La télémédecine au Québec : état de la situation des considérations légales, juridiques et déontologiques

Alami, Hassane; Gagnon, Marie Pierre; Fortin, Jean‐Paul; Kouri, Robert P.

doi:10.1016/j.eurtel.2015.04.004

Cited by 11 publications

(13 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Telehealth, defined as health care and services, as well as social, preventive and curative services, delivered remotely by means of a telecommunication, including audiovisual exchanges for information, education and research, and treatment of clinical and administrative data purposes [ 1 ], has become an inescapable part of health system reform strategies [ 2 , 3 ]. In recent years, many projects and programs have been initiated with the objective to develop new models of service delivery, capitalizing on the potential of telehealth to improve accessibility, quality, continuity, efficiency, and integration of health care and services, especially for populations with chronic diseases and those living in rural and remote areas [ 2 , 4 - 9 ].…”

Section: Introductionmentioning

confidence: 99%

Involving Citizen-Patients in the Development of Telehealth Services: Qualitative Study of Experts’ and Citizen-Patients’ Perspectives

Alami¹,

Gagnon²,

Fortin³

2018

J Participat Med

View full text Add to dashboard Cite

Background Decisions regarding telehealth services in Quebec (Canada) have been largely technocratic by nature for the last 15 years, and the involvement of citizen-patients in the development of telehealth services is virtually nonexistent. In view of the societal challenges that telehealth raises, citizen-patient involvement could ensure more balance between evidence from traditional research methodologies and technical experts and the needs and expectations of populations in decisions about telehealth services. Objective This study aimed to explore the perception of various stakeholders (decision makers, telehealth program and policy managers, clinicians, researchers, evaluators, and citizen-patients) regarding the involvement of citizen-patients in the development of telehealth services in Quebec. In particular, we explored its potential advantages, added value, obstacles, and challenges it raises for decision making. Methods We used a qualitative research approach based on semistructured individual interviews, with a total of 29 key actors. Respondents were identified by the contact network method. Interviews were recorded and transcribed verbatim. A pragmatic content thematic analysis was performed. To increase the capacity for interpretation and analysis, we were guided by the principle of data triangulation. Results Citizen-patient involvement in decision making is perceived more as a theoretical idea than as a practical reality in health care organizations or in the health system. There is very little connection between citizen involvement structures or patient and user groups and telehealth leaders. For the respondents, citizen-patient involvement in telehealth could increase the accountability and transparency of decision making and make it more pragmatic within an innovation-driven health system. This involvement could also make citizen-patients ambassadors and promoters of telehealth and improve the quality and organization of health services while ensuring they are more socially relevant. Challenges and constraints that were reported include the ambiguity of the citizen-patient , who should be involved and how, claimant citizen-patient, the risk of professionalization of citizen-patient involvement, and the gap between decision time versus time to involve the citizen-patient. Conclusions This study provides a basis for future research on the potential of involving citizen-patients in telehealth. There is a great need for research on the issue of citizen-patient involvement as an organizational innovation (in terms of decision-making model). Research on the organizational predisposition and preparation for such a change becomes central. More efforts to synthesize and translate knowledge on public participation in decision making in the health sector, particularly in the field of technology development, are needed. ...

show abstract

Section: Introductionmentioning

confidence: 99%

Involving Citizen-Patients in the Development of Telehealth Services: Qualitative Study of Experts’ and Citizen-Patients’ Perspectives

Alami¹,

Gagnon²,

Fortin³

2018

J Participat Med

View full text Add to dashboard Cite

show abstract

“…Avec la télésanté, de nouveaux types d’information apparaissent dans le dossier médical du patient modifiant ainsi son contenu et impactant les règles de sa gestion : sécurité de transmission, partage, enregistrement et conservation [38] , [39] . Notons au passage que la traçabilité de l’information ou l’identification des personnes (ou tiers) ayant eu accès aux dossiers (ex.…”

Section: Les Conséquences Inattendues De La Télésantéunclassified

“…Notons au passage que la traçabilité de l’information ou l’identification des personnes (ou tiers) ayant eu accès aux dossiers (ex. simple consultation, modification, ajout, suppression), ne sont pas des plus aisées [38] , [39] . La télésanté implique l’intervention de plusieurs professionnels (ex.…”

Section: Les Conséquences Inattendues De La Télésantéunclassified

“…Toutefois, elle soulève la problématique de savoir le lieu de dispensation de l’acte médical : doit-il être celui où se trouve le patient, ou celui où se trouve le professionnel ? [39] , [45] . La connaissance du lieu où est posé l’acte est nécessaire pour définir sous quel cadre légal les responsabilités peuvent être engagées en cas de préjudice sur le patient [46] .…”

Section: Les Conséquences Inattendues De La Télésantéunclassified

See 1 more Smart Citation

Au-delà de l’évaluation des bénéfices : réflexion sur les conséquences inattendues de la télésanté

Alami

Gagnon

Côté

et al. 2020

Ethics, Medicine and Public Health

Self Cite

View full text Add to dashboard Cite

La télésanté est considérée comme un levier incontournable dans les choix des politiques en santé. Toutefois, il subsiste de nombreux enjeux face à son intégration réussie dans les pratiques cliniques. À ce jour, un grand nombre d’initiatives en télésanté peine à dépasser le stade de projet pilote. Cette situation s’explique en partie par une culture de l’innovation qui est principalement focalisée sur les bénéfices attendus de la technologie et moins sur les changements et les transformations qu’elle peut entraîner. La télésanté est utilisée dans des établissements de santé dont la dynamique sociale est pour le moins complexe. Son introduction entraîne des conséquences inattendues pouvant affecter aussi bien les patients, les communautés, les professionnels, les établissements que les systèmes de santé et la société dans son ensemble. L’objectif de cet article est de discuter de certaines des conséquences inattendues découlant de l’utilisation de la télésanté dans les établissements et systèmes de santé.

show abstract

“…Moreover, this involvement should not only occur in the evaluation of telehealth as a "technical object" (e.g. survey about technology acceptance and satisfaction), but in the prioritization, planning and implementation of telehealth services [13,23].…”

Section: Introductionmentioning

confidence: 99%

Involving Citizen-Patients in the Development of Telehealth Services: Qualitative Study of Experts’ and Citizen-Patients’ Perspectives (Preprint)

Alami¹,

Gagnon²,

Fortin³

2018

Preprint

View full text Add to dashboard Cite

BACKGROUND Decisions regarding telehealth services in Quebec (Canada) have been largely technocratic by nature for the last 15 years, and the involvement of citizen-patients in the development of telehealth services is virtually nonexistent. In view of the societal challenges that telehealth raises, citizen-patient involvement could ensure more balance between evidence from traditional research methodologies and technical experts and the needs and expectations of populations in decisions about telehealth services. OBJECTIVE This study aimed to explore the perception of various stakeholders (decision makers, telehealth program and policy managers, clinicians, researchers, evaluators, and citizen-patients) regarding the involvement of citizen-patients in the development of telehealth services in Quebec. In particular, we explored its potential advantages, added value, obstacles, and challenges it raises for decision making. METHODS We used a qualitative research approach based on semistructured individual interviews, with a total of 29 key actors. Respondents were identified by the contact network method. Interviews were recorded and transcribed verbatim. A pragmatic content thematic analysis was performed. To increase the capacity for interpretation and analysis, we were guided by the principle of data triangulation. RESULTS Citizen-patient involvement in decision making is perceived more as a theoretical idea than as a practical reality in health care organizations or in the health system. There is very little connection between citizen involvement structures or patient and user groups and telehealth leaders. For the respondents, citizen-patient involvement in telehealth could increase the accountability and transparency of decision making and make it more pragmatic within an innovation-driven health system. This involvement could also make citizen-patients ambassadors and promoters of telehealth and improve the quality and organization of health services while ensuring they are more socially relevant. Challenges and constraints that were reported include the ambiguity of the citizen-patient, who should be involved and how, claimant citizen-patient, the risk of professionalization of citizen-patient involvement, and the gap between decision time versus time to involve the citizen-patient. CONCLUSIONS This study provides a basis for future research on the potential of involving citizen-patients in telehealth. There is a great need for research on the issue of citizen-patient involvement as an organizational innovation (in terms of decision-making model). Research on the organizational predisposition and preparation for such a change becomes central. More efforts to synthesize and translate knowledge on public participation in decision making in the health sector, particularly in the field of technology development, are needed.

show abstract

La télémédecine au Québec : état de la situation des considérations légales, juridiques et déontologiques

Cited by 11 publications

References 24 publications

Involving Citizen-Patients in the Development of Telehealth Services: Qualitative Study of Experts’ and Citizen-Patients’ Perspectives

Involving Citizen-Patients in the Development of Telehealth Services: Qualitative Study of Experts’ and Citizen-Patients’ Perspectives

Au-delà de l’évaluation des bénéfices : réflexion sur les conséquences inattendues de la télésanté

Involving Citizen-Patients in the Development of Telehealth Services: Qualitative Study of Experts’ and Citizen-Patients’ Perspectives (Preprint)

Contact Info

Product

Resources

About