Practical and Ethical Considerations in Telehealth

Course overview

Course Description: This course is based on material published in the Yale Journal of Biology and Medicine and the Journal of Medical Internet Research. Both articles are open-access articles Telehealth has been a long-awaited advancement with the potential to improve efficiency, convenience, and quality in healthcare. However, as telehealth becomes integrated into routine clinical care, it is imperative to consider the practical and ethical implications that could undermine or devalue care delivery. The medical profession must ensure that it is implemented judiciously and with robust quality standards, guided by fair and equitable policies that balance patient autonomy with rigorous standards of care and access. Such a system must recognize the opportunity for more patient input as stakeholders to tailor care to their needs and preferences while also acknowledging the risk of suboptimal care if convenience is prioritized over quality. More studies of optimal care models are needed to integrate data in terms of both stakeholder input and outcomes. As the use of technology to deliver health services is increasing rapidly and has further intensified during the COVID-19 pandemic, these initiatives may fail if ethical impacts are not fully identified and acted upon by practitioners. Ignoring the ethical impacts of information and communication technology health service delivery creates an unintended risk for patients and can lead to reduced effectiveness, noncompliance, and harm, undermining the best intentions of governments and clinicians. Our aim was to explore how ethical considerations or impacts may be different, greater, or more variable in information and communication technology methods versus face-to-face healthcare delivery models and how they may be applied in practice. We undertook a systemic literature review to provide a critical overview of existing research into the incorporation of ethical principles into telehealth practice. Several studies proposed frameworks, codes of conduct, or guidelines, but there was little discussion or evidence of how these recommendations are being used to improve ethical telehealth practice. This course on ethical principles in the context of telehealth is designed for social workers, professional counselors, psychologists, nurses, and substance abuse counselors, who do clinical work. In addition, this course is appropriate for intermediate and advanced-level practitioners who wish to develop their knowledge of ethical principles in the context of telehealth. The course material includes a literature review of interventions. It may also be useful for licensed clinicians who require continuing clinical education courses for license renewal. Authors: Hull, Oen-Hsiao, Spatz (Article 1); Keenan, Tsourtos, Bahrami (Article 2) Learning Objectives: This course will provide the practitioner with detailed information regarding ethical principles in the context of telehealth. Specifically, a professional will: Recognize practical and ethical considerations that could undermine or devalue telehealth care delivery. Describe how ethical considerations and impacts may be applied in telehealth practice. Identify recommendations for maintaining or improving autonomy in telehealth practice. Citations: Hull, S. C., Oen-Hsiao, J. M., & Spatz, E. S. (2022). Practical and Ethical Considerations in Telehealth: Pitfalls and Opportunities. The Yale Journal of Biology and Medicine, 95(3), 367-370. Keenan, A. J., Tsourtos, G., & Tieman, J. (2021). The Value of Applying Ethical Principles in Telehealth Practices: Systematic Review. Journal of medical Internet research, 23(3), e25698. https://doi.org/10.2196/25698