Ethical Practice in Telemedicine

Innovation in technology, including information technology, is redefining how people perceive time and distance. It is reshaping how individuals interact with and relate to others, including when, where, and how patients and physicians engage with one another.

  1. Inform users about the limitations of the relationship and services provided.
  2. Advise site users about how to arrange for needed care when follow-up care is indicated.
  3. Encourage users who have primary care physicians to inform their primary physicians about the online health consultation, even if in-person care is not immediately needed. Physicians who provide clinical services through telehealth/telemedicine must uphold the standards of professionalism expected in in-person interactions, follow appropriate ethical guidelines of relevant specialty societies and adhere to applicable law governing the practice of telemedicine. In the context of telehealth/telemedicine they further should:
  4. Be proficient in the use of the relevant technologies and comfortable interacting with patients and/or surrogates electronically.
  5. Recognize the limitations of the relevant technologies and take appropriate steps to overcome those limitations. Physicians must ensure that they have the information they need to make well-grounded clinical recommendations when they cannot personally conduct a physical examination, such as by having another health care professional at the patient’s site conduct the exam or obtaining vital information through remote technologies.
  6. Be prudent in carrying out a diagnostic evaluation or prescribing medication by:
    1. establishing the patient’s identity;
    2. confirming that telehealth/telemedicine services are appropriate for that patient’s individual situation and medical needs;
    3. evaluating the indication, appropriateness and safety of any prescription in keeping with best practice guidelines and any formulary limitations that apply to the electronic interaction;
    4. documenting the clinical evaluation and prescription.
    1. identify and address adverse consequences as technologies and activities evolve;
    2. identify and encourage dissemination of both positive and negative outcomes.
    AMA Principles of Medical Ethics: I, IV, VI, IX

    Council Reports

    Ethics Cases & Legal Briefs

    Related Opinions

    Opinion 1.2.9

    Use of Remote Sensing & Monitoring Devices

    Devices that transmit patient information wirelessly to remote receiving stations can offer convenience for both patients and physicians, enhance the efficiency and quality of care, and promote increased access to care, but also raise concerns about safety and the confidentiality of patient information.

    Opinion 2.1.1

    Informed Consent

    Informed consent to medical treatment is fundamental in both ethics and law. Patients have the right to receive information and ask questions about recommended treatments so that they can make well-considered decisions about care.