Regulating Ethics in Telemedicine

Advancing technology is allowing access to healthcare providers, quite literally, at your fingertips.  Patients can reach their doctors by telephone, text, FaceTime, email and webcam.  They can send vital signs, medical records and pictures of problems (like a nasty cut or a weird rash) to their doctors instantaneously.  Likewise, doctors are making quick diagnoses of diabetes, heart attacks, strokes and other life-changing conditions.  According to a recent article in The Wall Street Journal, over 15 million Americans received telemedical care in 2015 and those numbers could rise an additional 30% this year.

With all of this medical care being provided via rapidly changing technology this begs the question, “Who is keeping this all in check?”

The American Medical Association met in Chicago on June 13, 2016 at its Annual Meeting and adopted new ethical guidelines which will steer physicians in learning the differences in the delivery of medical care by telemedicine as compared to traditional office or hospital visits. The greater than 230,000-member group determined that while the fundamental ethical responsibilities of a physician providing care via telemedicine do not change, emerging technologies required the need for further guidance.

Some of the new guidelines include:

Disclosure of potential conflicts of interest 

A physician is required to disclose to the patient any financial or other interest in particular telemedicine applications or services.

Privacy protections 

Telemedicine applications and/or services must have appropriate safeguards in place for patient privacy and confidentiality. Those safeguards must help prevent unauthorized access to a patient’s account.

Disclosure of the limitations of telemedicine 

Physicians should discuss the limitations of providing medical care via telemedicine and encourage patients who have a primary care physician to inform him/her about their telehealth care and follow-up in person when needed.

Recognition of the limitations of technology

Physicians must recognize that all of the relevant information needed to diagnose or treat may not be available through the technology used. For example, a physician conducting an exam via webcam may not be getting a clear picture of the patient’s current condition. The guidelines suggest having another health care professional at the patient’s location conduct an exam or obtaining vital information through other remote technologies.

The AMA’s full report and guidelines will be published and available in the next several months.  The new guidelines will become part of the AMA’s Code of Medical Ethics.