Modern Doctors’ House Calls: Skype Chat and Fast Diagnosis | Hacker News Reader

Modern Doctors’ House Calls: Skype Chat and Fast Diagnosis

nytimes.com

30 pointsdnetesn18 comments

I'm curious: the folks reading HN are obviously pretty comfortable with technology, but I get the impression from the comments that almost everyone has heard about telemedicine, but virtually no-one actually uses it.

For those who have not used telemedicine services, why is that? Couldn't find one? Preference for an in-person visit? Concern about the accuracy of the diagnosis? If you have used a telemedicine service, how did you find the experience and would you do it again?

[Full Disclojure :) I'm a physician currently working on umedoc.com, one of thousands of telemedicine startups...]

I haven't heard of one from someone I trust yet. I would like to, with a positive recommendation.

I've used a telemedicine service: FaceTime with my grandmother who is a nurse.

But to more seriously answer your question, I really just haven't known about actual services that I could use. Also, how does it work with health insurance?

Meta-comment: it is gratifying that this article legitimately covers the relevant pros and cons (including the unexpected one that it may raise medical costs).

These days (and maybe perhaps for a long time) article either cover only one side or have pseudo-balance (e.g. quoting anti-vaxxers as legitimate)

Definitely seems like the future. Meadow (YC W15) is doing Skype evaluations for renewing medical marijuana prescriptions: https://getmeadow.com/md-renewal

Not sure whether they're only doing renewals because of legal regulations or to limit actual fraud.

As much as I'd like to see something like this be the future, sadly Skype is not HIPAA compliant.

As a founder of a tele-health technology company, and I can say from my vantage point that this type of service is the future. We are just waiting for the payers, both private and government, to catch up, as well as appropriate legislation to be changed/enacted.

Honestly-not-being-snarky question: how long do you give it until insurance companies start erecting barriers (e.g. preauthorization) to in-person visits?

Or hire providers themselves and own the vertical.

Don't do your medical consultations over insecure channels.

The most insecure channel is likely the insurance company that's retains your medical records (sorry, "billing data") indefinitely. I'm three for three on past health insurers getting hacked and disclosing everything, and have more worthless third-party "credit protection" settlements than I could possibly use (just enter your SSN!).

I came to post the same thing. I would want an actually secure line (ZRTP, or similar) to be used for medical communication.

What is the worst that will happen?

Of course, I'd like to see secure communications be the norm. So I'm not saying you're wrong. I am just saying that I'm not worried too much about this.

Let's look at the secure channels when I visit the clinic.

Like the secure channel at the office where I physically go in and the doctor discusses medical stuff with me and the door wide open? Or where even when the door is closed I can hear his consultation with the people in the next room? That's gotta be some violation.

Or the secure channel where the receptionist uses a 25 year old computer system to enter my SSN and scan my insurance card? A credit card number is worth next to nothing. A medical ID number is worth a lot more. And considering all the break-ins recently...

Or the secure channel where I hear all sorts of things as a visitor at a hospital? They'd openly discuss my mom's cancer treatments in the hallway where everyone could hear.

Or the secure channel where I have to provide a doctor's note to my supervisor because otherwise it's unexcused. And now HR knows I was at the doctor. And if I have lots of excuses, I might lose my job. Not the kind of security you're talking about, but it's a different kind of security. :)

Secure channel or not, if someone wants to get information on me, they're gonna.

Actually, I'm now quite depressed and I think I want to have a quick nap. :(

Microsoft may already have access to your medical data by other means.

That said, if you need medical consultation, get it, through whatever means are available to you. If I were in a financial tight spot and the options are "wait for it to be bad enough for insurance to cover it" and "get early care to prevent it from ever getting that bad, but over an insecure channel" I would personally choose the latter. YMMV

> Don't do your medical consultations over insecure channels.

It's not any more insecure as the last dentist office I went to (and no longer go to). They had the username and password for the system written on a sticky note next to the computer. Let's just say I'm more concerned about doctors who have real offices leaking my data than some guy on skype.

The sad part after working in IT for a couple of years - I would not be surprised at all if I could audit some medical offices and find the credentials-on-sticky-note or computers-never-locked security issues.

Like a phone call?

(I know, I know, "not like they do anything useful for you that way in the first place", but you get the point.)

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