{"id":3614,"date":"2012-08-20T17:45:52","date_gmt":"2012-08-20T21:45:52","guid":{"rendered":"http:\/\/www.poweryourpractice.com\/?p=3614"},"modified":"2012-08-20T17:45:52","modified_gmt":"2012-08-20T21:45:52","slug":"addressing-telemeds-ethical-challenges-at-your-practice","status":"publish","type":"post","link":"https:\/\/carecloud.com\/continuum\/addressing-telemeds-ethical-challenges-at-your-practice\/","title":{"rendered":"Addressing Telemed’s Ethical Challenges at Your Practice"},"content":{"rendered":"

There\u2019s a mass in your lower back and its edges are rough to the touch. You\u2019re anxious, naturally. Perhaps you\u2019re struggling with depression after a divorce. However, you live in a rural area<\/a>,\u00a0and finding a specialist would require an hour-long drive, which interferes with the daily operations of your own general practice.<\/p>\n

Would you seek medical advice first online? You\u2019re a physician and know that web chatting or Skyping isn\u2019t the proper way to initially go about checking out your symptoms but does every patient know that?<\/strong><\/p>\n

You also know you don\u2019t want to take first-time patients via Skype or email \u2013 the ethical repercussions are enormous.<\/strong> With that said, we dig deeper into a few examples and discuss how you can avoid telemed\u2019s ethical pitfalls.<\/p>\n

General Rules of Thumb
\n<\/strong>There are several questionable issues with telemedicine. In fact, it may be the most contentious of all recent medical innovations, ethically speaking.<\/p>\n

Before anything else, avoid legal and ethical issues by practicing telemedicine within your state, or you could be facing some rather menacing federal charges.<\/p>\n

Also, CMS requires you to have a process in place for credentialing, meaning the verification of a provider\u2019s credentials, so you can prove you have the license, education, and provider\u2019s insurance to practice.<\/strong> Lastly, don\u2019t forget to follow AMA\u2019s guidelines for telemedical practices.<\/p>\n

Skype and Other Forms of Video Conferencing
\n<\/strong>Physicians and other industry delegates gathered at the Council on Ethical and Judicial Affairs open forum at the AMA Annual Meeting earlier this year to discuss many of these contentions, and Skyping took center stage.<\/p>\n

While we don\u2019t worry about Skyping with a family member studying abroad, it\u2019s still a very insecure technology in the medical world<\/strong>, where sensitive information can be compromised due to the lack of guaranteed confidentiality.<\/p>\n

However, Skype meets HIPAA encryption requirements, making it technically safer than a telephone conversation, which can easily be tapped and is easier to usurp information from.<\/p>\n

You also can\u2019t readily tell, from looking at one\u2019s Skype log, what calls were placed to friends, family, patients, and\/or lovers, so it\u2019s safer than both phone calls and email exchanges in that sense. In a sense, the Skype debate is reminiscent of the \u201990s cell phone scare. Do, however, ensure your computer is password protected and be cautious about who can access your Skype account.<\/p>\n

If you want to play it a little safer, consider more sophisticated platforms by companies like Cisco, who provide stronger encryption and aren\u2019t unspecialized, proprietary third parties that won\u2019t let you know if a breach has occurred.<\/p>\n

Conflicts with Online Chat
\n<\/strong>What about web-based chat services, where a patient can ask physicians questions regarding their symptoms in an effort to receive quick, short answers that serve as mini-diagnoses?<\/p>\n

A virus can easily be mistaken for a bacterial infection, or the online doctor may suggest treatment for muscle spasms instead of a herniated disk. Imagine the risks associated with incorrect prescriptions.<\/p>\n

The patient chat scare is a little different in nature from Skyping, but ultimately produces similar conclusions. A doctor shouldn\u2019t diagnose patients online<\/strong> in the first place.<\/p>\n

Telemedicine is more useful after the first patient-doctor encounter,<\/a> when the intention is to provide support for an existing condition and\/or ailment. Just don\u2019t try diagnosing, but you wouldn\u2019t anyway. You\u2019re a professional, right?<\/p>\n

ePrescription Abuse
\n<\/strong>What about patients who actively seek a certain prescription? This is fairly popular with mental health patients, who want an escape from depression or anxiety.<\/strong><\/p>\n

In 2005, a Stanford teenager committed suicide after being prescribed fluoxetine (generic Prozac) for depression online two months earlier. This put into question the idea of who \u2018owns\u2019 a prescription, how \u2018follow-ups\u2019 are performed online, and whether you can use telemedical technologies to create effective therapeutic relationships.<\/p>\n

The case of prescribing for mental health is always tricky, whether it\u2019s a remote or in-person relationship. States like Virginia have even passed legislation<\/strong> on this matter.\u00a0In the end, no matter what kind of medicine you practice, a general rule of thumb still stands \u2013 forge a physical, genuine relationship with your patient before prescribing online.<\/a><\/p>\n

With the telemedicine market set to more than double by 2015, these issues are about to start feeling much closer to home, and your practice is going to have to adjust.<\/p>\n

Are you ready to do so?<\/strong><\/p>\n","protected":false},"excerpt":{"rendered":"

There\u2019s a mass in your lower back and its edges are rough to the touch. You\u2019re anxious, naturally. Perhaps you\u2019re struggling with depression after a divorce. However, you live in a rural area,\u00a0and finding a specialist would require an hour-long drive, which interferes with the daily operations of your own general practice. Would you seek […]<\/p>\n","protected":false},"author":1,"featured_media":32788,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[8],"tags":[],"class_list":["post-3614","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-trends"],"yoast_head":"\nAddressing Telemedicine Ethical Challenges at Your Practice<\/title>\n<meta name=\"description\" content=\"The ethical repercussions are enormous here we discuss some of the ethical challenges associated with telemedicine at your practice below. 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