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The use of telecommunications technology to provide, enhance, or expedite health care services.
Accessing off-site databases, linking clinics or physicians' offices to central hospitals, or transmitting x-rays or other diagnostic images for examination at another site.
Electronic transfer of information should be secure and remain confidential .
We should make sure the right access to the right data by the right people.
Patient information + Inappropriate disclosure
= Breach of confidentiality
Patient information + Inaccurate / Incomplete data =
possible medical error or compromised patient safety
Telemedicine law is still in the formative stage, so:
providers are encouraged to adjust telemedicine policies and procedures
appropriately. Standards of care and informed consent
laws are different than what we are doing now in our daily practice and even vary from country to country and providers should always be in touch with legal counsels.
Telemedicine doesn’t change a providers duty to protect the confidentiality of patients medical information
The originating site remains responsible for overseeing the safety and quality of services offered to it’s patients.
hospitals are encouraged to use same facilities and applications.
(1) the traditional medico-legal issues not unique to the medium;
(2) conflicts in state law, which telemedicine amplifies because it connects geographically separate facilities;
(3) issues unique to telemedicine.
The telemedicine system can fail without provider control
Power failure Telecommunication interruption Remote equipment failure Unreliable information : distorted colors
, incomplete files ,… Hackers
Identity of all participating physician and staff
Location of the patient and healthcare provider
The beginning and ending time of the encounters
The equipment used and the resolution of the images and or sound
Patient has an option to withhold or withdraw consent at any time without affecting the right to future care or treatment
The potential risks consequences and benefits of telemedicine
All existing confidentiality protections apply
All existing law regarding patient access to medical information and copies of medical records.
Prior to receiving telemedicine services the patient must sign a statement confirming that the above information was provided.
E-mail correspondence with patients is simple but it has it’s own risks :
Inadequate protection Miscommunication and availability to
unauthorized individuals Delayed treatment
Establish a turnaround time for messages
Used an automatic reply function to acknowledge receipt
Inform patient about privacy and security limitations of e-mail
Retain and integrate electronic and or paper copies of medical reports
Establish policies that describe the types of transaction ( prescription refill , appropriate scheduling , etc …) and sensitivity of subject matter ( HIV , mental health , etc …).
Instruct patients ( indicate category of transaction in the subjective of message to expedite response).