Ethical Issues in Telehealth
The promotion of remote clinical care through the use of health information and technology has the potential to change patient-centered care. We can communicate with patients through a variety of channels, including texting, emailing, and using mobile applications. Telehealth can combine remote access and sensing techniques with automated reminders and conversations when patients are not present at the doctor’s office to enhance patient engagement (Kaplan, 2020). By easing communication between members of the healthcare team, technology can help improve care coordination. Despite these advantages, there are serious concerns about how the introduction of telehealth may impact the provision of care.
The influence of new technology on the relationships between patients and healthcare professionals or caregivers is discussed by commentators. Tele-applications may alter the relationship between patients and clinicians by promoting “educated consent” or “informed autonomy,” in which patients’ access to knowledge and social support assists them in making medical choices consistent with their principles and treatment objectives (Gott, 2018). As clinical and trustee relationships develop between patients and telehealth personnel, or as patients and their loved ones become more engaged in their health choices based on the encouragement and information provided by online support groups, the use of such applications may also facilitate patients bypassing their primary care physician.
Risks to Patients Privacy
Privacy concerns are valid. Patients might not be aware of the people who would contact them and disclose their private medical data. Since this data can be accessed from many different computers and devices, there is an increased potential of security flaws, which could lower patient acceptance of telemedicine. With web sockets, an uncertainty regarding who would respond could lead to further privacy issues. These worries are important, particularly in view of the previously indicated uncertainties surrounding the new model of healthcare delivery. However, security concerns are more pragmatic than moral insofar as new encryption and security methods to protect data continue to develop (Kaplan, 2020). Any new telehealth program must include and communicate to patients a thorough privacy and security plan in order to motivate patient confidence.
Also frequently mentioned as an ethical challenge associated with telehealth technologies is informed consent. We explore what constitutes “informed permission” and believe that “informed consent” in telehealth goes beyond what is commonly stated for clinical tests or public health decisions. The concept of “informed” needs to be revised when new technology call for education about the advantages and drawbacks of using them. It is wise to advise people to change their permission as they become more familiar with the advances and compare them to other possibilities. We think that knowing these benefits and drawbacks demonstrates that one is informed (Gott, 2018). This is a widely accepted concept in clinical investigations, where adverse events often fall into categories that are understood. Consent requires accepting unexpected risks since new technology may carry unknown hazards.
As quickly as telehealth technology are developing, ethical questions about medical practice are as well. Modifications to the way we should practice core medical ethics are required in light of the virtual potential of the Internet as a platform for medical care. Healthcare professionals are now faced with a new set of ethical problems relating to the patient-physician relationship, economics, privacy, cost, and responsibility as a result of the widespread use and accessibility of telecommunications technology (Gott, 2018). If providers and healthcare organizations are aware of these challenges, they can avoid some common mistakes while establishing and implementing a telehealth program for clinical outcomes, research, and education.
Technology is an amazing and helps out so much being used every day for communication, research, our personal lives, and so much more. With this technology coming into the medical world and becoming the big part that it is, it has become some patients main source for their disease process and more. As helpful as technology is, there can be certain aspects that may lead to some ethical issues. Patient confidentiality is one of our main concerns as healthcare workers, making sure the patients information is kept safe. With HIPAA there are many rules for the safety and security of the patients information, rules had to be adapted and changed as technology changed.
Young J. (2018) says, “Under HIPAA and the DHHS, the Privacy Rule was established in August, 2002.16 The rule attempts to strike a balance between allowing the appropriate flow of information needed to provide high quality healthcare and assuring that an individuals health information is appropriately protected. It protects all individually identifiable health information held or transmitted by a covered entity or its business associates, in any form or media, whether electronic, in print or verbally.17 As defined by the Privacy Rule, PHI includes data that would allow an outside party to identify an individual, including demographic data relating to: 1) an individuals past, present or future physical or mental health; 2) the provision of healthcare to an individual; or 3) past, present or future payment for the provision of healthcare to an individual. 18 PHI includes common identifiers, such as name, address, date of birth, email address, Social Security Number and, depending on the incidence and prevalence of a given condition, data as broad as zip code.”
The systems used broadly throughout the hospital and when necessary, even shared with other providers, need to be safe and productive by being appropriately encrypted, firewalls maintained and updated, and any video, audio and PHI stored securely while each system needs to be approved by an accredited Institutional Review Board. There are many things we do in order to keep the safety of the patient information and records. The FDA also plays a role in ensuring the safety and effectiveness of each program.
Another issue can be patients comfort with communication to their providers. A study was conducted by Langarizadeh M., Moghbeli F., and Aliabadi A. (2017) about the ethics involved in Telehealth. In the study, the doctor-patient relationship was the main ethical issue. Although, computers and hospital phones are the main communication between nurses and providers, the patients may feel they aren’t being treated. Not physically seeing the doctor may make the patient feel a loss of trust. The communication between the patient and their provider includes diagnosis, care plans, surgical procedures, consent papers, and more. With that, we need our patients to feel safe and that they can trust us healthcare providers.