AMA ethics council to revisit telemedicine guidelines
The American Medical Association's (AMA) ethics council has finally issued guidelines on online or mobile visits for doctors and healthcare providers. The use of telehealthcare is increasing in the US, and the AMA issued several recommendations including; doctors must maintain the same levels of professionalism and trust with an online consultation, they should inform patients of the technology’s limitations, tailor any required informed consent accordingly and encourage quality continuity of care. The guidelines also urged doctors to “advocate for access” to telemedicine, and put the onus on medics and professional organisations and institutions to “identify and address adverse consequences”.

A year ago the American Medical Association's ethics council almost took a vote to adopt a set of guidelines focused on ethical considerations related to the use of online or mobile visits between patients and physicians, but a physician from Texas helped convince the committee to rethink its plans and table the discussion until later that year.

Now, 12 months later, the guidelines appear to have changed little but remote visits has turned into one of the biggest trends in healthcare. Next week the association plans to discuss adding the guidelines at its annual conference in Chicago.

"As in any mode of care, patients need to be able to trust that physicians will place patient welfare above other interests, provide competent care, provide the information patients need to make well-considered decisions about care, respect patient privacy and confidentiality, and take steps to ensure continuity of care," the executive summary of the report that accompanies the guidelines explains. "Although physicians’ fundamental ethical responsibilities do not change, the continuum of possible patient-physician interactions in telehealth/telemedicine give rise to differing levels of accountability for physicians. All physicians who participate in telehealth/telemedicine have an ethical responsibility to uphold fundamental fiduciary obligations and to protect privacy and confidentiality."

The report that accompanies the guidelines includes a number of recommendations to physicians who use telemedicine services: they should inform patients about the limitations of these services and encourage them to let their PCPs know about any online visits they've had. Professionalism should be up to the same standards as in-person interactions, and physicians should tailor informed consent processes so they work effectively via telehealth services. Physicians should take steps to promote continuity of care for the patients they see via telemedicine technologies and they should work with professional organizations (like the AMA) to help improve telemedicine services and develop clinical standards.

"Physicians collectively should advocate for access to telehealth/telemedicine services for all patients who could benefit from receiving care electronically," the report reads. "Professional organizations and institutions should monitor telehealth/telemedicine to identify and address adverse consequences as technologies evolve and identify and encourage dissemination of positive outcomes."

While the full report isn't available publicly since it will likely publish in a peer-review journal at a later date, the full text of the language the AMA's council will potentially add to its wider ethical guidelines for its members is included below:

