03/01/02 - The Herald

On-line doctor could replace hospital visits

Alan MacDermid & Murray Richie

A pre-recorded telephone questionnaire soon could replace repeated hospital visits for patients with chronic illnesses. The Scottish Executive is already backing the first full-scale trial of the system, devised by an anaesthetist turned computer buff as the latest answer to swelling waiting lists. It would mean that regular routine care for patients with chronic illnesses could be carried out in the same way as home banking.

The patients could go for months without setting foot in hospital - as long as they did not mind using their telephone keypad to answer questions from a recorded voice. Face-to-face consultations with a specialist also could be held in a GP practice through video conferencing connected through the internet.

At the heart of Dr Pradeep Ramayya's system is a computerised patient record capable of including X-ray or scan images as well as up-to-date notes, test results and prescription regimes. It is already undergoing trials in the rheumatology department at Glasgow Royal Infirmary and an accident and emergency department in Hereford. "By reducing the time consultants have to spend on routine monitoring appointments, and in some cases the hours of travelling to outreach clinics, they will have more quality time to spend with patients who need it most," said Dr Ramayya.

He formed his own company, AxSys Technology, after setting up the first intensive care unit computer system at Aberdeen Royal Infirmary and then running the paper-free patient record system at HCI in Clydebank, where the company is based.

Dr Rajam Madhok, a consultant rheumatologist at Glasgow Royal Infirmary, conducted a small pilot trial and is being backed by the Scottish Executive for an extended trial this year. "My main concern is to avoid prescription errors and also to ensure patients are complying with their drugs," he said.

"It is part of our commitment to be available, and this system means they can call 24 hours a day, seven days a week, and if there is a problem I can get back to them." Dr Ramayya said: "About 75% of the healthcare budget is spent on routine management of chronic diseases like asthma, diabetes or arthritis. If you got even 40% of that on to this system, you could make a huge difference to waiting lists for those who need to attend in person."