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Telemedicine Tele-abused

Patientline is a firm, which specialises in phone and telehealth services to help relieve the stress of hospitalisation. They provide a telephone/television unit next to the beds of more than 160 NHS trust hospitals in the United Kingdom.

These allow each patient to have a personal phone line out of the hospital, television, and video features, and internet/intranet connectivity allowing in-hospital medical services such as enabling patients to order food via their bedside unit, or sending patient records directly to the unit for the doctor's use. The Intranet link even allows remote doctor visits to individual patients.

The service is not free to patients, however. Unlike NHS-provided services, Patientline is a commercial service, and as such is in it to make a profit. As large a profit as possible. With call rates of £0.28 ($0.57 usd) a minute out of the hospital, and £.048 ($1 usd) a minute for relatives to phone in, the basic telephone services are hideously overpriced - pay phones are cheaper.

This is where the problem has arisen. Recently, ex-employees of Patientline's sales staff have come forwards to publicly admit they were pressurised by the company to approach seriously and critically ill patients in hospitals, and hard-sell the benefits of Patientline, to do everything short of force them to sign up for the services.

Company documents show that Patientline had recently started moving to a more "sales-driven" culture with all staff being urged to try to increase revenue.

In March 2007, the company, which has systems installed at 75,000 hospital bedsides, was being criticised for increasing the cost of calls by 160%.

One former employee was quoted as saying "It reminded me of a cold calling job. Going from door to door, except with this it was going from patient to patient. It did not matter how ill they looked."

This is the potential problem with telehealth, unless it is carefully regulated. It has the potential to truly revolutionise healthcare, and enable hospitals to cope with ever increasing patient numbers, possibly beyond previous breaking points, and still with less stress, as they take much of the travel and the administration out of the loop.

However, if as happened with Patientline, a single, private provider installs it in hospitals or homes across a country, there is a potential problem. If, as happened in this case, when people are used to it, or see it as a life line, the company turns round and uses the seriously ill, the desperate, and the long-term disabled as a captive market to bleed as much as possible from, telehealth turns from a lifeline, into a source of worry and grief. Extra and unreasonable burden of billing, at the time a person is most vulnerable. Hard sell tactics, which involve heavy use of psychological blackmail, when a person is perhaps terminally ill and in hospital, is criminal beyond reproach.

In order for telehealth systems to work, they must be regulated, such that this kind of thing cannot be repeated. There is no point having an internet-based, remote based doctor-patient communication system, if it's very point is to bleed the disabled, and terminally ill, dry - maybe push them to the grave a little faster with hard sale threats and pressure.



BBC: Phone firm 'pressures patients'

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