want your medical history to be exposed. Doctors are now using secure systems for video calling and other remote care, also under pressure from stricter privacy laws. “In the early years, patients simply emailed to the general e-mail address of the practice,” says Timmers. “Now such a thing is unthinkable. An open e-mail server does not have enough protections built in to guarantee privacy. That is why e-consultations have been running via a specially secured patient portal for years.”
This can also be done digitally
- Collect and manage your medical data
A personal health environment (PBL) is an app or a website in which you can collect information from all your healthcare providers. So from your GP as well as from your specialist, pharmacist or dietician. on digitalzorggids.nl you will find a decision aid to find the PBL that suits you best. - Online therapy for mental problems
There are all kinds of e-mental health, from self-tests to full-fledged talk therapy via chat or webcam. A successful example is Trimbos’ self-help program Color your life, intended for people with depressive symptoms. on mentalvitaal.nl you will find a lot of information and an overview of reliable e-mental health programs. - Webcam consultation from a dermatologist
skinconsult.nl is a website with reliable information about skin problems and a digital diagnosis tool. If you want, you can also request a personal online consultation with dermatologist Dick van Gerwen via the website
Read all about the coronavirus in the file: www.plusonline.nl/coronavirus
Watch the videos in which Bart Timmers answers questions from readers about the coronavirus: www.plusonline.nl/dokter-bart- Geef- Antwoord
