Regulatory and ethical challenges in telemedicine practice

Care Technology and Ethical Concerns

Complete APA Reference

Fed'n of State Med. (2014, April 26). State Medical Board's Appropriate Regulation of Telemedicine (SMART) Workgroup, Model Policy for the Appropriate Use of Telemedicine Technologies in the Practice of Medicine. Retrieved from www.fsmb.org/pdf/FSMB_Telemedicine_Policy.pdf

Privacy issues

Entrepreneurs have continued to develop new interfaces and mobile medical tools for effective physician-physician and physician-patient communications. Before the overdependence on the telemedicine technology for obtaining and transferring patients' confidential health data, providers should make sure that the communication channels are well secured, good implementation of entity- and business associate that are technology-specific as well as other privacy agreements and confidentiality, get the users and the administrators educated on the right use of these telemedicine technologies and help in the understanding of which patient information are being collected and how they are being collected and stored.

When information is shared among different entities, every disclosure must agree with all state and federal privacy and security laws, which includes the Health Insurance Portability and Accountability Act and the Economic and Clinical Health Act Information Technology.

Licensure

Irrespective of advancements in telemedicine, health care authorities are still liable for all care offered to patients. Under the final rule of CMS, which comes into effect on July 5, 2011, which is a revision of the participation in the federal Medicare Conditions of Participation for health centers, health care bodies may depend on the privileging and credentialing decisions of hospitals in distant locations, or the information made available by other telemedicine entities for the determination of the privileges that accrue health practitioners who administer telemedicine services these distant hospitals so long as some given conditions are met such as a written agreement on complaint.

In order to alleviate possible fraud and careless credentialing claims and its associated risks, when going into a written agreement with these distant medical centers, healthcare authorities are expected to know whose responsibility it is to provide the needed care to the patient and when such cares will be provided, confirm the fact that any signed written agreement is a reflection of recent legal requirements, institute some precise responsibilities of these distant hospitals as well as telemedicine entities, and make sure the written agreements contain adequate warranties, representations, and indemnifications with regards to the quality of the services offered by the distant site hospitals and the entities with which the distant hospital subcontracts.

Liability issues

More healthcare authorities are making use of technologies to enlarge their networks with other health providers. In a similar way, more developers create telecommunication tools that virtually connect the patients to health care providers. Similarly, health care legal representatives must know the legal battles faced by telemedicine service providers; they must also know about the different laws that affect telemedicine technologies and the use of suitable equipment. The federation of then State Medical Boards has given definition to the term Telemedicine Technologies as "the technological tools and devices that enable secure electronic exchange of information and communication between a license giver in one location and a patient in a different location irrespective of the involvement of an intervening healthcare provider or not (Fed'n of State Med, 2014)." These may involve equipment for multimedia communications, mobile health tools, and two-way video interface platforms.

Reimbursement

Reimbursement has remained a barrier to telemedicine. The reimbursement of Medicare for telemedicine services is restricted and requires a general face-to-face contact between the healthcare provider and the patient, with the exception of some specific telemedicine services made available at a suitable facility situated in a rural area outside the metropolis caused due to shortage in health care professionals. Reimbursement of Medicaid varies among states, and only 20 states have initiated laws that protects or permits the reimbursement for a number of telemedicine services by some commercial insurance service providers. These providers are expected to carry out a scrutiny of all federal Medicare and state Medicaid reimbursement policies, insurance regulations by state health care authorities, and requirements for private payer contract to make sure they are aware of the different requirements for disbursement and the restrictions that may possibly affect their billing techniques, know which of the telemedicine services that qualify or does not qualify for disbursement, and only tender complaint claims in order to escape liability for both abuse, fraud and false claims (Kadzielski & Kim, 2014).