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Ethical issues of telehealth
Technology in health care essay
Ethical issues of telehealth
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1. Introduction
The delivery of health care has always been influenced by technological developments and innovations. This is particularly true in modern health care professionals where they are obsessed with technology and rush to apply them. One of the most recent applications of ICT – Information and computer technology- is telehealth. Telehealth is the use of communication, diagnostic and information technology to provide health care when patients and providers are geographically separated [2], Technologies include videoconferencing, the internet, store -and-forward imaging, streaming media, terrestrial and wireless communications. Telehealth could be as simple as two health professionals discussing a case over the telephone or as sophisticated as doing robotic surgery between facilities at different ends of the globe.
The temptation for informatics professionals and health care providers alike is to follow the technological imperative and to see the implementation of telehealth as merely a technical problem where any and all issues can be solved by developing technical fixes. Although this technology provides cost-effective and efficient services, there lies a danger that focusing mainly on pragmatic considerations will ignore profound ethical and legal issues that could interfere with its implementation [1-2].
2. Telehealth Challenges
The relationship between informed consent, the physician-patient relationship and electronic health records (EHRs) are important variables when dealing with the ethical and legal issues in telehealth service implementation. In fact, EHRs are central to the implementation of telehealth.
In the traditional model of the physician-patient relationship, the physician had control of the in...
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... teleadvice in the absence of a pre-existing patient-physician relationship - Systematic review and expert survey. Journal of Medical Internet Research, 2(1).
[2] Kluge, E. H. W. (2011). Ethical and legal challenges for health telematics in a global world: Telehealth and the technological imperative. International Journal of Medical Informatics, 80(2), e1-e5.
[3] Akabayashi, A., Slingsby, B. T. (2006). Informed consent revisited: Japan and the U.S. Am. J. Bioethics, 6 (1) 9–14.
[4] Oudshoorn, N. (2008) Diagnosis at a distance: the invisible work of patients and healthcare professionals in cardiac telemonitoring technology. Soc. Health Illness, 30 (2), 272–288.
[5] Bellazzi, R., Montani, S., Riva, A., Stefanelli, M. (2001) Web-based telemedicine systems for home-care: technical issues and experiences. Comput. Methods Prog. Biomed, 64 (3), 175–187
Cardiac monitoring has been available since the early 1960s (Henriques-Forsythe, Ivonye, Jamched, Kamuguisha, Olejeme & Onwuanyi, 2009). George, Walsh-Irwin, Queen, Vander Heuvel, Hawkins, & Roberts (2015) explain, “Remote telemetry monitoring is the monitoring of cardiac rhythms of acute care inpatients from a central locate by personnel who are not directly involved with patient care” (p. 11). Researchers and authors published a multitude of articles, best practices, and standards for hospital monitoring (Drew, 2004, Funk, 2010). A basic internet query reveals injuries and deaths related to remote telemetry monitoring. Guidelines, best practices, and research provide the best evidence in the delivery of safe quality care
Wade, V. A., Karnon, J. Elshaug, A., & Hiller, J. E. (2010). A systematic review of economic analyses of telehealth services using real time video communication. BMC Health Service Research,
Savel, R. H., & Munro, C. L. (2013, November). Promise and pitfalls of the electronic health
Stakeholders in health care include health care organizations, physicians, insurers, employers, consumers, and policymakers. The complexity of health care itself makes balancing the needs of all stakeholders and compliance with health care law a challenge for American Well. Ethical issues in telehealth include concerns of health care quality and buy-in from physicians and policymakers. American Well must use the ethical decision making process to ensure compliance with health care law while also developing products that physicians are willing to utilize and policy-makers are willing to support. Ethical reasoning, ethical principles and decision making are valuable tools that will assist American Well in aligning decisions with changes in health care
Medical ethics in general is not a modern term; it goes back in time to the 12th century to the Hippocratic Oath. Recently in the 21st century the interest in medical ethics was provoked by a series of medical scandals: Nazi medical experiments, the infamous Tuskegee syphilis studies and so on. After which autonomy in the form of an informed consent was obligatory for minor and major procedures. (2, 3)
Telehealth has shown benefits in monitoring patients with chronic health conditions, decreasing hospital admissions and emergency room visits, and improving treatment regimen compliance at home. Zimmerman & Barnason (2007) investigated the use of telehealth devices with cardiac surgical patients. Health Buddy devices can deliver information, education, and professional support for post-operative cardiac patients. The patient’s responses triggered different algorithms to further individualize post-operative interventions (Zimmerman & Barnason, 2006). Health care professionals were able to monitor recovery at home, progress following cardiac s...
The purpose of telemedicine is to remove distance as a barrier to health care. While telehealth is an accepted resource to bridge the gap between local and global health care, integrating telehealth into existing health infrastructures presents a challenge for both governments and policy makers (HRSA, 2011). Today there are policy barriers that prevent the expansion of telehealth, including reimbursement issues raised by Medicare and private payers, state licensure, and liability and privacy concerns.
XIAO-YING, Z., & PEIYING, Z. (2016). Telemedicine in clinical setting. Experimental & Therapeutic Medicine, 12(4), 2405-2407.
Telepsychiatry has been used for many years and is highly regarded as an area where the use of telemedicine has been successful. It has been defined as “The delivery of healthcare and the exchange of healthcare information for purposes of providing psychiatric services across distances” (Woo...
Advances in technology have influences our society at home, work and in our health care. It all started with online banking, atm cards, and availability of children’s grades online, and buying tickets for social outings. There was nothing electronic about going the doctor’s office. Health care cost has been rising and medical errors resulting in loss of life cried for change. As technologies advanced, the process to reduce medical errors and protect important health care information was evolving. In January 2004, President Bush announced in the State of the Union address the plan to launch an electronic health record (EHR) within the next ten years (American Healthtech, 2012).
Telemedicine is a new comer to the field of medicine and it is the treatment of patients by means of telecommunications technology. Telemedicine is carried out in a variety of ways whether it is by smart phone, wireless tools or other forms of telecommunications. Examples of telemedicine include: 1) transmission of medical images 2) care services at the home of the patient 3) Diagnosis at distance 4) education and training of patients. The diversity of practices in what is known as telemedicine raises many questions and one of those questions, which is extremely important, relate to the safety of the practice and the risks involved.
Telehealth allows a lower-level healthcare practitioner to communicate with a physician or specialist when necessary. Remote rural areas use a Physician Assistant or a Nurse Practitioner on location in remote areas. When procedures call for a physician, an internet or satellite link provides a teleconference with a physician who can prescribe appropriate treatment (Gangon, Duplantie, Fortin & Landry 2006). This could be implemented in lower income urban areas, allowing free clinics to lower costs, and require fewer physicians. Programs that increase the level of healthcare available to school children could be increased.
The article titled “Contemporary Ethical Analyses: A Shortfall in Scientific Knowledge” describes the ethics through the public’s eye. One of the major ethical issues brought up is informed consent.
Mandl, Kenneth, MD., Kohane, Isaac, MD., Brandt, Allan, MD. (1998). “Electronic Patient – Physician Communication: Problems and Promise”. Annals of Internal Medicine, 129, 495 – 500.
Information and Communication Technology (ICT) has been shown to be increasingly important in the education or training and professional practice of healthcare. This paper discusses the impacts of using ICT in Healthcare and its administration. Health Information technology has availed better access to information, improved communication amongst physicians, clinicians, pharmacists and other healthcare workers facilitating continuing professional development for healthcare professionals, patients and the community as a whole. This paper takes a look at the roles, benefits of Information and Communication Technology (ICT) in healthcare services and goes on to outline the ICT proceeds/equipment used in the health sector such as the