Telehealth Gets Ethical

By Scott E. Rupp, via Multibriefs

Telehealth efforts continue to gain traction as more health systems explore ways to implement the strategies to meet patients and move more people to outpatient care. With the growth have come the vendors, the technology and the regulation. Now comes a set of ethics guidelines from the American Medical Association.

The ethical implications of telemedicine is now a spotlight issue for the AMA, Forbes reports. The AMA board has adopted guidelines on the "ethical practice" of care delivered via telephone, videoconferencing or other remote means.

This makes the AMA another prominent voice in the wilderness — quite literally, since telehealth services are particularly important to rural communities.

Here's the reason for the batting about of potential guidelines: The AMA hopes to attempt to ensure quality of care, and it wants vendors serving the space to be transparent about any limitations of their service, to inform patients of necessary follow-up care and to encourage them to share their telehealth experience with their primary care physician.

The AMA's Council on Ethical and Judicial Affairs says new technologies and platforms have made it difficult for physicians to know where their responsibilities lie in treating patients from a distance.

"As in any mode of care, patients need to be able to trust that physicians will place patient welfare above other interests, provide competent care, provide the information patients need to make well-considered decisions about care, respect patient privacy and confidentiality and take steps to ensure continuity of care," the organization said in a statement.

"Although physicians’ fundamental ethical responsibilities do not change, the continuum of possible patient-physician interactions in telehealth/telemedicine give rise to differing levels of accountability for physicians. All physicians who participate in telehealth/telemedicine have an ethical responsibility to uphold fundamental fiduciary obligations and to protect privacy and confidentiality."

This is the third time the AMA has examined the issue of telemedicine ethics. Some physician holdouts, though, said as recently as June 2016 that a physician and patient should meet first in person, rather than via technology. In so doing, the physician can better understand the patient, his or her needs and the condition.

Other issues that continue to take a make headlines in relation to telehealth are patient privacy and information during a telemedicine visit, ensuring the coordination of care following a visit, disclosing any financial interest by the provider in the telemedicine platform, and determining whether the platform being used — phone, online or video — is appropriate when prescribing medications.

However, some AMA members said they "are worried about the proliferation of telehealth and are hopeful (the) vote on the council's report given the number of patients engaging online with providers of medical care and mental health services," the mHealth Intelligence reports.

Scott E. Rupp is a writer and an award-winning journalist focused on healthcare technology. He has worked as a public relations executive for a major electronic health record/practice management vendor, and he currently manages his own agency, millerrupp. In addition to writing for a variety of publications, Scott also offers his insights on healthcare technology and its leaders on his site, Electronic Health Reporter.