Adventures in telepsychiatry

Psychiatric Times has a recent article on using the Internet to connect with patients.

The authors bring up a whole group of points that I agree with:

• Email is already verging on obsolescence for people under 30
• The patients under 30 don’t understand why anyone providing a service wouldn’t answer text messages
• Psychiatrists tend to be late-adopters of technology
• Email delivery is sometimes delayed and isn’t suitable for emergency communications in many cases

They also bring up a couple of other issues that make good sense to me. First, email isn’t usually encrypted. I discourage patients from saying anything very personal in emails. I think an email with content like “Your labs looked fine,” isn’t likely to hurt many people, but “I’m having an affair” could be really dangerous.

The obvious solution to this problem is the more widespread use of encryption technologies like PGP . I can use it, but I doubt that most of my patients even know what it is. PGP is a great idea, but as far as I can tell, it never really caught on, primarily because it can involve so many steps to exchange keys, enter passwords, decrypt the text, and so on.

The second issue is that despite mentioning IM, Twitter, social media and the like, they barely mentioned Google Wave and Skype. Google wave (old post here) isn’t really ready for prime time yet but Skype’s been around for a while. Basically, I think Skype could be for real-time (synchronous) communication, while Google Wave would basically do the asynchronous communication that the authors of the article are talking about. All that’s really necessary is for Wave to get some better security features, and for someone to start a “medical Wave” server to make sure the data are secure.

Basically, I think Google Wave and Skype are going to take over a lot of what the under-30 crowd is using.

Let them know how being obsolete feels like for a change.