Hilary Daniel, BS; Lois Snyder Sulmasy, JD; for the Health and Public Policy Committee of the American College of Physicians *
Financial Support: Financial support for the development of this paper comes exclusively from the ACP operating budget.
Disclosures: Authors have disclosed no conflicts of interest. Authors followed the policy regarding conflicts of interest described at www.annals.org/article.aspx?articleid=745942. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M15-0498.
Editors' Disclosures: Christine Laine, MD, MPH, Editor in Chief, reports that she has no financial relationships or interests to disclose. Darren B. Taichman, MD, PhD, Executive Deputy Editor, reports that he has no financial relationships or interests to disclose. Cynthia D. Mulrow, MD, MSc, Senior Deputy Editor, reports that she has no relationships or interests to disclose. Deborah Cotton, MD, MPH, Deputy Editor, reports that she has no financial relationships or interest to disclose. Jaya K. Rao, MD, MHS, Deputy Editor, reports that she has stock holdings/options in Eli Lilly and Pfizer. Sankey V. Williams, MD, Deputy Editor, reports that he has no financial relationships or interests to disclose. Catharine B. Stack, PhD, MS, Deputy Editor for Statistics, reports that she has stock holdings in Pfizer.
Requests for Single Reprints: Hilary Daniel, BS, American College of Physicians, 25 Massachusetts Avenue NW, Suite 700, Washington, DC 20001; e-mail, firstname.lastname@example.org.
Current Author Addresses: Ms. Daniel: American College of Physicians, 25 Massachusetts Avenue NW, Suite 700, Washington, DC 20001.
Ms. Snyder Sulmasy: American College of Physicians, 190 N. Independence Mall West, Philadelphia, PA 19160.
Author Contributions: Conception and design: H. Daniel, D.M. DeLong, M.W. Beachy, G.A. Hood, G.C. Kane, A. Minaei.
Analysis and interpretation of the data: J.F. Bush, A. Minaei.
Drafting of the article: L. Snyder Sulmasy.
Critical revision of the article for important intellectual content: H. Daniel, L. Snyder Sulmasy, T. Tape, D.M. DeLong, M.W. Beachy, T. Henry, G.A. Hood, R.H. Lohr, A. Minaei, D.V. Moyer, S. Rehman.
Final approval of the article: H. Daniel, L. Snyder Sulmasy, T. Tape, D.M. DeLong, M.W. Beachy, S.S. Bornstein, J.F. Bush, T. Henry, G.A. Hood, G.C. Kane, R.H. Lohr, A. Minaei, D.V. Moyer, K.E. Olive, S. Rehman.
Administrative, technical, or logistic support: S.S. Bornstein.
Telemedicine—the use of technology to deliver care at a distance—is rapidly growing and can potentially expand access for patients, enhance patient–physician collaboration, improve health outcomes, and reduce medical costs. However, the potential benefits of telemedicine must be measured against the risks and challenges associated with its use, including the absence of the physical examination, variation in state practice and licensing regulations, and issues surrounding the establishment of the patient–physician relationship. This paper offers policy recommendations for the practice and use of telemedicine in primary care and reimbursement policies associated with telemedicine use. The positions put forward by the American College of Physicians highlight a meaningful approach to telemedicine policies and regulations that will have lasting positive effects for patients and physicians.
Table. Types of Telemedicine
The physician's primary commitment must always be to the patient's welfare and best interest, whether in preventing or treating illness or helping patients to cope with illness, disability, and death.…The interest of the patient should always be promoted regardless of financial arrangements; the health care setting; or patient characteristics, such as decision-making capacity, behavior, or social status.
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Faculty of Sciences, Universidad Nacional Autónoma de México
September 9, 2015
Data security and Telemedicine: a pending issue
To the editor,
Data security and Telemedicine: a pending issue
I read with great interest an article by Hilary & Snyder (1) that clearly puts in perspective the use of Telemedicine in primary care. It states the pros and cons of this technology from the medical and patient point of view, and it highlights the need to improve the protection of data.
Safety of/from electronic devices is an unsolved issue in computer sciences. Stealing information from databases (2) takes place, despite of the security measures constantly implemented; affecting users’ trust in new technologies.
It is not always possible to guarantee the safety of storage and transmission of information, but successful protection strategies can be used, such as what living organisms use to protect their hereditary information (DNA). And that is hosting the information in all of its cells (3). This strategy can be used to guarantee the availability of information.
Medical information is a very sensitive topic among people, failure in transmission or storage that lead to loss, alteration, or misuse of this information is a legitimate concern; and it would be advisable to find ways to prevent that.
Carlos Polanco, Ph.D., D.Sc.
Universidad Nacional Autónoma de México, México City, México.
(1) Daniel Hilary D, Snyder S. Policy Recommendations to Guide the Use of Telemedicine in Primary Care Settings: An American College of Physicians Position PaperRecommendations for the Use of Telemedicine in Primary Care Settings. Ann Intern Med 2015; DOI: 10.7326/M15-0498.
(2) Kelly G, McKenzie B. Security, privacy, and confidentiality issues on the Internet. J Med Internet Res 2002;4:e12. DOI: 10.2196/jmir.4.2.e12
(3) Watson JD, Crick FHC. The structure of DNA. Cold Spring Harbor Symp Quant Biol 1953;18:123–113.
Daniel H, Sulmasy LS, for the Health and Public Policy Committee of the American College of Physicians. Policy Recommendations to Guide the Use of Telemedicine in Primary Care Settings: An American College of Physicians Position Paper. Ann Intern Med. 2015;163:787–789. [Epub ahead of print 8 September 2015]. doi: https://doi.org/10.7326/M15-0498
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Published: Ann Intern Med. 2015;163(10):787-789.
Published at www.annals.org on 8 September 2015
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