Medico‐legal implications of audiovisual recordings of telehealth encounters

Farmer, Caitlin C; Pang, Sam; Kevat, Dev; Dean, Jessica; Panaccio, Danielle; Mahar, Patrick

doi:10.5694/mja2.51008

Cited by 5 publications

(4 citation statements)

References 2 publications

(2 reference statements)

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“…The concerns reported by the selected articles mostly pertain to the ethical and legal aspects (often interlinked), which were already highlighted in previous literature before the pandemic [7], but nevertheless remain crucial. These included the following: informed consent (information about the risks and benefits of remote therapy) and autonomy (87%), patient privacy (78%) and confidentiality (57%), data protection and security (74.%), malpractice and professional liability/integrity (70%), equity of access (30%), quality of care (30%), the professional-patient relationship (22%), and the principle of beneficence or being disposed to act for the benefit of others (13%) [1,6,8,10,11,[16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34]. Non-maleficence is the principle of preventing harm by actively promoting confidentiality, safety/safeguarding, and security.…”

Section: Resultsmentioning

confidence: 99%

“…Commentary Italy [1] Law/regulations/legal issues (83%) stress the absence or variation of the rules among countries and the need for guidelines/best practices or standardization of telemedicine services. In particular, the questions raised regarded the following aspects: costs of services and reimbursement, insurance coverage, virtual prescription of medications, accreditation, licensing, commercialization, recording (as an area of controversy), and evaluation of the effectiveness of the services such as health outcomes and delivery, in terms of quality and cost, individual experience, program implementation, and key performance indicators [1,6,8,10,11,16,19,[21][22][23][24][27][28][29][30][31][32]34].…”

Section: Resultsmentioning

confidence: 99%

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Ethical and Legal Challenges of Telemedicine in the Era of the COVID-19 Pandemic

et al. 2021

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Background and objective: Telemedicine or telehealth services has been increasingly practiced in the recent years. During the COVID-19 pandemic, telemedicine turned into and indispensable service in order to avoid contagion between healthcare professionals and patients, involving a growing number of medical disciplines. Nevertheless, at present, several ethical and legal issues related to the practice of these services still remain unsolved and need adequate regulation. This narrative review will give a synthesis of the main ethical and legal issues of telemedicine practice during the COVID-19 pandemic. Material and Methods: A literature search was performed on PubMed using MeSH terms: Telemedicine (which includes Mobile Health or Health, Mobile, mHealth, Telehealth, and eHealth), Ethics, Legislation/Jurisprudence, and COVID-19. These terms were combined into a search string to better identify relevant articles published in the English language from March 2019 to September 2021. Results: Overall, 24 out of the initial 85 articles were considered eligible for this review. Legal and ethical issues concerned important aspects such as: informed consent (information about the risks and benefits of remote therapy) and autonomy (87%), patient privacy (78%) and confidentiality (57%), data protection and security (74%), malpractice and professional liability/integrity (70%), equity of access (30%), quality of care (30%), the professional–patient relationship (22%), and the principle of beneficence or being disposed to act for the benefit of others (13%). Conclusions: The ethical and legal issues related to the practice of telehealth or telemedicine services still need standard and specific rules of application in order to guarantee equitable access, quality of care, sustainable costs, professional liability, respect of patient privacy, data protection, and confidentiality. At present, telemedicine services could be only used as complementary or supplementary tools to the traditional healthcare services. Some indications for medical providers are suggested.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Ethical and Legal Challenges of Telemedicine in the Era of the COVID-19 Pandemic

et al. 2021

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“…Additionally, further study needs to be undertaken of the safeguarding risks associated with virtual consultations, as people with intellectual disabilities represent a group particularly vulnerable to abuse, 28 and a virtual environment potentially enables easier involvement of individuals not acting in the patients’ best interests in the clinical consultation. 29 While challenges exist to engage people with intellectual disabilities in research, there is an appetite both from those with disabilities and researchers to have meaningful engagement. 27 …”

Section: Discussionmentioning

confidence: 99%

Acceptability of virtual psychiatric consultations for routine follow-ups post COVID-19 pandemic for people with intellectual disabilities: cross-sectional study

Tromans,

Rybczynska-Bunt,

Mitchell

et al. 2024

BJPsych open

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Background After the rapid implementation of digital health services during the COVID-19 pandemic, a paucity of research exists about the suitability of remote consulting in people with intellectual disabilities and their carers, particularly for neuropsychiatric reviews. Aim This study examines when remote neuropsychiatric routine consulting is suitable for this population. Method A survey was conducted of people with intellectual disabilities and their carers, examining their preference between face-to-face and video consultations for ongoing neuropsychiatric reviews within a rural countywide intellectual disability service in Cornwall, England (population: 538 000). The survey was sent to all adults with intellectual disabilities open to the service on 30 July 2022, closing on 30 September 2022. Participants were asked to provide responses on 11 items predesigned and co-produced between clinicians and experts by experience. The entire service caseload of people had White ethnicity, reflecting the ethnic demographics of Cornwall. Responses received without consent were excluded from the study dataset. Results Of 271 eligible participants, 119 responses were received, 104 of whom consented to having their anonymised data used for research analysis. There were no significant differences between preferences and age and gender variables. There was no statistically significant difference regarding preference for the reintroduction of face-to-face appointments (52.0%) compared with video consultations (48.0%). Travel distance (>10 miles) to the clinical setting was important but did not outweigh benefits for those preferring a face-to-face appointment. Conclusions This study offers insights into the factors that influence preferences about what type of neuropsychiatric appointment is most suitable for people with intellectual disabilities.

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“…Qualitative research has been used to demonstrate patient and clinician perspectives of using telehealth during and after the acute phase of the COVID-19 pandemic across various specialties, highlighting barriers and facilitators to its ongoing use. There are numerous barriers, including, but not limited to, the lack of clear legal and regulatory frameworks [ 14 , 24 , 25 ], funding and reimbursement challenges [ 26 ], variable digital literacy [ 27 , 28 ], and lack of access to technology [ 27 ]. Facilitators primarily centre around convenience and flexibility, such as reduced travel, cost-savings, increased safety (e.g.…”

Section: Introductionmentioning

confidence: 99%

Tailoring communication practices to support effective delivery of telehealth in general practice

White,

Nguyen,

Roger

et al. 2024

BMC Prim. Care

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Background The unprecedented increase in telehealth use due to COVID-19 has changed general practitioners’ (GP) and patients’ engagement in healthcare. There is limited specific advice for effective communication when using telehealth. Examining telehealth use in practice in conjunction with perspectives on telehealth as they relate to communication allows opportunities to produce evidence-based guidance for optimal use of telehealth, while also offering practitioners the opportunity to reflect on elements of their communicative practice common to both styles of consultation. The objective of this research was to develop evidence-based resources to support effective, person-centred communication when GPs and patients use telehealth. This included examination of interactional practices of recorded telehealth consultations, exploration of GP and patient perspectives relating to telehealth, and identifying priorities for guidance informed by these analyses as well as participant co-design. Methods This study involved recording telehealth consultations (n = 42), conducting patient surveys (n = 153), and interviewing patients (n = 9) and GPs (n = 15). These were examined using interaction analytic methods, quantitative analysis, and thematic analyses, to create a robust, integrated picture of telehealth practice and perspectives. The process of research translation involved a co-design approach, engaging with providers, patients, and policy makers to facilitate development of evidence-based principles that focus on supporting effective communication when using telehealth. Results Three key themes relating to communication in telehealth were identified across the different analyses. These were relationship building, conversational flow, and safety netting. The draft best practice principles drawn from these themes were modified based on co-design feedback into five Best Practice Principles for Communication between GPs and Patients using Telehealth. Conclusions Effective communication is supported through relationship building and attention to conversational flow in telehealth consultations, which in turn allows for safety netting to occur. In telehealth, GPs and patients recognise that not being co-present changes the consultation and use both intuitive and strategic interactional adjustments to support their exchange. The mixed-method examination of experiences through both a detailed analysis of telehealth consultations in practice and comparative exploration of GP and patient perspectives enabled the identification of principles that can support effective communication when using telehealth. Co-design helped ensure these principles are ready for implementation into practice.

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Medico‐legal implications of audiovisual recordings of telehealth encounters

Cited by 5 publications

References 2 publications

Ethical and Legal Challenges of Telemedicine in the Era of the COVID-19 Pandemic

Ethical and Legal Challenges of Telemedicine in the Era of the COVID-19 Pandemic

Acceptability of virtual psychiatric consultations for routine follow-ups post COVID-19 pandemic for people with intellectual disabilities: cross-sectional study

Tailoring communication practices to support effective delivery of telehealth in general practice

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