On June 13th the American Medical Association (AMA) adopted a new guidance for ethical practice in telehealth and telemedicine. The guidance outlines the new ethical responsibilities of physicians when using telemedicine as opposed to traditional interactions in a medical office or hospital. The new guidance was drafted by the AMA’s Council on Ethics and Judicial Affairs and approved on a vote by physicians across the United States. The American Medical Association saw the new guidance as necessary given the ways recent technological innovations are reshaping communication between patients and physicians.  

The guidance emphasizes that physicians using telehealth must uphold the same guidelines as in any model of care. Physicians must continue to put patient welfare above their own interests, provide competent and sufficient care, respect patient privacy, and ensure continuity of care. The AMA notes, however, that telehealth gives rise to new responsibility and accountability on behalf of physicians. Among these responsibilities is that the physician must disclose any additional interests involved in their use of telehealth and eliminate any conflicts of interests that may exist. In addition, they must be sure that the health information they give is both objective and accurate. Physicians must also ensure that appropriate security measures are in place to protect patient information throughout transmission.
 

The guidance lists these additional standards for physicians:

• Physicians should inform the patient of any limitations involved in the use of telehealth, instruct patients on how to seek follow up care, and encourage users to update their primary care physicians on the status of their telehealth consultations. 
• They must uphold the same standard of professionalism present in in-person care and follow any state or federal laws applicable to telemedicine.
• They should be comfortable with electronic interaction and have a strong understanding for use of the technology. 
• During electronic interactions, physicians must establish the patient’s identity, confirm that the use of telehealth is appropriate for the individual patient and their medical needs, evaluate the prescription based on its indication, appropriateness, and safety, and document the clinical evaluation and eventual prescription.

The guidance also outlines several responsibilities for physicians to collectively uphold:

• Physicians should support the refinement of telehealth and take actions towards the creation of standards that will ensure safety and quality. 
• They should promote telehealth policy changes that increase access to telehealth among the technology’s greatest potential beneficiaries. 
• They should continue to address any adverse consequences of new technologies as well as encourage dissemination of positive and negative outcomes as a result of their use.

The AMA plans to publically release the guidance in the coming weeks. Read the AMA’s press release.