AMA Journal of Ethics^®

The Indian Health Service has been a leader in implementing telehealth programs and technologies that increase access to and efficiencies in care, particularly in the fields of mental health and ophthalmology.

Teleradiology can contribute to quality care when teleradiologists communicate and collaborate with referring physicians, have real-time access to patients’ medical records, and consult for hospitals that have error detection and correction systems in place.

Telemedicine's potential to advance humanitarian efforts can be realized through further research into best practices, codification of responsibilities and liabilities, counseling and informed consent prior to the creation of electronic health records, strengthening of IT infrastructure, and the integration of an informatics curriculum into residency training programs.

Medical schools should integrate health IT and biomedical informatics into their formal curricula. The George Washington University Emergency Medicine Telemedicine and Digital Health Fellowship was designed to train graduate physicians to use telemedicine in their clinical and research work.

Ensuring the ethical acceptability of telemedicine requires avoiding one-size-fits-all solutions and protecting the patient-physician relationship, patient privacy, and patient-centered care.

This month, Virtual Mentor theme editor Vinod Nambudiri, MD, MBA, a resident in internal medicine and dermatology in the Harvard Combined Medicine-Dermatology Residency Training Program, interviewed Naomi Fried, PhD, about telemedicine's regulatory challenges and the opportunities it presents for innovation in health care delivery and medical education.

Ideally, telepsychiatry treatment should include collaboration with patients’ primary care physicians. One way to facilitate the collaboration is for patients to have videoconference appointments with their psychiatrists in the primary care clinic.

An effective policy regarding retail clinics in a primary care practice should address patients' need for timely and convenient acute care and build capacity for enhanced access to acute care within the primary care clinic itself.

Telepsychiatry extends access to psychiatric treatment to those who might not otherwise get it, but licensure problems and the risk of boundary violations between patients and physicians need to be worked out.

This month Virtual Mentor spoke with Dr. Emeka Okafor about the benefits of, and barriers to, telemedicine, and what can be done to help regulate this growing industry.