Page 84 - HA Convention 2016 [Full Version]

HOSPITAL AUTHORITY CONVENTION 2016 Symposiums

S4.1 Telemedicine in Chronic Disease Management 16:15 Convention Hall C

Tuesday, 3 May Ethical Issues in Telemedicine

Klitzman R

Psychiatry Department, Columbia University, USA

Telemedicine promises to aid the delivery of healthcare in many ways, but also poses a series of ethical challenges. Electronic
communication is revolutionising almost every aspect of modern life, including healthcare. Yet many of these advances are
only recently developing, and their full extent, impact, benefits and risks remain unclear. Telemedicine can involve giving and
receiving information among multiple stakeholders, including patients, family members, physicians, nurses, researchers,
hospital administrators, health departments, other government agencies, insurers, and pharmaceutical companies. This
information can be used for disease prevention, diagnosis, monitoring and treatment. But many questions arise concerning,
for instance, what the specific benefits and risks may be of e-diagnosis and e-treatment in various fields – from
telepsychiatry to telesurgery, teleradiology, and telepathology – all of which may make diagnosis and treatment more widely
and cheaply available. Will or should the quality or standards of care change? Electronic health records are increasingly used
to monitor and assess providers and healthcare systems, but does that detract from the quality of face-to-face provider-
patient interactions and care, and if so, how much, if any, is acceptable?

Health information can also cause stigma, embarrassment or discrimination, and confidentiality is thus vital. The ease of
transmission and dissemination of information means that other individuals may obtain it, posing threats. Questions arise
of how much protection is needed, and if protection is not absolute in the “real world”, what minimum standard should
be established; whether whole genome and whole exome sequencing data, or other sensitive information should always
be placed in electronic records and treated the same as other information there; and whether patients might not disclose
important information to providers because of fears that confidentiality may be violated.

Health systems face challenges of how to manage large amounts of “big data” to make best use of it, who should have
access to these data, and how much to switch to telemedicine vs. face-to-face treatment. Critical questions emerge about
how patients and provides view and make decisions about these issues. This presentation will explore these quandaries and
ways of addressing them.

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