Despite the convenience and efficiency that telehealth offers, important issues so far hinder wider adoption.
They include the ethics and quality of remote vs. in-person care as well as reimbursement for physicians, as outlined in an article at Healthcare IT News.
For such a hands-on business, remote care could depersonalize the doctor-patient relationship. The American Medical Association’s long-standing policy encourages establishment of a doctor-patient relationship in person first, and the group has called for telemedicine to be a core part of med school.
"In thinking about how we care for all of our patients, we're not just relying on the visits we have with them," Shivan Mehta, director of operations at the Penn Medicine Center for Health Care Innovation, tells Healthcare IT News, emphasizing that social media and text messaging also could be used to forge deeper relationships with patients between visits.
Quality and ethics are closely related, too. Doctors’ fundamental ethical responsibilities do not change, AMA Board Member Jack Resneck, M.D., said when announcing new guidance on telemedicine in June, which calls for the highest standards regardless of the form interactions take.
David Fleming, co-director of the MU Center for Health Ethics at the University of Missouri School of Medicine, tells Healthcare IT News that ethical concerns that might present themselves differently with remote care, such as ensuring privacy and confidentiality of patient data, avoiding discrimination, and preventing exploitation of patients.
Reimbursement has been considered the major barrier to telemedicine, with different rules for government and private payers.
On efforts to achieve uniformity, Kofi Jones, director of government affairs for telehealth services provider American Well, says the focus must be on getting policymakers to view telehealth as "simply a modality of care delivery, not a different type of healthcare, and should be viewed in a similar light."