Ethical Concerns

Ethical Concerns

  • Does the patient have access? 92% of patients (James, et al, 2019) were able to access information technology in which to participate in telehealth. 
    • Internet
    • Devices to support
    • Geographical location
  • Does the patient need any physical evaluation?
  • Does the practitioner need medical epuiptment for the exam?
  • Does the patient have any disabilities that may require support for their visit?
  • Privacy and confidentiality: Since the pandemic, intrusions of uninvited guests on web conferencing has occurred, resulting in a concern of outside threats or “hackers” obtaining PHI during a private conversation between provider and patient. One study found that patients were more concerned with the intrusion on a Telehealth visit but there was no concern over privacy with the use of a patient portal (Tasneem et al., 2019).
  • Costs: There has been a consensus of satisfaction with the savings of travel time and money that telehealth technologies offered (Powell, et al., 2017).  Cost savings included tolls, parking, fuel, and wear and tear on a vehicle. The savings on transportation supports increased access to care when a patient may not otherwise be able to afford.

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American Nurses Association Core Priniclpes of Connected Health (2019): There are thirteen principles for nursing to follow in providing services using connected healthcare technologies ethically.  Nursing professional practice should remain the same, including the standards of practice as governed by the state board of nursing practice regardless of an in-person visit or via telehealth.  Rules and laws should be followed to ensure the deliver of safe patient care.  The nurse should be involved in prioritizing improved access to the technologies.  Community outreach nurses are instrumental in assessing needs and providing local supports in technology to assist.  Nursing professionals should be instrumental in creating competencies and training to education nurses in delivery of safe patient care through the use of technology.  Nurses should be educated on adequate use of the technology to support access to care and maintain patient satisfaction with the services.   Nursing must be aware of protected health information and maintain confidentiality in all aspects of care when using technology.  Just as the nurse obtains consent for services rendered in-person, it is important that informed consent be obtained for the telehealth visit.  Assessment and documentation are important to maintain.  The final and most important principle is that practices be continually updated as we move forward with connected health.  Patient satisfaction is on the line, by nursing providing similar ethical principles to telehealth use as they would in-person, outcomes improve and satisfaction increases.