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Ethics in Telehealth: Comparison between Guidelines and Practice-based Experience -the Case for Learning Health

Craig E Kuziemsky1, Inga Hunter2, Shashi B Gogia3

  • 1Office of Research Services and School of Business, MacEwan University, Edmonton, Alberta, Canada.

Yearbook of Medical Informatics
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Telehealth ethics guidelines, focusing on macro-level issues, do not align with practitioner needs at the micro-level. Bridging this gap requires understanding diverse healthcare contexts and adopting a learning health system approach for ethical telehealth practice.

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Area of Science:

  • Medical Ethics
  • Health Informatics
  • Telemedicine

Background:

  • Telehealth adoption presents unique ethical challenges.
  • Existing macro-level telehealth guidelines may not fully address micro-level practitioner concerns.
  • Understanding the discrepancies between established guidelines and on-the-ground practice is crucial.

Purpose of the Study:

  • To analyze ethical issues in telehealth.
  • To compare established macro-level telehealth guidelines with micro-level practitioner perspectives.
  • To identify and suggest methods for bridging the gap between guidelines and practice.

Main Methods:

  • Developed four key issues for an ethical telehealth framework.
  • Reviewed guidelines from the American Medical Association, World Medical Association, and Health Professions Council of South Africa.
  • Compared published guidelines with practitioner viewpoints to find similarities and differences.

Main Results:

  • Significant differences exist between telehealth ethics guidelines and practitioner perspectives.
  • Contextual variations in telehealth use, international practices, and patient-provider interaction complexity contribute to these differences.
  • Guidelines predominantly address macro-level concerns (technology, data security), while practitioners focus on micro-level application.

Conclusions:

  • Telehealth ethics guidelines have a macro-level focus, contrasting with practitioners' micro-level needs.
  • A learning health system approach, integrating diverse clinical contexts and outcomes, is recommended to align guidelines with practice.
  • Enhanced understanding of healthcare systems by both guideline developers and practitioners is essential for ethical telehealth conduct.