Patient-Doctor Ethical Dilemmas

In the United States, a renewed interest occurred in telehealth in the 1990s according to McGonigle and Mastrian because of escalating costs, the need for greater access for all

The growing demand of an affordable and more accessible care has resulted in rapid adoption of telemedicine. There is a new and improved healthcare marketplace in the making and healthcare providers are striving to grow and adapt their business models around it.

The purpose of this paper is to discuss how technology has impacted the health care delivery system. Health care technology is advancing at an increasingly rapid rate in the United States, and globally. Patients and providers are witnessing these changes through the use of telehealth, and telemedicine applications. Telehealth, and telemedicine are often used interchangeably, however there is a difference between the two applications. Telehealth is the use of technology to deliver health care, health information, or health education at a distance (U.S. Department of Health and Human Services, n.d.).

The benefits of telehealth consultations are immeasurable; clients are able to access a knowledgeable health care professional and receive a telephone triage/assessment and recommendations. This allows the patient to have immediate access to good health advice and quicker solutions. Telemedicine is one of the many vehicles of telehealth; for example, the cardiologist orders an outpatient Holter Monitor trial to evaluate arrhythmias. The technician calls the patient at the sign of any abnormal rhythm and investigate the activity performed when the reading fluctuation then the reported is communicated to the cardiologist. If warranted, the cardiology staff will contact the patient with instructions schedule an immediate appointment. Telehealth services resources would benefit the client in this next example, an individual’s come in for a sick visit expecting a prescription to be written for their illness; they receive informative instructions because of the nature of the

Many of these barriers exist from lack of essentially knowing the benefits of what the incorporation of telehealth can offer within the aspect of this type of community. At times, there has been a great interest in telehealth surrounding its potential to reduce health care costs along with the improvement of patient outcomes, but at times there has been no known scientific evidence base underpinning it (McLean, Sheikh, Cresswell, Nurmmatov, Mukherjee, Hemmi & Pagilari, 2013).

In this discussion, it is indispensable to review issues concerning telehealth, ethical issues and nursing relevance, and implications for nursing in an effort to renew healthcare as a whole.

Telehealth is the monitoring via remote exchange of physiological data between a patient at home and health care professionals at hospitals or clinics to assist with diagnosis and treatment. As our society ages and health care costs increase, government and private insurance payers are seeking technological interventions. Technological solutions may provide high quality healthcare services at a distance, utilize professional resources more effectively, and enable elderly and ill patients to remain in their own homes. Patients may experience decreased hospitalization and urgent care settings, and out of home care may not be required as the patient is monitored at home. However, no study has been able to prove telehealth

Although the telehealth seems to have the advantage of maximizing effectiveness and efficiency at the lowest possible cost when properly planned and executed; there are serious ethical and legal problems that should be solved prior to its implementation. Telehealth, as in other health related technological developments is a subject of ongoing debate.

Often the biggest barriers to accessing healthcare are cost and location. Lower income individuals just do not have the resources to have optimal healthcare, or cannot take the time away from employment to deal with health issues. One potential solution to help with these problems could be “telehealth.” Telehealth allows a lower level healthcare practitioner to communicate with a physician or specialists when necessary. Remote rural areas use a Physician Assistant or a Nurse Practitioner on location in remote areas.

The early years of telemedicine in the U.S. were trying to figure out a way to make telemedicine work. The cost of the treatment wasn’t a factor in the beginning. Eventually, the cost of equipment became a problem. “Telemedicine has been too focused on proving that the technology works, rather than on cost-benefit ratios” (Jacobus, 2004, p. 56). Telemedicine is used mostly to treat chronic diseases such as cardiovascular diseases, cancers, diabetes, and chronic obstructive pulmonary disease (COPD) (Kamei, 2013, p 154). These chronic diseases are responsible for about 63% of deaths worldwide (Kamei, 2013, p. 154). Telemedicine allows patients to stay in the comforts of his/her own home to be treated by a telehealth professional. When

The author’s statements are based on both fact and opinion. The conclusions reached state the need for reform in healthcare delivery, as the societal challenges of European countries changes the face of the healthcare industry (Iakovidis, 2013). Keywords in this article are European Commission, ICT for health, Active and healthy ageing, Personal health system. Some of these keywords are objective, while others can be used subjectively. This article will be suitable for my portfolio project, as it provides background on the use of telemedicine in the European Union, including opportunities and political considerations of information and communication technologies (ICTs).

There is an increasing need within the U.S. for quality health care to be provided to individuals who have limited access whether it is due to a rural environment, disabilities, or in the field of battle. Telemedicine is literally medicine provided at a distance. Telehealth is able to alleviate some of the effects of a growing shortage of professionals such as primary care physicians. In this type of health care delivery, the dynamics between the patient and the entire health care system changes. Telemedicine meets the increasing demands of patients to have greater access, or responsiveness, from a health care provider. It also meets the needs of the provider who is very interested in time-saving, safety-enhancing assistance in their daily practice. Employers and health plans are also very interested in telemedicine as a means of improving compliance with treatment plans and care management initiatives (Hodgkins, 2008). The use of email also allows the patient to have increased access to their health care providers. Instead of calling their health care provider’s office, patients are now able to email their non-emergent health care questions to their provider. Conversely, health care providers are able to email patients reminders for appointments or wellness tips.

There are several forms of technology that is used to monitor, assist patients with self-care management, assist physicians with delivering care to their patients, including consultation with specialist, and overcoming barriers with transportation. “60% of the healthcare executives, physicians, and nurses in this inaugural survey said that telemedicine was a high priority for 2015“ (Vockley, 2015, para. 7) Telemedicine

ONLINE CARE AND ITS POTENTIAL  Communication : The Interaction between the Doctor and Patient can be immensely improved , where the patient can provide their feedback , acknowledgment and condition via email instead of scheduling new appointment  Choice of Doctors: The Patients can choose which doctors want to be seen there by giving them an option to pick doctors of their choice based on their experience and reviews  Second Opinion: The patient can take an immediate second opinion if in case of doubt. There by eliminating ones cynicism about their illness  Social Stigma: The concept of Social stigma is completely removed as customer can have privacy as he can book the appointment meet the doctor from

Communication can be done between patients and doctors and even doctors and doctors so easily now. Some doctors are with companies that entirely service patients through computers without ever meeting in person, such as Curology, a group dermatologists that consult with patients who upload their pictures of problem areas to the website and receive a customized medication in return. This demonstrates just how far the field of medicine has gotten thanks to computers.