AMA adopts ethical guidelines on telemedicine
June 28, 2016
The American Medical Association (AMA) has adopted new ethical guidance to help physicians understand how their fundamental responsibilities may play out differently when patient interactions occur through telemedicine, compared with traditional patient interactions at a medical office or hospital.
The guidance on telehealth and telemedicine was developed over the past three years by the AMA's Council on Ethics & Judicial Affairs, and adopted at this month’s annual meeting by a vote of physicians from every corner of the country. The development of the guidelines coincides with innovations in technology that are changing the ways in which people live their lives, including reshaping the ways they engage with medicine.
"Telehealth and telemedicine are another stage in the ongoing evolution of new models for the delivery of care and patient-physician interactions," said AMA board member Jack Resneck. "The new AMA ethical guidance notes that while new technologies and new models of care will continue to emerge, physicians' fundamental ethical responsibilities do not change."
In any model for 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 needed to ensure continuity of care.
The evolution of telehealth and telemedicine capabilities offers increasingly sophisticated ways to conduct patient evaluations as technologies for obtaining patient information remotely continue to evolve and improve. The AMA guidelines permit physicians using telehealth and telemedicine technology to exercise discretion in conducting a diagnostic evaluation and prescribing therapy, within certain safeguards.
"Physicians who provide clinical services through telemedicine must recognise the limitation of the relevant technologies and take appropriate steps to overcome those limitations," said Resneck. "What matters is that physicians have access to the relevant information they need to make well-grounded recommendations for each patient."
The AMA guidelines also recognise that a coordinated effort across the profession is necessary to achieve the promise and avoid the pitfalls of telemedicine. Active engagement should support on-going refinement of telemedicine technologies and relevant standards, while also promoting initiatives that will help make needed technology more readily available to all patients who want to use telemedicine services.
Also at the annual meeting in Chicago, and recognising that formal training in telemedicine is not widely offered to physicians-in-training, the AMA adopted a policy aimed at ensuring medical students and residents learn how to use telemedicine in clinical practice. The policy specifically encourages the accrediting bodies for both undergraduate and graduate medical education to include core competencies for telemedicine in their programmes. The policy also reaffirms existing AMA policy, which supports reducing barriers to incorporating the appropriate use of telemedicine into the education of physicians.
"The vast majority of medical students are not being taught how to use technologies such as telemedicine or electronic health records during medical school and residency," said AMA immediate past president Robert Wah. “As innovations in care delivery and technology continue to transform healthcare, we must ensure that our current and future physicians have the tools and resources they need to provide the best possible care for their patients. In particular, exposure to and evidence-based instruction in telemedicine's capabilities and limitations at all levels of physician education will be essential to harnessing its potential."