The use of telecommunications technology to provide, enhance, or expedite health care services.

Accessing off-site databases, linking clinics or physicians' offices to central hospitals, or transmitting x-rays or other diagnostic images for examination at another site.

Electronic transfer of information should be secure and remain confidential .

We should make sure the right access to the right data by the right people.

Patient information + Inappropriate disclosure

= Breach of confidentiality

Patient information + Inaccurate / Incomplete data =

possible medical error or compromised patient safety

Telemedicine law is still in the formative stage, so:

providers are encouraged to adjust telemedicine policies and procedures

appropriately. Standards of care and informed consent

laws are different than what we are doing now in our daily practice and even vary from country to country and providers should always be in touch with legal counsels.

Telemedicine doesn’t change a providers duty to protect the confidentiality of patients medical information

The originating site remains responsible for overseeing the safety and quality of services offered to it’s patients.

hospitals are encouraged to use same facilities and applications.

(1) the traditional medico-legal issues not unique to the medium;

(2) conflicts in state law, which telemedicine amplifies because it connects geographically separate facilities;

(3) issues unique to telemedicine.

The telemedicine system can fail without provider control

Power failure Telecommunication interruption Remote equipment failure Unreliable information : distorted colors

, incomplete files ,… Hackers

Identity of all participating physician and staff

Location of the patient and healthcare provider

The beginning and ending time of the encounters

The equipment used and the resolution of the images and or sound

Patient has an option to withhold or withdraw consent at any time without affecting the right to future care or treatment

The potential risks consequences and benefits of telemedicine

All existing confidentiality protections apply

All existing law regarding patient access to medical information and copies of medical records.

Prior to receiving telemedicine services the patient must sign a statement confirming that the above information was provided.

E-mail correspondence with patients is simple but it has it’s own risks :

Inadequate protection Miscommunication and availability to

unauthorized individuals Delayed treatment

Establish a turnaround time for messages

Used an automatic reply function to acknowledge receipt

Inform patient about privacy and security limitations of e-mail

Retain and integrate electronic and or paper copies of medical reports

Establish policies that describe the types of transaction ( prescription refill , appropriate scheduling , etc …) and sensitivity of subject matter ( HIV , mental health , etc …).

Instruct patients ( indicate category of transaction in the subjective of message to expedite response).