Telemedicine's Challenges for the Medical Profession

Telemedicine—the use of communication technology to connect patients in one location with clinicians in another—can reduce inequalities in access to care and lead to better health outcomes. Skeptics worry that these benefits are outweighed by diminished privacy and security of medical information and loss of the therapeutic value in hands-on encounters between patients and their physicians. Many contributors to the December issue believe that, through its novelty, telemedicine draws our attention to the ever-present need for improving access to care, privacy the security of medical information, and the quality of patient-physician relationships for all patients.

Volume 16, Number 12: 955-1035 Full Issue PDF
  • From the Editor
    Dec 2014

    Telemedicine: A Dynamic and Expanding Practice

    Vinod E. Nambudiri, MD, MBA
    Telemedicine has generated new models for efficient patient care, decreased disparities in access, and been criticized for its limitations.
    Virtual Mentor. 2014;16(12):957-959. doi: 10.1001/virtualmentor.2014.16.12.fred1-1412.
  • Case and Commentary
    Dec 2014

    Teleradiology: The Importance of Communication

    Richard Gunderman, MD, PhD
    Teleradiology can contribute to quality care when teleradiologists communicate and collaborate with referring physicians, have real-time access to patients’ medical records, and consult for hospitals that have error detection and correction systems in place.
    Virtual Mentor. 2014;16(12):960-963. doi: 10.1001/virtualmentor.2014.16.12.ecas1-1412.
  • Case and Commentary
    Dec 2014

    Telepsychiatry as Part of a Comprehensive Care Plan

    Nicholas Freudenberg, MD and Peter M. Yellowlees, MBBS, MD
    Ideally, telepsychiatry treatment should include collaboration with patients’ primary care physicians. One way to facilitate the collaboration is for patients to have videoconference appointments with their psychiatrists in the primary care clinic.
    Virtual Mentor. 2014;16(12):964-968. doi: 10.1001/virtualmentor.2014.16.12.ecas2-1412.
  • Case and Commentary
    Dec 2014

    The Tele-ICU

    Allison Harriott, MD, MPH and Michael A. DeVita, MD
    Telemedicine intensive care units enable off-site physicians to cover many care centers, thereby increasing efficiency and access to care, although their use also raises concerns about varying standards of care, unreliable equipment, the erosion of trust in the patient-physician relationship, and the adequacy of the informed consent process.
    Virtual Mentor. 2014;16(12):969-975. doi: 10.1001/virtualmentor.2014.16.12.ecas3-1412.
  • Medical Education
    Dec 2014

    The George Washington University Emergency Medicine Telemedicine and Digital Health Fellowship

    Neal Sikka, MD, Tina Choudhri, MD, and Robert Jarrin, JD
    Medical schools should integrate health IT and biomedical informatics into their formal curricula. The George Washington University Emergency Medicine Telemedicine and Digital Health Fellowship was designed to train graduate physicians to use telemedicine in their clinical and research work.
    Virtual Mentor. 2014;16(12):976-980. doi: 10.1001/virtualmentor.2014.16.12.medu1-1412.
  • In the Literature
    Dec 2014

    Privacy and Security Concerns in Telehealth

    Timothy M. Hale, PhD and Joseph C. Kvedar, MD
    Arguments that mistrust about information security will deter patients from embracing telehealth care ignore patients' willingness to take on risk in the pursuit of health benefits and the role physicians will play in encouraging adoption.
    Virtual Mentor. 2014;16(12):981-985. doi: 10.1001/virtualmentor.2014.16.12.jdsc1-1412.
  • State of the Art and Science
    Dec 2014

    The Success of Telehealth Care in the Indian Health Service

    Howard Hays, MD, MSPH, Mark Carroll, MD, Stewart Ferguson, PhD, Christopher Fore, PhD, and Mark Horton, OD, MD
    The Indian Health Service has been a leader in implementing telehealth programs and technologies that increase access to and efficiencies in care, particularly in the fields of mental health and ophthalmology.
    Virtual Mentor. 2014;16(12):986-996. doi: 10.1001/virtualmentor.2014.16.12.stas1-1412.
  • State of the Art and Science
    Dec 2014

    Telemedicine Use in International Relief Efforts

    Eseosa Asemota, MD, MPH and Carrie L. Kovarik, MD
    Telemedicine's potential to advance humanitarian efforts can be realized through further research into best practices, codification of responsibilities and liabilities, counseling and informed consent prior to the creation of electronic health records, strengthening of IT infrastructure, and the integration of an informatics curriculum into residency training programs.
    Virtual Mentor. 2014;16(12):997-1001. doi: 10.1001/virtualmentor.2014.16.12.stas2-1412.
  • Policy Forum
    Dec 2014

    Telemedicine: Innovation Has Outpaced Policy

    Karen Rheuban, MD, Christine Shanahan, and Katherine Willson
    For telemedicine to be properly integrated into everyday care in the twenty-first century, we need to advance beyond twentieth-century policy.
    Virtual Mentor. 2014;16(12):1002-1009. doi: 10.1001/virtualmentor.2014.16.12.pfor1-1412.
  • Policy Forum
    Dec 2014

    Interstate Licensure for Telemedicine: The Time Has Come

    Mei Wa Kwong, JD, Mario Gutierrez, MPH, and James P. Marcin, MD, MPH
    Although cross-state licensure is currently a barrier to the widespread adoption of telemedicine, policies that would expedite it or remove the requirement to be licensed where patients are located have been proposed by the Federation of State Medical Boards and the federal government.
    Virtual Mentor. 2014;16(12):1010-1013. doi: 10.1001/virtualmentor.2014.16.12.pfor2-1412.
  • Medicine and Society
    Dec 2014

    Telemedicine’s Potential Ethical Pitfalls

    Shivan J. Mehta, MD, MBA
    Ensuring the ethical acceptability of telemedicine requires avoiding one-size-fits-all solutions and protecting the patient-physician relationship, patient privacy, and patient-centered care.
    Virtual Mentor. 2014;16(12):1014-1017. doi: 10.1001/virtualmentor.2014.16.12.msoc1-1412.
  • podcast-1412
    Podcast
    Dec 2014

    Ethics Talk: Telemedicine - Its Opportunities and Challenges

    This month, Virtual Mentor theme editor Vinod Nambudiri, MD, MBA, a resident in internal medicine and dermatology in the Harvard Combined Medicine-Dermatology Residency Training Program, interviewed Naomi Fried, PhD, about telemedicine's regulatory challenges and the opportunities it presents for innovation in health care delivery and medical education.