Page 34 - Telemedicine - Essentials of Virtual Care Delivery Part Two

SVMIC Telemedicine: Essentials of Virtual Care Delivery

which conditions are amenable to telemedical management.

While these are all ethical duties, they are qualitatively no
different from the corresponding responsibilities in practicing

medicine in a conventional medicine setting. Some authors
suggest managing and disclosing substantive financial conflicts

of interest, which, again, are duties that apply in all medical
settings.

The fundamental principle of medical ethics is that there is a

fiduciary relationship between the doctor and patient. Nothing
in telemedicine changes that a bit.

A Quick Look at Payment

This course is not designed as a guide to
reimbursement strategies. The multiplicity of

payors and policies and their rapidly
changing nature makes that almost

impossible to do in this format. Unquestionably, the future of
telemedicine depends on the way services are valued and

compensated within the totality of the healthcare economy. The
following discussion has the limited goal of providing a general

orientation to the issues surrounding payment, at the time of
writing.

The payment landscape for telemedicine today is largely

unsettled. A number of fast-growing services have built their
businesses entirely on direct patient payment or subscription

models. Some self-insured employers were early adopters of
telehealth benefits for their employees and provided telehealth

coverage in conjunction with select providers. Some offered a

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