Page 23 - Part 2 Introduction to Telemedicine

SVMIC Introduction to Telemedicine

Technical Responsibilities

Negligence can be alleged in connection with the selection,

configuration, maintenance and support of telemedical
infrastructure. One risk unique to telemedicine is breaking the

connection. Prior to an encounter, participants should understand
what to do in the event of a disruption in service. Imagine if, as it

becomes increasingly apparent that a patient needs urgent in-
person care, the line goes dead. Protecting the system from

hackers, malware and other cyber threats is just as much a part of

providing a safe environment as clearing ice from the parking lot.

Administrative Responsibilities

Negligence can be alleged in connection with organizational

policies, hiring and training of employees, use of outside
contractors, security and privacy events, disaster response and

other matters related to the governance of systems.

Ethical Issues
There are few ethical issues unique to telemedicine. The AMA

addresses telemedicine in its Code of Medical Ethics, but finds

nothing novel. There are well-understood analogies to draw upon
9
from a deep well of modern bioethical thinking.

Most commentary available to practitioners on telemedicine ethics
offers sensible, but nearly self-evident advice about issues

discussed above, such as assuring security, privacy and technical

quality, verifying the identities of participants, documenting
adequately and using good judgment about which conditions are

amenable to telemedical management. While these are all ethical

duties, they are qualitatively no different from the corresponding

9 American Medical Association, Code of Medical Ethics Opinion 1.2.12, https://www.ama-assn.org/delivering-
care/ethical-practice-telemedicine [7/19/18]

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