Between Strangers: The Practice Of Medicine Online

Miller, Tracy; Derse, Arthur R.

doi:10.1377/hlthaff.21.4.168

Cited by 48 publications

(40 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The National Association of State Attorneys General formed a task force to look specifically at the problem of internet prescribing, and has proposed legislation at the federal level to grant state attorneys general subpoena and enforcement authority for prescriptions made over the Internet. 2 An obvious problem is in determining the legitimacy and honesty of so many self-proclaimed providers of health and medical services on the Internet. Consumers need to learn to act cautiously, to discern, and to ask the right questions, such as: Is that a licensed pharmacy that is trying to sell me something on the Internet, or a sham operation of unknown location?…”

Section: Enforcementmentioning

confidence: 99%

“…6 Market research has shown that approximately 7% of those seeking health information on the Web in 2001 (or three million people) received consultation online with a medical practitioner for a specific medical condition. 7 The number of people getting medical advice online has grown exponentially, along with the growth of use of the Internet by the general population. At least one author has commented that inconsistencies among state laws (and sporadic licensure enforcement) do not provide the best outcomes in regulating interstate telemedicine.…”

Section: Enforcementmentioning

confidence: 99%

See 1 more Smart Citation

Telemedicine Licensure in the United States: The Need for a Cooperative Regional Approach

Cwiek

Rafiq

Qamar

et al. 2007

Telemedicine and e-Health

View full text Add to dashboard Cite

The extraordinary successes and refinement of modern telemedicine applications in recent years have been diminished somewhat by the anachronistic licensure laws of the 50 state jurisdictions that limit the practice of medicine to specific state geographic boundaries. This approach is deficient when applied to telemedicine because, with the advent of the Internet and modern technological advances, differences in space and time are rendered nearly meaningless. It is recommended in this paper that the practice of telemedicine be handled differently than the practice of face-to-face medicine, as related to licensure. Although it may be argued persuasively that a national licensure model for telemedicine should be advanced, the political and constitutional hurdles may be too great to overcome. It is therefore recommended that a voluntary, regional geographic approach be instituted by jurisdictions already demonstrating a commonality of interests, such as through the Southern Governors' Association or the Western Governors' Association. The benefits to be derived from this approach would include improving access to healthcare and medical specialists, enhancing the quality and timeliness of care, cutting medical costs by moving information instead of people, securing patients' access to medical records and information, and facilitating commercial export of American telemedicine services.

show abstract

Section: Enforcementmentioning

confidence: 99%

Section: Enforcementmentioning

confidence: 99%

Telemedicine Licensure in the United States: The Need for a Cooperative Regional Approach

Cwiek

Rafiq

Qamar

et al. 2007

Telemedicine and e-Health

View full text Add to dashboard Cite

show abstract

“…While there are concerns about potential lack of accountability in the m-health field, and that online communications could miss non-verbal cues that can ultimately impact empathy and patient satisfaction [12], it is also evidence that web-based programs can facilitate disclosure [13], and such online interventions are as effective or even more efficient than traditional interventions in mental health [14,15]. Furthermore, evidence shows that telepsychiatry is as accurate as in person psychiatry and online users experience the same degree of satisfaction as face-to-face users [16].…”

Section: Introductionmentioning

confidence: 99%

Using New and Innovative Technologies to Assess Clinical Stage in Early Intervention Youth Mental Health Services: Evaluation Study (Preprint)

Ospina-Pinillos¹,

Davenport²,

Iorfino³

et al. 2018

Preprint

View full text Add to dashboard Cite

Background: Globally, there is increasing recognition that new strategies are required to reduce the disability due to common mental health problems. As 75% of mental health and substance misuse disorders emerge during the teenage or early adulthood years, these strategies need to be readily accessible to young people. When considering how to provide such services at scale, e-health technologies show promise in augmenting traditional clinicbased services. Objective: The aim of this study was to assess the effectiveness and accuracy of an online assessment of clinical staging for use in a prototypic Internet-based early intervention youth mental health service system, known as the Mental Health eClinic. Methods: An online version of clinical staging for early intervention youth mental health services, was compared directly with clinician assessments within two Sydney-based primary care service hubs (headspace Camperdown and Campbelltown). Two hundred and four (N=204) young people were recruited in the study. Eligible participants completed both faceto-face and online assessments which were randomly allocated and counterbalanced at a one-to-three ratio. These assessments were: (1) a traditional 45 to 60-minute headspace face-to-face assessment performed by a Youth Access Clinician; and (2) a self-report online survey followed by an online 'video-visit' assessment with a clinician taking approximately 15 minutes. All assessments were completed within a two-week timeframe from initial presentation. Results: Of the 72 participants who completed the study, 72% were female and the mean age was 20.4 years. Sixty eight percent (49/72) of the participants were recruited from headspace Camperdown and the remaining 32% (23/72) from headspace Campbelltown. Inter-rater agreement of participants' clinical stages, as determined after the face-to-face assessment and after the online assessment, demonstrated fair agreement (κ=0.39, P<0.001), with concordance in 68% of cases (49/72). In 26% of cases, the face-to-face assessment appeared to downrate the lifetime history of mental health problems. By contrast, the online evaluation placed greater weight on past history of mental health disorders (P=0.001), as well as any previous suicide planning (P=0.002) and current substance misuse (P=0.03). Conclusions:The online application of clinical staging presents a technologically-advanced and clinically-efficient method for determining key clinical service parameters. It has the potential to be adapted to varied settings in which young people are connecting with traditional clinical services and assist to provide optimal care.

show abstract

“…One advantage of online consultation is anonymity-delicate issues can be addressed more comfortably [14,19]. It is not clear whether online medical advice can substitute for or just complement in-person medical consultation [10,21].…”

Section: Introductionmentioning

confidence: 99%

When Do Patients With Hand Illness Seek Online Health Consultations and What Do They Ask?

Briët

Hageman

Blok

et al. 2014

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

Background Several websites allow people to post health questions and get answers from doctors. Knowing more about what patients seek from these websites might help inoffice educational efforts, but little is known about what occurs on these sites. Questions/purposes This study addressed whether patients seeking advice online already have seen a physician, the type of questions asked, if they are dissatisfied with their doctor, the characteristics of the physicians who respond, and the content of their answers. This study documents the circumstances and content of questions asked about hand illness, the characteristics of the physician responders, and their responses. Methods One hundred thirty-one hand surgery-related questions from an online health consultation website were reviewed retrospectively. The timing of and reason for the consultation, the content of the questions, the specialty of physician responder, and the content of the responses were recorded. Results Sixty patients (46%) were seeking information before seeing a doctor, 21 (16%) after a medical encounter, and 19 (15%) after hand surgery. With increasing contact with providers, patient queries transitioned from diagnosis, to treatment, to prognosis, and potential complications. Patients who had seen a doctor often expressed dissatisfaction (16 of 37 patients [43%]) as did those who had hand surgery (seven of 26 patients [27%]). Between one and eight doctors (average, two) answered each query. Most of the answering physicians were hand surgeons. The information they provided predominantly addressed diagnosis. Conclusions Online consultations are most common among patients who have not seen a doctor, but also reflect uncertainty and dissatisfaction after seeing a doctor. Although online health consultations might support patients' quest for information and understanding, and the potential for multiple answers from different doctors creates the possibility for increased balance and breadth of opinions, the quality of the information and cost-effectiveness of this approach are uncertain and need to be evaluated carefully in future studies.

show abstract

Between Strangers: The Practice Of Medicine Online

Cited by 48 publications

References 14 publications

Telemedicine Licensure in the United States: The Need for a Cooperative Regional Approach

Telemedicine Licensure in the United States: The Need for a Cooperative Regional Approach

Using New and Innovative Technologies to Assess Clinical Stage in Early Intervention Youth Mental Health Services: Evaluation Study (Preprint)

When Do Patients With Hand Illness Seek Online Health Consultations and What Do They Ask?

Contact Info

Product

Resources

About