Balancing Health Information Exchange and Privacy Governance from a Patient-Centred Connected Health and Telehealth Perspective

Gogia, Shashi Bhushan; Househ, Mowafa; Petersen, Carolyn; Basu, Arindam

doi:10.1055/s-0038-1641195

Cited by 29 publications

(31 citation statements)

References 34 publications

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“…Telehealth will continue to be an essential part of healthcare delivery as patient care delivery becomes more complex and requires care coordination and information sharing over time and across providers and settings. However, telehealth introduces ethical issues due to changes in patient-provider communication patterns, access to care delivery services, and how patients interact with telehealth tools [3]. While we are often quick to criticize these new care delivery models, we must remember that healthcare is a learning health system and therefore we must learn from past experiences (both positive and negative) to improve care delivery moving forward [45].…”

Section: Discussionmentioning

confidence: 99%

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Ethics in Telehealth: Comparison between Guidelines and Practice-based Experience -the Case for Learning Health Systems

Hunter

Gogia²,

lyenger

et al. 2020

Yearb Med Inform

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Objectives: To understand ethical issues within the telehealth domain, specifically how well established macro level telehealth guidelines map with micro level practitioner perspectives. Methods: We developed four overarching issues to use as a starting point for developing an ethical framework for telehealth. We then reviewed telemedicine ethics guidelines elaborated by the American Medical Association (AMA), the World Medical Association (WMA), and the telehealth component of the Health Professions council of South Africa (HPCSA). We then compared these guidelines with practitioner perspectives to identify the similarities and differences between them. Finally, we generated suggestions to bridge the gap between ethics guidelines and the micro level use of telehealth. Results: Clear differences emerged between the ethics guidelines and the practitioner perspectives. The main reason for the differences were the different contexts where telehealth was used, for example, variability in international practice and variations in the complexity of patient-provider interactions. Overall, published guidelines largely focus on macro level Keywords Ethics, telehealth, learning health system, informatics Yearb Med Inform 2020 http://dx.

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Section: Discussionmentioning

confidence: 99%

“…Unintended consequences of telehealth usage have been reported including ethical issues [3][4][5]. These consequences occur due to complexities of remote care delivery by physicians, remote monitoring, and patient-provider communication through mobile health applications.…”

Section: Introductionmentioning

confidence: 99%

Ethics in Telehealth: Comparison between Guidelines and Practice-based Experience -the Case for Learning Health Systems

Hunter

Gogia²,

lyenger

et al. 2020

Yearb Med Inform

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“…This includes the need of combining telemedicine with the secure and standardized transmission of health information. 43 Emphasize the need of combining telemedicine with the secure and standardized transmission of health information…”

Section: Health Informatics For Patient Safetymentioning

confidence: 99%

Evidence-Based Health Informatics as the Foundation for the COVID-19 Response: A Joint Call for Action

et al. 2020

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Background As a major public health crisis, the novel coronavirus disease 2019 (COVID-19) pandemic demonstrates the urgent need for safe, effective, and evidence-based implementations of digital health. The urgency stems from the frequent tendency to focus attention on seemingly high promising digital health interventions despite being poorly validated in times of crisis. Aim In this paper, we describe a joint call for action to use and leverage evidence-based health informatics as the foundation for the COVID-19 response and public health interventions. Tangible examples are provided for how the working groups and special interest groups of the International Medical Informatics Association (IMIA) are helping to build an evidence-based response to this crisis. Methods Leaders of working and special interest groups of the IMIA, a total of 26 groups, were contacted via e-mail to provide a summary of the scientific-based efforts taken to combat COVID-19 pandemic and participate in the discussion toward the creation of this manuscript. A total of 13 groups participated in this manuscript. Results Various efforts were exerted by members of IMIA including (1) developing evidence-based guidelines for the design and deployment of digital health solutions during COVID-19; (2) surveying clinical informaticians internationally about key digital solutions deployed to combat COVID-19 and the challenges faced when implementing and using them; and (3) offering necessary resources for clinicians about the use of digital tools in clinical practice, education, and research during COVID-19. Discussion Rigor and evidence need to be taken into consideration when designing, implementing, and using digital tools to combat COVID-19 to avoid delays and unforeseen negative consequences. It is paramount to employ a multidisciplinary approach for the development and implementation of digital health tools that have been rapidly deployed in response to the pandemic bearing in mind human factors, ethics, data privacy, and the diversity of context at the local, national, and international levels. The training and capacity building of front-line workers is crucial and must be linked to a clear strategy for evaluation of ongoing experiences.

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“…Despite the potential of telehealth for health professionals and health delivery systems to extend care delivery beyond routine care such as face-to-face delivery, implementing telehealth presents several challenges including scale up and long-term sustainability [ 9 ]. Telehealth implementation is a sociotechnical endeavour and human-centred design approaches, and local care delivery practices and enablers must be considered [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Telehealth and the COVID-19 Pandemic: International Perspectives and a Health Systems Framework for Telehealth Implementation to Support Critical Response

et al. 2021

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Objectives: Telehealth implementation is a complex systems-based endeavour. This paper compares telehealth responses to (COrona VIrus Disease 2019) COVID-19 across ten countries to identify lessons learned about the complexity of telehealth during critical response such as in response to a global pandemic. Our overall objective is to develop a health systems-based framework for telehealth implementation to support critical response. Methods: We sought responses from the members of the International Medical Informatics Association (IMIA) Telehealth Working Group (WG) on their practices and perception of telehealth practices during the times of COVID-19 pandemic in their respective countries. We then analysed their responses to identify six emerging themes that we mapped to the World Health Organization (WHO) model of health systems. Results: Our analysis identified six emergent themes. (1) Government, legal or regulatory aspects of telehealth; (2) Increase in telehealth capacity and delivery; (3) Regulated and unregulated telehealth; (4) Changes in the uptake and perception of telemedicine; (5) Public engagement in telehealth responses to COVID-19; and (6) Implications for training and education. We discuss these themes and then use them to develop a systems framework for telehealth support in critical response. Conclusion: COVID-19 has introduced new challenges for telehealth support in times of critical response. Our themes and systems framework extend the WHO systems model and highlight that telemedicine usage in response to the COVID-19 pandemic is complex and multidimensional. Our systems-based framework provides guidance for telehealth implementation as part of health systems response to a global pandemic such as COVID-19.

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Balancing Health Information Exchange and Privacy Governance from a Patient-Centred Connected Health and Telehealth Perspective

Cited by 29 publications

References 34 publications

Ethics in Telehealth: Comparison between Guidelines and Practice-based Experience -the Case for Learning Health Systems

Ethics in Telehealth: Comparison between Guidelines and Practice-based Experience -the Case for Learning Health Systems

Evidence-Based Health Informatics as the Foundation for the COVID-19 Response: A Joint Call for Action

Telehealth and the COVID-19 Pandemic: International Perspectives and a Health Systems Framework for Telehealth Implementation to Support Critical Response

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