Med board punishes doc for treating patients via Skype

While telemedicine may hold a lot of promise for improving patient care, one doctor in Eastern Oklahoma was disciplined for treating his patients over video conferencing platform Skype for mental health issues, NewsOK reported.

Thomas Trow, M.D., used Skype, claiming he thought it to be suitable for communicating with his rural patients, and prescribing patients Xanax and other powerful narcotics. However, the Medical Board of Oklahoma doesn't approve of Skype as a telemedicine communication system, according to NewsOK. One patient was treated for three drug overdoses in less than six months, and later died, while two others also died while under Trow's care, although investigators said it wasn't attributable to the doctor.

Trow was put on probation and ordered to complete a course on prescribing practices, according to NewsOK.

The article reports that in March, a representative of the Oklahoma Health Care Authority alleged that Trow was "practicing telemedicine via Skype on SoonerCare members and prescribing [controlled dangerous drugs] without ever seeing the patients in person for an initial evaluation," according to a complaint filed in June by a medical board investigator.

Boston-based radio station WBUR, via its CommonHealth blog, asked Joseph Kvedar, M.D., founder of the Center for Connected Health at Partners Healthcare, for his opinion on this case.

Kvedar, a FierceHealthIT Editorial Advisory Board member, said he recognizes that what Trow did is illegal, but also raised the question: Can Skype substitute for an in-person visit?

"Although some studies suggest virtual visits can be useful, the evidence is not yet overwhelming," Kvedar said. "I can't say with 100 percent certainty how virtual visits will best be used, but based on several pilot programs under way at Partners, I have a hunch or two."

The situation in Oklahoma leaves medical providers and HIT advocates in an unclear place, Kvedar said. Follow-up visits to patients the doctor had met before may have been acceptable, prescribing sedatives to patients he'd never met before may not have been.

"But the story does provide a nice backdrop to think about how technology is changing the way care is delivered and what your follow-up visit might look like in the near future," Kvedar said. "We have to do the studies, so don't ask your doctor to Skype you just yet, but I'm optimistic that this technology will change health-care delivery for the better--and soon."

At the HIMSS Policy Summit in Washington, D.C., last week, a panel of government employees touted the uses and potential for telemedicine and argued for a culture change leaning more towards expanded telemedicine services. 

To learn more:
- read the NewsOK article
- read the WBUR post

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