Not enough telling in telemedicine

COLLEGE STATION - Telemedicine has enabled greater access to health services, but the potential communication problems it brings with it could interfere with the technology's potential to improve the diagnosing and treating of illness, says a health communication authority at Texas A&M University.

Telemedicine - the delivery of health related services via remote telecommunications - is valuable for delivering health- related services to remote areas, but the dynamics of the interactions associated with it can increase the likelihood of uncertainty, frustration and unmet expectations for all involved, says Richard L. Street, who has spent more than 15 years studying health communication.

Street, working with the Texas Tech University Telemedicine program, analyzed teleconsultations involving videoconferencing between a patient and primary care giver at one location and a specialist at another in order to identify patterns of talk that could affect quality of care.

While the teleconsultation may allow the specialist and primary care provider to exchange information and ideas, such a teleconsultation may restrict patient involvement in the encounter, he says.

"While patients usually account for about 40 percent of the talk occurring in traditional consultations, they account for only 23 percent in teleconsultations," he notes.

Patients rarely asked questions or asserted a perspective or an opinion - something less than ideal considering how much a patient interacts with his or her doctor can have profound effects on diagnosis, treatment and even health improvement, Street says.

Patients who actively participate in consultations with their physicians, he explains, receive a greater amount of information, understand the issues better and are more satisfied with their care - all o

Contact: Ryan A. Garcia
Texas A&M University

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