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AMA telecare guidelines provide clarity

In June, the American Medical Association published a set of guidelines to physicians engaging with patients through online technology. The guidelines have helped open a conversation about what is available and what patients should expect.

Given the wide variety of telehealth apps – from simple messaging platforms to “advice” to full-service online medical visits – the AMA’s guidelines are valuable for establishing standards in an emerging category.

As vice chair of the American Telemedicine Association’s teledermatology special-interest group, and founder of DermatologistOnCall, I strongly endorse the recommendations set out in the AMA’s guidelines. They provide valuable help to physicians pursuing telemedicine and patients who want to become smarter consumers.

Telemedicine is relatively new, so it will take some time before the differences between “advice” apps and providers offering clinical services becomes apparent. For patients looking for online clinical services – the virtual equivalent of an office visit – it is important to know what to look for in an app.

▪ Patients should look for the lock symbol in the browser and for compliance with HIPAA (the law that sets patient privacy standards).

▪ Doctors in the U.S. and licensed to practice in the patient’s state, which is important in case an in-person follow-up is needed.

▪ Sites offering only medical opinions should clearly say they can’t offer a diagnosis.

▪ A site offering clinical services will need a patient’s medical history, medications, allergies, current condition, etc.

▪ Check the ability to write prescriptions – though some states limit this capability over the internet.

Continuity of care is also important to the AMA and to doctors, so the ability to e-message the doctor to ask clarifying questions, conduct follow-up visits, and even send paperwork to a primary care doctor are all examples of helpful features.

Telemedicine “visits” help doctors deliver care to those in need. Many patients can benefit from telemedicine – those with their own packed schedules, those juggling the medical schedules of others, the elderly who might have trouble getting to the doctor, those who live in rural areas where specialists are not available, those with chronic conditions, and those who travel frequently.

With mobile applications, consumers are experiencing an always on/always available interactions. As a result, they will increasingly expect (and eventually demand) health care services be available and delivered in the same manner.

“Doctor shopping” today has an almost literal meaning. However, selling virtual, web-accessible health care to consumers will require significant thought due to its impact on an individual’s well-being.

Patients might already be wondering, “Is this really reliable?” It’s up to the medical community to see that the telemedicine promise delivers.

Not only are private practices catching onto the need to compete in this area, but an increasing number of medical schools, including UC Merced, are offering telemedicine training as part of the curriculum. Further, an increasing number of insurers are covering certain forms of telemedicine, or giving telemedicine careful consideration for future coverage.

Patients appreciate what this can mean – from saving time to less time away from work or school and less time waiting for appointments.

The AMA’s guidelines are useful in helping to shape quality standards for these apps, and to help differentiate the offerings. I know many other practicing clinicians will join me in applauding the guidelines.

Dr. Mark Seraly of Washington County, Pa., is the founder of DermatologistOnCall. He wrote this for The Modesto Bee.

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