This blog post is a writing assignment for MAST 1010: Legal & Ethical Concerns in the Medical Office, part of the Health Care Management (HC23) Associate of Applied Science Degree program at Southern Crescent Technical College.
Telemedicine has existed since 500 BCE when medical information was sent across long distances using messengers, light reflections, and smoke signals. Over time many inventions improved telemedicine, including the telegraph, the printing press, the telephone, and the internet. Computers, cameras, microphones, and the internet led to how telemedicine works today. People now even use smartphones and tablets for health care (Jin, 2020, p. 1-2).
One concern for Telemedicine is HIPAA compliance. Providers must use encryption, audit logs, and access controls to comply, and some EHR systems have these features. During the COVID-19 pandemic, HHS allowed providers to use popular social apps for telemedicine, like Zoom, Facebook Messenger, and Skype. Such services typically do not offer business associate agreements (BAAs) that take liability for a breach. HIPAA requires vendors to have BAAs. Additional privacy concerns include people who may listen and are located in the same room with the patient who are not on camera and unknown to the care provider (Jin, 2020, p 2).
Telemedicine has some limitations. The care provider cannot give as thorough of a physical exam or take vitals. If the patient has equipment at home, she might take her own vitals, which increases the likelihood of error. Calls can be disconnected, and emergencies can occur during calls when the physician cannot immediately and directly intervene. Reimbursement and scheduling are still challenging and confusing factors (Jin, 2020, p. 3-4).
Telemedicine also has many benefits. It increases access to health care for the immunocompromised and those in rural areas and helps patients access specialists and be seen more quickly. It has been a valuable tool during the COVID-19 pandemic to continue providing health care while social distancing (Jin, 2020, p 4).
Telemedicine has a multitude of legal concerns. Current laws do not provide complete support for the advancement and use of telemedicine as a normal delivery method for all patients. The problems unique to telemedicine are not adequately addressed by current legislation. Additionally, telemedicine allows physicians to easily see patients anywhere, including in other states where they may not be licensed (Jin, 2020, p 5).
Telemedicine has ethical concerns. Care providers must provide the same quality of care virtually as in-person visits. Physicians must use sound judgment to determine when telemedicine is appropriate and when to see patients in person, as virtual encounters are not best for all health concerns. Providers should provide their patients with relevant information about the benefits and risks of telemedicine, so they can maintain autonomy and decide if it is right for them and authorize its use before their appointment (Jin, 2020, 5-6).
The future of telemedicine is bright. One of the most recent and biggest advancements in telemedicine is using it for real-time remote monitoring. In the future, we will see further integration of telemedicine technology with the EHR, automatically syncing data with the patient’s medical record. Also, artificial intelligence can predict trends and help patients prevent problems before symptoms occur (Jin, 2020, p. 6).
Despite telemedicine’s bright future, hurdles must be crossed before it can fully advance. Technology has already far outpaced our current laws, and lawmakers will need to revise them or make new laws. Until then, the demand for telemedicine will be greater than the ability to provide it legally and compliantly, especially after the COVID-19 pandemic increased its use and normalized it. While popular communication apps have been allowed for emergency use during the pandemic, physicians should know that continuing to use them in the future may violate HIPAA and lead to compliance issues. Developing widespread HIPAA-compliant software within the EHR would be invaluable to advancing telemedicine. Medical practices will need to address scheduling issues, and reimbursement issues will also need to be addressed. Once the healthcare industry crosses these hurdles, telemedicine will be even more common. It will also continue to help many people who would ordinarily not have access or limited access to healthcare or specialists.
Jin, M. X., Kim, S. Y., Miller, L. J., Behari, G., and Correa, R. (2020, Aug. 20). Telemedicine: Current Impact on the Future. NCBI. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7502422/
Module 3 Current Event
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