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Please share what you have learned from this week topic with your friends here. This could be infographic picture or text summarization.
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This week I have learned about telehealth/telemedicine and ethical issue. Telemedicine helps consumers to get to medical care easier, but it also increases the risk of privacy, conflict of interest, and inadequate standard of care.
The benefits of telehealth/telemedicine are:
– Reduce the cost of medical services. (eg. travel expenses to the hospital)
– Reduce workload in the hospital (can reserve workforce and resources only for severe cases that need intensive medical care)
– Reduce waiting time in the hospital.
– Easier to reach specialize care.
– Reduce hospital overcrowd, leads to reduce hospital infection.
The concerns are:
– Standard of care (Lack of physical examination and investigations information)
– Reimbursement issue (some health care plans did not design for telemedicine service reimbursement)
– Risk of privacy and personal data breach
– Technology barrier (consumers need sufficient electronic health literacy enough to make use of telemedicine)
From the case study:
The person should be responsible for the incidence should be:
– The doctor (since the doctor should be aware of the limitation of telemedicine and should not take risk of advising patients without a proper physical examination or other clinical information, especially in this case).
– The service provider (according to Civil and Commercial Conde, the hospital should be responsible for the incidence if the doctor practice as an employee of the organization).
– The patient should be aware of the limitation of the service (which should be completely informed by the doctor or the service provider before the session begins), which in my opinion about this case, should not be responsible.
The solution to prevent the issue:
– Develop clear protocols for telemedicine practice.
– Inform patients about the limitation of the service and gain informed consent from every patient.
– Create and develop the standard of care for telemedicine practice. -
I have learning about Telemedicine and Ethic issue in Telehealth. Telemedicine has many benefits to help Medical staffs (Physicians, Pharmacist or etc.), Patients and System administrators to communicate and develop the system.
The benefits of this kind of telemedicine as follow
– Easy to access to Medical specialist, available for all users,
– Save the time for waiting doctor appointments.
– Save the money for travel costs, especially patients who are far away from the hospital.
– Reduce the number of people coming to the hospital.
– Reduce crowded of patients in hospital.
– Social Distancing of COVID-19 Epidemic situation.
– Reduce transmission diseases.
– Privacy of patients (For special diseases; HIV or sexual transmission diseases)Telehealth might be risks/concerns as follow;
– Misdiagnosis, not enough physical examination and wrong prescription.
– Confidentiality’s
– Reimbursement; Make sure this program included in the insurance policy.
– Data privacy; both of physicians and patients
– System is stable and securityAnd as per case study, I think Telemedicine is suitable for the diagnosis of non-serious diseases or non-specific diagnostic tests. May be used to monitor or follow-up after treatment results or inquiring about various health problems or prescription.
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First, the meeting was fruitful. I have learned a lot about telemedicine in terms of ethical issues.
For the benefit of telemedicine, we agree that telemedicine is reduced cost in terms of the indirect budget such as travel cost and reduced waiting line in the hospital. However, telemedicine has several risks to concern about such as patient data breaches, reimbursement issues which is a new knowledge for me, and misdiagnosis.
In this scenario, the patient will take a risk to make telemedicine in terms of misdiagnosis and not receiving physical examination. Also, the doctor should understand the system and comfortable to use it. Because this system uses the only conversation between doctor and patient, so a doctor should be careful and make the right decision based on the patient information and legislation.
From my point of view, telemedicine should implement only in non-emergency cases or non-severe symptoms only under PDPA and related Act.
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Summary link https://prnt.sc/130ug3l
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I would like to share my thought on Telemedicine on topics of benefit, disadvantage, and concern.
Benefit
– Faster access to healthcare
– 24/7 access
– Emergency care screening
– Broader coverage
– Lower non-essential cost
– Easy access to medical consultation
– Access to specialistDisadvantage
– Require technological infrastructure setup
– Need system specialist
– Higher cost for the instrument
– Require end-user devices (mobile phone or tablet)
– Require physicians training
– Difficult to differentiate diseases
– Difficult to perform continuous care
– Unable to perform physical and laboratory examinationConcern
– Privacy because the service providers or physician can obtain certain patient information
– Monetary as many insurance companies did not have a plan about telemedicine such as drug order and doctor fee -
My wrap-up of week2, please follow this link http://prnt.sc/131keps
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Here is my wrap-up of week 2, check it out! https://ibb.co/2vbHnXd
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Please see my wrap up at https://prnt.sc/132qpa5
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This week, we have been learnt and discussed about the benefits and risks/concerns of telemedicine. Same as week 1’s activities that all students were requested to review the provided articles and case study that will be used to share and discussion during the webinar meeting.
All students and other participants who joined this meeting had provided the answers and explanations about benefits and risks/concerns of telemedicine on the case study. The following lists are the example of answers from students.
Benefits:
– Reduce hospital workload
– Safer than use the drug by yourself
– Safe environment
– Save cost
– On demand service
– Cost
– Reduce the waiting line in hospital
– Fast and easy access to the medical professional
– Provide specialized consult
– Increase the effectiveness of access to treatment
– Save direct cost such as travel cost etc.
– No need to go to hospital
– Save time
– Easier to reach for medical services
– Access
Risk/Concerns:
– Doctor shopping
– Incorrect diagnosis/prescription
– Week doctor patient relationship
– Symptom may not improve
– Trust by patients and physician on the system
– Confidentiality
– Misdiagnosis
– Dealing with third party application provider
– Lack of physician examination data
– Easily misdiagnosis
– Technology/ data barrier
– Interoperability
– Could not give timely intervention to patient because of lack of physician examination
– Not enough physical examination for diagnosis
– Data breach
– Standard of care
– Acceptability of the patients
– Reimbursement
– Digital literacy of the usersWe all agreed that telemedicine brought many good things to support the medical health requirement in this era and the future. However, there were many concerns came up as well.
We also discussed about who should be responsible/accountable for this incidence (study case)? Yes, we all think that all of them; doctor, patient, and provider should response on this incident but in different responsibilities according their roles.
The webinar meeting was ended with the discussion about what could be the best solution/ mitigation in handling such ethical and legal concerns? Here below are the answers from students:
– Provide a guideline for patient and physician
– Patient consent form
– Transparency and informed consent
– Cleary defines in Law
– Patient must be informed beforehand about limitation of telemedicine
– Competence of health professional
– Proper protocol for telemedicine practice
– Workshops & policies > laws, regulations > standard operating procedures
– Patient must understand the risk and doctor will understand the system
– Consent form
– Provide official consent form that give all of benefits and limitations to patient before service
In my opinion, I would summarize that telemedicine will increase the accessibility of health care in-term of quality of service, timely, cost and will change the medical practice in the future as well (more or less in some way). However, it could not replace or use for all medical care. There are many concerns that should be clearly addressed before approving to use in each country and should be considered about ethical and laws/regulation. -
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-Patient satisfaction, adoption & retention concerns.
-Diagnosis & exam challenges.
-Quality of care & continuity concerns.
-Medicare & Medicaid reimbursement concerns.
-Telehealth restrictions & regulations.
-Privacy & security concerns.
-Program awareness concerns, sustainability & growth.
-Technical training & restructuring responsibilities.
-Hospital integration & implementation challenges. -
Please follow this link for my wrap-up assignment.
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Here’s my wrap-up. Please follow this link https://ibb.co/r0RrSkL .
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