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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 -
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 -
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 -
Rhode Island Medical Journal (2013) Feb 2020The use of telehealth - the delivery of healthcare services through the use of two-way electronic audiovisual technology - has grown significantly in the U.S. in recent...
The use of telehealth - the delivery of healthcare services through the use of two-way electronic audiovisual technology - has grown significantly in the U.S. in recent years. Telehealth offers patients and providers significant benefits as a lower cost, easier way to access quality care, but the medical community is still working to perfect the balance between technology and in-person care. This article covers the current national telehealth landscape, consumer perceptions of telehealth, as well as the steps Blue Cross & Blue Shield of Rhode Island (BCBSRI) has taken to cover telehealth services for its members and implement a user-friendly mobile app to facilitate this type of care, as well as how it fits into their primary-care strategy. It discusses some existing applications for telehealth, as well as some ideal-state, practical ideas about the future of telehealth's use.
Topics: Efficiency, Organizational; Health Care Costs; Health Services Accessibility; Humans; Patient Acceptance of Health Care; Rhode Island; Technology; Telemedicine; United States
PubMed: 32013298
DOI: No ID Found -
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 -
Soins; La Revue de Reference Infirmiere Nov 2016Developments in cyberhealth are now accessible to all patients and healthcare professionals. These tools enable expert advice to be provided remotely and ensure a... (Review)
Review
Developments in cyberhealth are now accessible to all patients and healthcare professionals. These tools enable expert advice to be provided remotely and ensure a continuity of care for all those who need it. Telecare is developing across the world, as are networks of nurses who practise it and researchers who analyse the results.
Topics: Global Health; History, 21st Century; Humans; Nurses; Nursing Care; Telemedicine
PubMed: 27894484
DOI: 10.1016/j.soin.2016.09.013 -
The New England Journal of Medicine Oct 2017
Topics: Biomedical Research; Humans; Licensure; Physician-Patient Relations; Telemedicine
PubMed: 29045204
DOI: 10.1056/NEJMsr1503323 -
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 -
Journal of Innovation in Health... Mar 2018Although the formal evidence base is equivocal, practical experience suggests that implementations of technology that support telemedicine initiatives can result in...
BACKGROUND
Although the formal evidence base is equivocal, practical experience suggests that implementations of technology that support telemedicine initiatives can result in improved patient outcomes, better patient and carer experience and reduced expenditure.
OBJECTIVE
To answer the questions "Is an investment in telemedicine worth it?" and "How do I make a telemedicine implementation work?"
METHODS
Summary of systematic review evidence and an illustrative case study. Discussion of implications for industry and policy.
RESULTS
Realisation of telemedicine benefits is much less to do with the technology itself and much more around the context of the implementing organisation and its ability to implement.
CONCLUSION
We recommend that local organisations consider deployment of telemedicine initiatives but with a greater awareness of the growing body of implementation best practice. We also recommend, for the NHS, that the centre takes a greater role in the collation and dissemination of best practice to support successful implementations of telemedicine and other health informatics initiatives.
Topics: Evidence-Based Medicine; Health Plan Implementation; Humans; Medical Informatics; Organizational Case Studies; Review Literature as Topic; Telemedicine
PubMed: 29717950
DOI: 10.14236/jhi.v25i1.957 -
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