SIT down, plug yourself in, look at the screen. The virtual doctor will see you now.
The future face of healthcare was unveiled yesterday, a virtual-reality doctor's surgery in a box – a dramatic breakthrough in telemedicine, currently being trialled in a Scottish hospital, which is set to revolutionise the delivery of healthcare.
Within the next few years the diagnostic booth could be fully functioning and serving Scotland's remotest communities, transforming the way that patients in the country's most isolated areas can be assessed by both doctors and specialist consultants without ever seeing each other face to face.
Using the latest advances in computer and medical technology, doctors will be able to examine and diagnose the conditions of patients living hundreds of miles away – monitoring a patient's heartbeat, their temperature, blood pressure, and carrying out a number of detailed medical examinations without having to leave their surgeries.
And eventually it is hoped that the virtual-reality surgeries could be housed in dedicated booths available for use by the public in community hospitals, community centres, and even supermarkets – improving the triage assessments currently being made by the out-of-hours NHS 24 service.
The system, known as "Health Presence", has been developed by the leading American technology company Cisco and is being assessed in a series of world-first patient trials at Aberdeen Royal Infirmary in partnership with the Scottish Centre for Telehealth and NHS Scotland.
Currently the system is being tested in a small room within the accident and emergency centre at the Royal Infirmary with the "virtual-reality" doctor in a separate room only a few yards away.
The first fully fitted booth is expected to go on trial at a more remote location later this year – probably within a dedicated medical facility in Aberdeen – but eventually it is hoped that hundreds of virtual-reality GP surgery pods could be used to cover the country .
Mr James Ferguson, an emergency consultant and a leading specialist in telehealth, said that the system was set to herald a revolution not just in the delivery of telemedicine, but for health services throughout Scotland.
"We know it's going to work, but before we put it into the remote sites we are trying it in a controlled environment – an emergency medical department where the patients will be seen twice so that we can determine if there are any problems," he said.
"We have found in every case we were able to make the right diagnosis at the end of the day."
Gordon Peterkin, the director of the Scottish Centre for Telemedicine, said the system was part of the centre's drive to provide new solutions through innovative technology to provide better care.
He said eventually it would not simply be used to help patients in remote parts of the country but in urban areas as well.
Nick Augustinos, the global health solutions director for Cisco Internet Business Solutions Group, said:
"We have an experience that is as close to real life as possible.
"It is designed to make patients feel comfortable and secure in an environment where they will receive effective care."
She could look in my ears or take a peek up my noseI HAD been expecting one of the weirdest experiences of my life – talking to a virtual doctor on a screen a few inches from my face while she gave me a full medical.
There I was taking my own blood pressure, hooked up to a machine monitoring my heart rate, blood oxygen, temperature and pulse.
But I was perfectly relaxed. Far from a feeling of being trapped in some sort of oddball video game, it seemed absolutely normal chatting to a doctor I had never spoken to before, as she checked my vital signs through a virtual-reality GP surgery that is set to revolutionise the delivery of telemedicine.
In her "remote" surgery – in fact only a few steps down the corridor at Aberdeen Royal Infirmary's accident and emergency unit – Dr Fiona Mair, a seven-year veteran of telemedicine, was checking on a series of readouts that showed how I was faring.
She could have peered down my throat, looked in my ears or taken a peek up my nose with the high-resolution cameras at my side on the table.
I was, she assured me, going to live for a few more days at least. I had a pulse of 90 and a blood pressure of 143 over 107.
Dr Mair, whose virtual reality bedside manner was impeccable, said: "Your readings are up, but that's because you are in an unusual situation, and is a normal physiological reaction."
She was, she said, delighted with the new system.
"On the whole the public like it. It means they don't have to travel, they are being seen by a senior doctor, and there is no waiting time. It's a win-win situation," she said.
"In the past I have been able to look at ECGs and X-rays. Now I can physically look inside your ear or mouth and see if there are any skin lesions. I can listen to your chest and I can listen to your heart.
"And the image quality is almost as if I can touch you.
"Yesterday we had a woman who examined her hand and wrist herself using the camera. There was a possibility of one of the bones in her wrist being broken. It was the correct diagnosis."
'YOU CAN'T BEAT FACE-TO-FACE CONTACT'THERE is a lot you can learn from face-to-face contact with patients, writes Dr Murray Macpherson.
In medicine, much can come down to non-verbal communication which, as doctors, we are taught to pick up on. You can pick up from various visual cues that a patient is anxious or unhappy about something and may want to tell you more.
You can get a sense that a patient may be talking about one problem, but there is something else also bothering them.
For example, a patient may visit with a sore throat. Through speaking to them face to face and encouraging them to open up, you may discover they have a family history of throat cancer which is why they are so worried. It is important to have eye contact with patients to encourage them to open up like this. You lose that sitting at a television screen.
You cannot truly look into their eyes, you cannot see the tears well up which suggest there is more troubling them.
Having the actual physical presence in the room with a patient is also very important. You can put an arm out to somebody to help comfort them. You do not even have to touch them, but the act of leaning forward, making them feel comfortable in your presence, helps in the consultation.
It is about having empathy with what is happening to them.
Physical examinations are also important when making a diagnosis. Being able to feel a patient's abdomen or listening to their chest is not possible by remote link. Being able to carry out an examination of a patient via a video link is not the same as having them with you in the surgery.
I can see a place for these types of new technology, particularly in rural areas where patients have to travel long distances to see a doctor. But I don't think you will ever really replace that bond you get from sitting next to somebody and talking to them about their problems.
Talking to patients through a screen is not going to be the same.
Dr Murray Macpherson is a GP in Erskine, RenfrewshireThe full article contains 1280 words and appears in The Scotsman newspaper.
