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AMA Adopts New Guidance for Ethical Practice in Telemedicine CHICAGO – New ethical guidance adopted at the American Medical Association’s (AMA) June Annual Meeting will help physicians understand how their fundamental responsibilities may play out differently when patient interactions occur through telemedicine, compared to traditional patient interactions at a medical office or hospital. The new ethical guidance on telehealth and telemedicine was developed over the past three years by the AMA’s Council on Ethics and Judicial Affairs and adopted by a vote of physicians from every corner of the country. The development of the new guidelines coincides with innovations in technology that are changing the ways in which people live their lives, including reshaping the ways they engage with medicine. “Telehealth and telemedicine are another stage in the ongoing evolution of new models for the delivery of care and patient-physician interactions,” said AMA Board Member Jack Resneck, MD. “The new AMA ethical guidance notes that while new technologies and new models of care will continue to emerge, physicians’ fundamental ethical responsibilities do not change.” In any model for 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 needed to ensure continuity of care. The evolution of telehealth and telemedicine capabilities offers increasingly sophisticated ways to conduct patient evaluations as technologies for obtaining patient information remotely continue to evolve and improve. The AMA guidelines permit physicians utilizing telehealth and telemedicine technology to exercise discretion in conducting a diagnostic evaluation and prescribing therapy, within certain safeguards. “Physicians who provide clinical services through telemedicine must recognize the limitation of the relevant technologies and take appropriate steps to overcome those limitations,” said Dr. Resneck. “What matters is that physicians have access to the relevant information they need to make well-grounded recommendations for each patient.” The AMA guidelines also recognize that a coordinated effort across the profession is necessary to achieve the promise and avoid the pitfalls of telemedicine. Active engagement should support ongoing refinement of telemedicine technologies and relevant standards while also promoting initiatives that will help make needed technology more readily available to all patients who want to use telemedicine services. n
New Policy Builds upon the AMA’s Efforts to Create the Medical School of the Future Recognizing that formalized training in telemedicine is not widely offered to physicians-in-training, the American Medical Association (AMA) also adopted policy aimed at ensuring medical students and residents learn how to use telemedicine in clinical practice. The new policy specifically encourages the accrediting bodies for both undergraduate and graduate medical education to include core competencies for telemedicine in their programs. The new policy also reaffirms existing AMA policy, which supports reducing barriers to incorporating the appropriate use of telemedicine into the education of physicians. “The vast majority of medical students are not being taught how to use technologies such as telemedicine or electronic health records during medical school and residency. As innovation in care delivery and technology continue to transform healthcare, we must ensure that our current and future physicians have the tools and resources they need to provide the best possible care for their patients,” said AMA Immediate Past President Robert M. Wah, MD. “In particular, exposure to and evidence-based instruction in telemedicine’s capabilities and limitations at all levels of physician education will be essential to harnessing its potential.” Today’s policy action extends the AMA’s ongoing work with 32 of the nation’s leading medical schools to create the medical school of the future. As part of the AMA Accelerating Change in Medical Education Consortium, the 32 schools are working together through a learning community to incorporate the newest technologies that will help prepare future physicians to practice in
the changing health care environment and better provide health care services to underserved populations. Several of the schools are developing and implementing innovative projects focused on technology. For example, Indiana University School of Medicine created a teaching electronic health record (EHR) using de-identified data to ensure medical students have access to EHRs during their medical training, which is now being implemented in other medical schools. Additionally, the University of North Dakota School of Medicine and Health Sciences is using advanced simulation and telemedicine technologies to help students develop skills specific to the needs of rural or remote communities. The AMA launched its Accelerating Change in Medical Education initiative in 2013 to bridge the gaps that exist between how medical students are trained and how healthcare is delivered. The AMA has since awarded $12.5 million in grants to 32 medical schools to develop innovative curricula that can ultimately be implemented in medical schools across the country. These innovative models are already supporting training for an estimated 19,000 medical students who will one day care for 33 million patients each year. The AMA’s initiative is also supporting medical school projects aimed at accelerating student progression through medical school, allowing them to enter residency sooner and contribute more rapidly to expanding the physician workforce. n
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