The problem with diagnosis via internet is that you can really only get a patient history and do a visual inspection - and even then the visual inspection is limited, since you can't use some extremely basic tools (medical torches, etc). Few doctors would be comfortable making decisions on the basis of those things alone - and many patients would not be comfortable with such a diagnosis.

I have a basic understanding of the limitations/problems that a GP would be faced with dealing with patients via internet, yet having a system set up that could help people in remote areas eg will help farmers wives to encourage hubby whose foot infection is turning into a serious blood infection to actually go to town to be seen because he is a typical kiwi male "she'll be right mate, been pissing on it for a week, that red stain is just from my piss, what do mean my piss shouldn't be that colour???" So I think it is a great idea for remote areas - it is a yes from me.

@hugheldredgrigg @tipenebutter
To make it clear, I'm not advocating the replacement of normal doctors visits or diagnosis with online diagnosis, or "online visits".
Its more about enhancing care than replacing it with technology.
However at the moment it can be a full days work for us to get a patient from home to a inpatient clinic for a 10 minute chat and then home again.
If for example a coordinated public health nurse was at the side of the patient while an online consultation took place. There would be both savings Health provider and benefits for a patient.
Of for example I know some mental health case workers who spend aprox 5 hours a day travelling and less than 90 minutes with patients.
Sure if DHBs and the like were silly there is a possibility of abuse of such a system and thence guidelines obviously are required to prevent this.

I actually work in this space, for a provider doing remote doctor appointments in the UK.

Doctors I've talked to have said that a lot of the diagnosis is in the history - so they can diagnose a reasonable number of aliments - especially common things - merely by talking with the patient. If it gets too tricky, the patient is simply referred to their GP, or a relevant referral is made to a specialist.

The doctors can even prescribe, and the medicine can be couriered to the patient in a matter of hours from remote pharmacies.

And there are platforms specifically set up for doing video chat with counsellors for mental health issues - see http://www.bigwhitewall.com/ for one such example that recently launched in Auckland as well.

What this all means is that such services are coming. Even ignoring any demand by hospitals to keep infectious people away, many patients themselves will eventually come to want it - since it means you can talk to your doctor without leaving home (and no waiting room!).

It would make a lot of sense for the Internet Party to at least be aware of this. As pointed out, KAREN could be used for the transport (reducing worry about the NSA). And of course, for people really worried, they can always go to their doctor. Real appointments will always be necessary. Online ones will cut a bunch of hassle for many people.

@nigelmcnie

If it gets too tricky, the patient is simply referred to their GP, or a relevant referral is made to a specialist.

This is what I was trying to say.

Glad someone as yourself is aroundwith knowledge in this area. My only real info is news articles.

The idea of a virtual/online hospital is that, I believe it would be easier to set up one national facility, rather than every DHB, Clinic etc developing their own facility.
Thus a current Dr in the system could refer a patient to the outpatients clinic, where it believed the care would be better and appropriate at that stage. And if the need arose the Virtual Hospital could refer the Patient back.

I didn't put much detail into the proposal as I believe the medical profession and relevant authorities should have a great deal of input.

You could certainly set up something nationally, but I should point out that each clinic "developing their own" isn't far from what's being pushed in the UK. But rather than make their own, they use a shared platform to offer the doctors. So Dr. Smith is in on Monday and Tuesday, but takes online appointments only on Wednesdays, for example.

I don't necessarily think the Internet Party needs to come up with a strategy to cover how it could be rolled out in New Zealand right now. I wouldn't be surprised if nobody reading this comment had ever had an online video chat with a doctor, so it's still early days even for the IDEA of e-health in NZ - and to a large extent it depends on the success of the UFB project.

The national hospital idea certainly sounds like it would be worth researching further. I wonder how you'd fund and ration it, since it wouldn't be per DHB - it might end up a bit "tragedy of the commons" if all DHBS were incentivised to push as many patients onto it as possible to cut their own workloads.

(mostly these are just rough thoughts, please don't make policy out of them!)