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Journal of General Internal Medicine Oct 2017This article summarizes the report of the American Medical Association's (AMA) Council on Ethical and Judicial Affairs (CEJA) on ethical practice in telehealth and... (Review)
Review
This article summarizes the report of the American Medical Association's (AMA) Council on Ethical and Judicial Affairs (CEJA) on ethical practice in telehealth and telemedicine. Through its reports and recommendations, CEJA is responsible for maintaining and updating the AMA Code of Medical Ethics (Code). CEJA reports are developed through an iterative process of deliberation with input from multiple stakeholders; report recommendations, once adopted by the AMA House of Delegates, become ethics policy of the AMA and are issued as Opinions in the Code. To provide enduring guidance for the medical profession as a whole, CEJA strives to articulate expectations for conduct that are as independent of specific technologies or models of practice as possible. The present report, developed at the request of the House of Delegates, provides broad guidance for ethical conduct relating to key issues in telehealth/telemedicine. The report and recommendations were debated at meetings of the House in June and November 2015; recommendations were adopted in June 2016 and published as Opinion E-1.2.12, Ethical Practice in Telemedicine, in November 2016. A summary of the key points of the recommendations can be found in Appendix A (online), and the full text of the opinion can be found in Appendix B (online).
Topics: Continuity of Patient Care; Ethics, Medical; Humans; Telemedicine
PubMed: 28653233
DOI: 10.1007/s11606-017-4082-2 -
Current Allergy and Asthma Reports Aug 2018Due to rapid advancements in quality of real-time, interactive, audio-visual, and digital technologies as well as impressive gains in internet speed and capacity,... (Review)
Review
PURPOSE OF REVIEW
Due to rapid advancements in quality of real-time, interactive, audio-visual, and digital technologies as well as impressive gains in internet speed and capacity, medicine delivered over distance is happening faster than many healthcare providers and leaders can grasp.
RECENT FINDINGS
Depending on which market report you ascribe to, industry projections for the global compounded annual growth rate of telemedicine are between 13 and 27%, with valuation growing to over 20 billion US dollars in the next several years. The Mayo Clinic has reworked its entire telemedicine interest to a model with centralized operations, one virtual technology platform, standardized training, and connectedness for all of its locations. The National Quality Forum spent 2016 and 2017 formulating 70 some pages of recommendations for expanded measures to valuate telemedicine over the foreseeable future. There are so many patient experience studies indicating high satisfaction with telemedicine, that professionals in the industry accept it as fact. Telemedicine is leaving novel to the past. This short, informative piece of writing includes expert opinion and research findings about what is telemedicine, why one should practice telemedicine, and how one should approach implementation; a primer from which to grow.
Topics: Humans; Insurance, Health; Legislation, Medical; Licensure, Medical; Telemedicine; Workforce
PubMed: 30145709
DOI: 10.1007/s11882-018-0808-4 -
Pediatrics Jul 2015Telemedicine is a technological tool that is improving the health of children around the world. This report chronicles the use of telemedicine by pediatricians and... (Review)
Review
Telemedicine is a technological tool that is improving the health of children around the world. This report chronicles the use of telemedicine by pediatricians and pediatric medical and surgical specialists to deliver inpatient and outpatient care, educate physicians and patients, and conduct medical research. It also describes the importance of telemedicine in responding to emergencies and disasters and providing access to pediatric care to remote and underserved populations. Barriers to telemedicine expansion are explained, such as legal issues, inadequate payment for services, technology costs and sustainability, and the lack of technology infrastructure on a national scale. Although certain challenges have constrained more widespread implementation, telemedicine's current use bears testimony to its effectiveness and potential. Telemedicine's widespread adoption will be influenced by the implementation of key provisions of the Patient Protection and Affordable Care Act, technological advances, and growing patient demand for virtual visits.
Topics: Child; Delivery of Health Care; Humans; Pediatrics; Telemedicine; United States
PubMed: 26122813
DOI: 10.1542/peds.2015-1517 -
The New England Journal of Medicine Oct 2017
Topics: Biomedical Research; Humans; Licensure; Physician-Patient Relations; Telemedicine
PubMed: 29045204
DOI: 10.1056/NEJMsr1503323 -
Sleep Medicine Clinics Sep 2020Sleep telemedicine practitioners must ensure their practice complies with all applicable institutional, state, and federal regulations. Providers must be licensed in any... (Review)
Review
Sleep telemedicine practitioners must ensure their practice complies with all applicable institutional, state, and federal regulations. Providers must be licensed in any state in which they provide care, have undergone credentialing and privileging procedures at outside facilities, and avoid real or perceived conflicts of interest while providing that care. Internet-based prescribing remains limited to certain circumstances. Whether or not a malpractice insurance policy covers telemedicine depends on the insurer, especially if interstate care is provided. All telemedicine programs must protect patient health information. Similarly, bioethical principles of autonomy, beneficence, nonmaleficence, and justice apply to both in-person and telemedicine-based care.
Topics: Credentialing; Electronic Prescribing; Humans; Informed Consent; Internet; Telemedicine
PubMed: 32762973
DOI: 10.1016/j.jsmc.2020.06.004 -
The Medical Clinics of North America May 2018Telemedicine and telehealth are the practices of medicine at a distance. Performing the equivalent of a complete clinical examination by telemedicine would be unusual.... (Review)
Review
Telemedicine and telehealth are the practices of medicine at a distance. Performing the equivalent of a complete clinical examination by telemedicine would be unusual. However, components of a more traditional clinical examination are part of the telemedicine workup for specific conditions. Telemedicine clinical examinations are facilitated, and enhanced, through the integration of a class of medical devices referred to as telemedicine peripherals (eg, electronic stethoscopes, tele-ophthalmoscopes, video-otoscopes, and so forth). Direct-to-consumer telehealth is a rapidly expanding segment of the health care service industry.
Topics: Humans; Physical Examination; Telemedicine
PubMed: 29650074
DOI: 10.1016/j.mcna.2018.01.002 -
Applied Clinical Informatics Nov 2016Developing countries need telemedicine applications that help in many situations, when physicians are a small number with respect to the population, when specialized... (Review)
Review
BACKGROUND
Developing countries need telemedicine applications that help in many situations, when physicians are a small number with respect to the population, when specialized physicians are not available, when patients and physicians in rural villages need assistance in the delivery of health care. Moreover, the requirements of telemedicine applications for developing countries are somewhat more demanding than for developed countries. Indeed, further social, organizational, and technical aspects need to be considered for successful telemedicine applications in developing countries.
OBJECTIVE
We consider all the major projects in telemedicine, devoted to developing countries, as described by the proper scientific literature. On the basis of such literature, we want to define a specific taxonomy that allows a proper classification and a fast overview of telemedicine projects in developing countries. Moreover, by considering both the literature and some recent direct experiences, we want to complete such overview by discussing some design issues to be taken into consideration when developing telemedicine software systems.
METHODS
We considered and reviewed the major conferences and journals in depth, and looked for reports on the telemedicine projects.
RESULTS
We provide the reader with a survey of the main projects and systems, from which we derived a taxonomy of features of telemedicine systems for developing countries. We also propose and discuss some classification criteria for design issues, based on the lessons learned in this research area.
CONCLUSIONS
We highlight some challenges and recommendations to be considered when designing a telemedicine system for developing countries.
Topics: Developing Countries; Humans; Surveys and Questionnaires; Telemedicine
PubMed: 27803948
DOI: 10.4338/ACI-2016-06-R-0089 -
Journal of Primary Care & Community... 2020Identify and summarize the available literature on the acceleration in the use of telemedicine in the midst of the COVID-19 pandemic, with an aim to provide...
OBJECTIVES
Identify and summarize the available literature on the acceleration in the use of telemedicine in the midst of the COVID-19 pandemic, with an aim to provide justification and guidance for its implementation to overcome the limitations associated with the pandemic worldwide.
METHODS
We conducted a scoping review through different search strategies in MEDLINE and Google Scholar to identify the available literature reporting data on implementation and usefulness of various modalities of telemedicine during the current pandemic. We summarized the included studies according to field and mode of implementation in a narrative way.
RESULTS
We included 45 studies that fulfilled selection criteria. About 38% of the studies were conducted in the United States of America (USA), followed by 15.5% in India and 15.5% in China. Most studies (73%) were cross-sectional studies based on historical records. All publications were written in English with the exception of 1 studied published in Spanish. The majority of reports focused on use of telemedicine for outpatient care, followed by in-hospital care.
CONCLUSION
The COVID-19 pandemic has promoted the use of telemedicine, a tool that has transformed the provision of medical services. Several modes of implementation are useful to overcome difficulties for patient care during the pandemic. Its benefits are specific to different fields of medical practice. Such benefits, along with the guidance and reported experiences should invite health systems to work for an effective and comprehensive implementation of telemedicine in various fields.
Topics: COVID-19; Humans; Pandemics; Patient Satisfaction; Remote Consultation; SARS-CoV-2; Telemedicine
PubMed: 33300414
DOI: 10.1177/2150132720980612 -
The New England Journal of Medicine Jul 2016
Review
Topics: Humans; Reimbursement Mechanisms; Telemedicine; United States
PubMed: 27410924
DOI: 10.1056/NEJMra1601705 -
Telemedicine Journal and E-health : the... Feb 2015A systematic review of cost-utility and cost-effectiveness research works of telemedicine, electronic health (e-health), and mobile health (m-health) systems in the... (Review)
Review
OBJECTIVE
A systematic review of cost-utility and cost-effectiveness research works of telemedicine, electronic health (e-health), and mobile health (m-health) systems in the literature is presented.
MATERIALS AND METHODS
Academic databases and systems such as PubMed, Scopus, ISI Web of Science, and IEEE Xplore were searched, using different combinations of terms such as "cost-utility" OR "cost utility" AND "telemedicine," "cost-effectiveness" OR "cost effectiveness" AND "mobile health," etc. In the articles searched, there were no limitations in the publication date.
RESULTS
The search identified 35 relevant works. Many of the articles were reviews of different studies. Seventy-nine percent concerned the cost-effectiveness of telemedicine systems in different specialties such as teleophthalmology, telecardiology, teledermatology, etc. More articles were found between 2000 and 2013. Cost-utility studies were done only for telemedicine systems.
CONCLUSIONS
There are few cost-utility and cost-effectiveness studies for e-health and m-health systems in the literature. Some cost-effectiveness studies demonstrate that telemedicine can reduce the costs, but not all. Among the main limitations of the economic evaluations of telemedicine systems are the lack of randomized control trials, small sample sizes, and the absence of quality data and appropriate measures.
Topics: Cost-Benefit Analysis; Electronic Health Records; Humans; Telemedicine
PubMed: 25474190
DOI: 10.1089/tmj.2014.0053