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    Ethics in Telehealth : Comparison between Guidelines and Practice-based Experience -the Case for Learning Health Systems. (2020)

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    Type of Content
    Journal Article
    UC Permalink
    https://hdl.handle.net/10092/100645
    
    Publisher's DOI/URI
    https://doi.org/10.1055/s-0040-1701976
    
    Publisher
    Georg Thieme Verlag KG
    ISSN
    0943-4747
    2364-0502
    Language
    English
    Collections
    • Health: Journal Articles [151]
    Authors
    Kuziemsky, C.E.
    Hunter, I.
    Gogia, S.B.
    Iyenger, S.
    Kulatunga, G.
    Rajput, V.
    Subbian, V.
    John, O.
    Kleber, A.
    Mandirola, H.F.
    Florez-Arango, J.
    Al-Shorbaji, N.
    Meher, S.
    Udayasankaran, J.G.
    Basu, Arindam
    show all
    Alternative Title
    Ethics in Telehealth : Comparison between Guidelines and Field Experience -the Case for Learning Health Systems
    Abstract

    OBJECTIVES:To understand ethical issues within the tele-health domain, specifically how well established macro level telehealth guidelines map with micro level practitioner perspectives. METHODS:We developed four overarching issues to use as a starting point for developing an ethical framework for telehealth. We then reviewed telemedicine ethics guidelines elaborated by the American Medical Association (AMA), the World Medical Association (WMA), and the telehealth component of the Health Professions council of South Africa (HPCSA). We then compared these guidelines with practitioner perspectives to identify the similarities and differences between them. Finally, we generated suggestions to bridge the gap between ethics guidelines and the micro level use of telehealth. RESULTS:Clear differences emerged between the ethics guidelines and the practitioner perspectives. The main reason for the differences were the different contexts where telehealth was used, for example, variability in international practice and variations in the complexity of patient-provider interactions. Overall, published guidelines largely focus on macro level issues related to technology and maintaining data security in patient-provider interactions while practitioner concern is focused on applying the guidelines to specific micro level contexts. CONCLUSIONS:Ethics guidelines on telehealth have a macro level focus in contrast to the micro level needs of practitioners. Work is needed to close this gap. We recommend that both telehealth practitioners and ethics guideline developers better understand healthcare systems and adopt a learning health system approach that draws upon different contexts of clinical practice, innovative models of care delivery, emergent data and evidence-based outcomes. This would help develop a clearer set of priorities and guidelines for the ethical conduct of telehealth.

    Citation
    Kuziemsky CE, Hunter I, Gogia SB, Iyenger S, Kulatunga G, Rajput V, Subbian V, John O, Kleber A, Mandirola HF, Florez-Arango J, Al-Shorbaji N, Meher S, Udayasankaran JG, Basu A (2020). Ethics in Telehealth: Comparison between Guidelines and Practice-based Experience -the Case for Learning Health Systems.. Yearbook of medical informatics.
    This citation is automatically generated and may be unreliable. Use as a guide only.
    Keywords
    ethics; telehealth; learning health system; informatics
    ANZSRC Fields of Research
    11 - Medical and Health Sciences::1117 - Public Health and Health Services::111711 - Health Information Systems (incl. Surveillance)
    50 - Philosophy and religious studies::5001 - Applied ethics::500106 - Medical ethics
    Rights
    All rights reserved unless otherwise stated
    http://hdl.handle.net/10092/17651

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