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Dr Howsen Kwan
(Class of 2005)
was the rst GP in Texas to provide
telemedicine primary care through
Access Physicians, a telemedicine multi-
specialty group. In addition, he recently
opened his own practice, OnsiteMD, a
direct primary care clinic.
"Telemedicine is an extremely broad
term with di erent technological
avenues," Dr Kwan says. "It can range
from a simple phone call or text message
to a sophisticated computer with video/
audio/diagnostic tools capable of
examining patients. I treat patients by
using high-resolution video to see and
speak with the patient then progress
to examining the patient using an
electronic stethoscope, digital otoscope,
and digital dermascope. is allows me
to listen to and examine, a patient with
equal or enhanced resolution."
Dr Kwan believes there are numerous
bene ts to the digital doctor concept:
" e most obvious is patient access.
My patients live in a rural Texas town
isolated from any major city. Most of
them had GPs that were a two-hour
drive away. With telemedicine, patients
have convenient access to taking care
of their medical issues in their own
town. In addition, my specialists are also
available via telemedicine so the patients
are receiving world-class care while in
their hometown."
Telemedicine provides cost and time
savings for all involved, Dr Kwan adds:
"Patients are saved from taking extended
time away from work and driving
long distances to see their physician.
Physicians have their work ow
streamlined as they do not need to travel
to di erent facilities allowing for more
time for patient contact. Telemedicine
opens a whole new avenue to provide
academic-level healthcare to patients
regardless of their geographical location.
It allows patients to have access to the
top specialists without the nancial and
travel burdens. While the traditional,
personal doctor-patient relationship
will never cease to exist, telemedicine
provides a great alternative to patients
who have limited access to healthcare."
A er graduating,
Dr Elaine Costelloe
(Class of 2006) did her intern year
in Ireland and then went abroad to
Australia and New Zealand. "I gained
fantastic experience in those countries
as a medical SHO. Following this, I
returned to Ireland, and trained as a GP.
I have been working as a GP since and I
truly enjoy my job."
Dr Costelloe now works with the
digital health service, babylon. A digital
consultation, according to Dr Costelloe,
can take two forms:
rough the amplitude-shi keying
(ASK) system, the digital doctor
has the opportunity to inform
patients about di erent diseases and
answer any medical questions they
may have. is is done via texting.
Doctors can also consult directly
with a patient via video or phone
Dr Costelloe comments: "During a
digital consultation, we can take a
detailed history, examine the patient,
prescribe and refer, if needed. It is very
similar to a normal consultation; we're
able to handle nine in 10 cases without
having to refer patients to a traditional
GP for examination.
" e key bene t of the digital doctor,
is to provide patients with access to a
GP, using the latest technology to do so.
Consultations can be done at work, or in
the privacy of the patient's home. Costs
are a ordable and similar to the cost of a
face-to-face consultation in Ireland."
Dr Costelloe concludes: "Digital health
services are not here to replace the
current system but to work side by
side with it. For patients who can't get
access to their GP, it provides them with
another option."
Advances in technology mean that telemedicine is now capable of offering new levels of
sophistication to patients.
RCSI Matters spoke to two Alumni, one based in the US and one
based in Ireland, who provide their perspectives on this innovative development
Dr Howsen Kwan
(Medicine, Class of 2005).
"Digital health services
are not here to replace
the current system but
to work side by side with
it," according to Dr Elaine
Costelloe (Class of 2006).
RCSI MattersSRH.indd 23
03/03/2016 11:54