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DOI: 10.15265/IY-2016-012
Unintended Consequences of Tele Health and their Possible Solutions
Contribution of the IMIA Working Group on TelehealthPublication History
10 November 2016
Publication Date:
06 March 2018 (online)
Summary
Objectives: Assess unforeseen consequences of Telehealth and suggest solutions
Methods: An outline was created collecting all possible ill effects classified into Clinical considerations, Administrative concerns including interpersonal relations, Technical issues, Legal / Ethical concerns and Miscellaneous. Each topic was assigned to a particular WG member to lead, gather opinion and review existing literature.
Results and Conclusion: A wide array of problems have been described. Except for technical issues, literature on this topic is scant, so this article is based more on personal experience and data collected from surveys. Much can be done to prevent such problems, such as a need for standardization with related clinical studies for devices as well as processes used for telehealth is underlined, besides evaluation of outcomes of projects undertaken.
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* We certify that all authors contributed to the creation of this article
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References
- 1 Kerr K, Norris TN. A review of telehealth and its relevance to New Zealand. first. Kerr KK, Norris TN. editors. Wellington: Ministry of Health New Zealand; 2004
- 2 chennai floods: Latest News, Videos and chen-nai floods Photos. Times of India [Internet]. Mumbai: 2015. Dec 6 [cited 2015 Dec 9]; Available from: http://timesofindia.indiatimes.com/topic/chennai-floods?gclid=Cj0KEQiAnJqzBRCW0rGWnKnckOIBEiQA6qDBanS9t_iMeGlld-euR2lTEJ712suwhS2hJ5ylvoqj-DrkaAgGB8P8HAQ
- 3 Kaewkamnerd S, Uthaipibull C, Intarapanich A, Pannarut M, Chaotheing S. et al. An automatic device for detection and classification of malaria parasite species in thick blood film. BMC Bioinformatics 2012; 13 (17) S18. Available from: www.ncbi.nlm.nih.gov/pubmed/23281600 www.pubmedcentral.nih.gov/articlerender.fcgi?artid=PMC3521230.
- 4 Hartvigsen G, Pedersen S. Lessons learned from 25 years with telemedicine in Northern Norway. In: NST Report No 6-2015. Norwegian Centre for Integrated Care and Telemedicine. University Hospital of North Norway; 2015. p. 405.
- 5 Radhakrishnan K. Unintended Consequences: How Telehealth Can Fail to Manage Chronic Diseases [Internet]. Longhorn Nursing. [cited 2015 Dec 14]. Available from: http://sites.utexas.edu/nursing/2013/04/02/unintended-consequences-how-telehealth-can-fail-to-manage-chronic-diseases/.
- 6 Telephone Consultations; Telephone Consulting. Patient [Internet]. 2009 [cited 2015 Dec 14]; Available from: http://patient.info/doctor/telephone-consultations.
- 7 Abelsen LR, Vestad A, Nygård D, Skipenes E, Eriksen HØ, Nohr LE. et al. Ses@m Tromsø: even-tyrlige muligheter for pleie- og omsorgstjenesten. (Ses@m Tromsø: adventurous opportunities for nursing and care services.) NST-report no 10. Ses@m Tromse; 2006
- 8 Nyheim B. Telemedisin: Kroken sykehjem er på nett. (Telemedicine: Kroken nursing home is online). Sykepleien. 2005; 93 (09) 2.
- 9 Eastman D, McCarthy C. Embracing change: Healthcare technology in the 21st century. Nurs Manage 2012; Jun 43 (06) 52-4.
- 10 Eastman D, McCarthy C. Embracing change: Healthcare technology in the 21st century. Nurs Manage 2012; Jun 43 (06) 52-4.
- 11 Kalyanpur A. Improvements of patient care through Teleradiology. Healthcare Executive 2012: 30-4.
- 12 Kannan R. No need to visit, you can see patients through “I-See-U.” The Hndu [Internet]. Chen-nai; 2013 Oct 2;8. Available from: http://www.thehindu.com/news/national/tamil-nadu/noneed-to-visit-you-can-see-patients-through-iseeu/article5190555.ece.
- 13 Statistics [Internet]. [cited 2015 Dec 13]. Available from: http://www.itu.int/en/ITU-D/Statistics/Pages/stat/default.aspx.
- 14 Chatterjee P. Death Rate goes up with Distance from District Hospital. Indian Express [Internet]. Aug;1. Available from: http://epaper.indianexpress.com/567918/Indian-Express/19-August-2015#clip/6256409/91cf622a-8bc8-4d94-9a91-2958570dc683/1226:347.9999999999999.
- 15 FloodRelief-HEALTHEDUCATIONPROJECT1. 2015
- 16 SahanaEden [Internet].. SahanaWiki. 2012 [cited 2015 Dec 14]. Available from: http://eden.sahanafoundation.org/wiki.
- 17 Gogia SB. Providing Tele mental health services after disasters – based on the Post Tsunami experience. In: Scupala Ada. editor. Cases in Managing E Services [Internet]. Pennsylvania. USA: IGI Global; 2009. p. 238-52. Available from: http://www.igi-global.com/bookstore/chapter.aspx?titleid=6425
- 18 Failures of Dallas hospital during Ebola crisis detailed in new report - The Washington Post [Internet]. [cited 2015 Dec 14]. Available from: https://www.washingtonpost.com/news/to-your-health/wp/2015/09/04/failures-of-dallas-hospital-during-ebola-crisis-detailed-in-new-report.
- 19 Cortese D, Abbot P, Chassin M, Lyon MG, Riley WG. The Expert Panel Report to Texas Health Resources Leadership on the 2014 Ebola Events. 2014
- 20 Doarn CR, Merrell RC. A Roadmap for Telemedicine: Barriers Yet to Overcome. Telemed J E Health 2008; 14 (09) 861-2.
- 21 Dronelife News. How Drones Can Have A Place In Health Care. Healthc News [Internet]. 2014; Available from: http://dronelife.com/2014/10/20/drones-can-place-health-care/.
- 22 Leauhatong T. A New System for Detecting and Alerting Falling. In: Asia Pacific Telemedicine Conference. Shanghai: APSCO; 2015
- 23 Koch S. Home telehealth – current state and future trends,. Int Med Informatics. 2006; 75 (08) 565-76.
- 24 Pantelopoulos A, Bourbakis NG. A survey on wearable sensor-based systems foir health monitoring and prognosis. IEEE Trans Syst Man, Cybern – Part C Appl Rev 2010; 40 (01) 1-12.
- 25 IHE Gazelle eHeallth Interoperability framwork [Internet]. Available from: https://gazelle.ihe.net.
- 26 Wartena F, Muskens J, Schmitt L. Continua: the impact of a personal telehealth ecosystem. In: IEEE International Conference on eHealth, Tele-medicine, and Social Science. 2009. p. 13-8.
- 27 MOHFW GOI. EMR/EHR Standards for India [Internet]. New Delhi: 2013 [cited 2015 Aug 1]. Available from: http://mohfw.nic.in/showfile.php?lid=1672.
- 28 Lee I, Pappas GJ, Cleaveland R, Hatcliff J, Krogh BH, Lee P. et al. High-confidence medical device software and systems. Computer (Long Beach Calif) 2006; 39 (04) 33-8.
- 29 Lupton D. Critical perspectives on digital health technologies. Sociol Compass 2014; 8 (12) 1344-59.
- 30 Venkatesh V, Bala H. Technology acceptance model 3 and a research agenda on interventions. Decis Sci 2008; 39 (02) 273-315.
- 31 Graziano F, Maugeri R, Iacopino DG. Whatsapp versus Telemedicine. Neuroreport 2015; 26 (10) 602-3.
- 32 Norum J, Pedersen S, Størmer JL, Rumpsfeld M, Stormo A, Jamissen N. et al. Prioritisation of tele-medicine services for large scale implementation in Norway. J Telemed Telecare 2007; 13: 185-92.
- 33 Aronson SH, Mackenzie C, Bell AG. The Lancet on the telephone 1876-1975. Med Hist 1977; 21: 69-87.
- 34 Law Journal Library - HeinOnline.org [Internet]. [cited 2015 Dec 13]. Available from: http://heinonline.org/HOL/Page?handle=hein.journals/jlah20&div=16&g_sent=1&collection=journals.
- 35 dod telemedicine licensure - Google Search [Internet]. [cited 2015 Dec 13]. Available from: https://www.google.com/search?q=VA+telemedicne+licensure&ie=utf-8&oe=utf-8#newwindow=1&safe=off&q=dod+telemedicine+licensure.
- 36 Will the TELE-MED Act of 2015 Really Change Licensure Rules? Health Care Law Today [Internet]. [cited 2015 Dec 13]. Available from: https://www.healthcarelawtoday.com/2015/08/26/will-the-telemed-act-of-2015-really-change-licensure-rules.
- 37 Commonwealth Health Ministers Book 2008: E-Health, Book 2008 [Internet]. Commonwealth Secretariat; 2008 [cited 2015 Dec 13]. 211 p. Available from: https://books.google.co.za/books/about/Commonwealth_Health_Ministers_Book_2008.html?id=7jYfAQAAIAAJ&pgis=1.
- 38 Gerber T, Olazabal V, Brown K, Pablos-Mendez A. An Agenda For Action On Global E-Health. Health Aff 2010; 29 (02) 233-6.
- 39 Spoofing porn sites..anyone experience? -Pirate4x4. Com : 4x4 and Off-Road Forum [Internet]. [cited 2015 Dec 14]. Available from: http://www.pirate4x4.com/forum/general-chit-chat/422770-spoofing-porn-sites-anyone-experience.html.
- 40 Practo and rating systems | Bespoke Data Insights [Internet]. [cited 2015 Dec 14]. Available from: http://bespokedata.in/practo-and-rating-systems.
- 41 Market Research Report - 25583. mHealth Market - Global Mobile Health Industry Analysis, Size, Share, Growth, Trends and Forecast, 2012 - 2018 [Internet]. Transparency Market Research; 2013 Available from: http://www.giiresearch.com/report/tsm258823-mhealth-market-global-mobile-health-industry.html.
- 42 Global Teledensity Hits 100%. Mobile payments world. 2015
- 43 de Assis Moura Jr. L. Embracing Strategies for eHealth. Yearb Med Inform 2015; Aug 13 10 (01) 1.
- 44 Gogia SB. Planning for Telemedicine in Community Health Care - the Road Ahead. In: Agarwala KN. editor. IIIT-A Series on E-Governance:3rd book: IT and Rural Health. Allahabad, Indian: Mcmillan; 2009. p. 103-20.
- 45 Bhatia S. Proof your EMR for color blind Clinicians [Internet]. 2016 [cited 2016 May 20]. Available from: http://blog.saurabhbhatia.com/2016/05/proof-your-emr-for-color-blind.html.
Correspondence to:
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References
- 1 Kerr K, Norris TN. A review of telehealth and its relevance to New Zealand. first. Kerr KK, Norris TN. editors. Wellington: Ministry of Health New Zealand; 2004
- 2 chennai floods: Latest News, Videos and chen-nai floods Photos. Times of India [Internet]. Mumbai: 2015. Dec 6 [cited 2015 Dec 9]; Available from: http://timesofindia.indiatimes.com/topic/chennai-floods?gclid=Cj0KEQiAnJqzBRCW0rGWnKnckOIBEiQA6qDBanS9t_iMeGlld-euR2lTEJ712suwhS2hJ5ylvoqj-DrkaAgGB8P8HAQ
- 3 Kaewkamnerd S, Uthaipibull C, Intarapanich A, Pannarut M, Chaotheing S. et al. An automatic device for detection and classification of malaria parasite species in thick blood film. BMC Bioinformatics 2012; 13 (17) S18. Available from: www.ncbi.nlm.nih.gov/pubmed/23281600 www.pubmedcentral.nih.gov/articlerender.fcgi?artid=PMC3521230.
- 4 Hartvigsen G, Pedersen S. Lessons learned from 25 years with telemedicine in Northern Norway. In: NST Report No 6-2015. Norwegian Centre for Integrated Care and Telemedicine. University Hospital of North Norway; 2015. p. 405.
- 5 Radhakrishnan K. Unintended Consequences: How Telehealth Can Fail to Manage Chronic Diseases [Internet]. Longhorn Nursing. [cited 2015 Dec 14]. Available from: http://sites.utexas.edu/nursing/2013/04/02/unintended-consequences-how-telehealth-can-fail-to-manage-chronic-diseases/.
- 6 Telephone Consultations; Telephone Consulting. Patient [Internet]. 2009 [cited 2015 Dec 14]; Available from: http://patient.info/doctor/telephone-consultations.
- 7 Abelsen LR, Vestad A, Nygård D, Skipenes E, Eriksen HØ, Nohr LE. et al. Ses@m Tromsø: even-tyrlige muligheter for pleie- og omsorgstjenesten. (Ses@m Tromsø: adventurous opportunities for nursing and care services.) NST-report no 10. Ses@m Tromse; 2006
- 8 Nyheim B. Telemedisin: Kroken sykehjem er på nett. (Telemedicine: Kroken nursing home is online). Sykepleien. 2005; 93 (09) 2.
- 9 Eastman D, McCarthy C. Embracing change: Healthcare technology in the 21st century. Nurs Manage 2012; Jun 43 (06) 52-4.
- 10 Eastman D, McCarthy C. Embracing change: Healthcare technology in the 21st century. Nurs Manage 2012; Jun 43 (06) 52-4.
- 11 Kalyanpur A. Improvements of patient care through Teleradiology. Healthcare Executive 2012: 30-4.
- 12 Kannan R. No need to visit, you can see patients through “I-See-U.” The Hndu [Internet]. Chen-nai; 2013 Oct 2;8. Available from: http://www.thehindu.com/news/national/tamil-nadu/noneed-to-visit-you-can-see-patients-through-iseeu/article5190555.ece.
- 13 Statistics [Internet]. [cited 2015 Dec 13]. Available from: http://www.itu.int/en/ITU-D/Statistics/Pages/stat/default.aspx.
- 14 Chatterjee P. Death Rate goes up with Distance from District Hospital. Indian Express [Internet]. Aug;1. Available from: http://epaper.indianexpress.com/567918/Indian-Express/19-August-2015#clip/6256409/91cf622a-8bc8-4d94-9a91-2958570dc683/1226:347.9999999999999.
- 15 FloodRelief-HEALTHEDUCATIONPROJECT1. 2015
- 16 SahanaEden [Internet].. SahanaWiki. 2012 [cited 2015 Dec 14]. Available from: http://eden.sahanafoundation.org/wiki.
- 17 Gogia SB. Providing Tele mental health services after disasters – based on the Post Tsunami experience. In: Scupala Ada. editor. Cases in Managing E Services [Internet]. Pennsylvania. USA: IGI Global; 2009. p. 238-52. Available from: http://www.igi-global.com/bookstore/chapter.aspx?titleid=6425
- 18 Failures of Dallas hospital during Ebola crisis detailed in new report - The Washington Post [Internet]. [cited 2015 Dec 14]. Available from: https://www.washingtonpost.com/news/to-your-health/wp/2015/09/04/failures-of-dallas-hospital-during-ebola-crisis-detailed-in-new-report.
- 19 Cortese D, Abbot P, Chassin M, Lyon MG, Riley WG. The Expert Panel Report to Texas Health Resources Leadership on the 2014 Ebola Events. 2014
- 20 Doarn CR, Merrell RC. A Roadmap for Telemedicine: Barriers Yet to Overcome. Telemed J E Health 2008; 14 (09) 861-2.
- 21 Dronelife News. How Drones Can Have A Place In Health Care. Healthc News [Internet]. 2014; Available from: http://dronelife.com/2014/10/20/drones-can-place-health-care/.
- 22 Leauhatong T. A New System for Detecting and Alerting Falling. In: Asia Pacific Telemedicine Conference. Shanghai: APSCO; 2015
- 23 Koch S. Home telehealth – current state and future trends,. Int Med Informatics. 2006; 75 (08) 565-76.
- 24 Pantelopoulos A, Bourbakis NG. A survey on wearable sensor-based systems foir health monitoring and prognosis. IEEE Trans Syst Man, Cybern – Part C Appl Rev 2010; 40 (01) 1-12.
- 25 IHE Gazelle eHeallth Interoperability framwork [Internet]. Available from: https://gazelle.ihe.net.
- 26 Wartena F, Muskens J, Schmitt L. Continua: the impact of a personal telehealth ecosystem. In: IEEE International Conference on eHealth, Tele-medicine, and Social Science. 2009. p. 13-8.
- 27 MOHFW GOI. EMR/EHR Standards for India [Internet]. New Delhi: 2013 [cited 2015 Aug 1]. Available from: http://mohfw.nic.in/showfile.php?lid=1672.
- 28 Lee I, Pappas GJ, Cleaveland R, Hatcliff J, Krogh BH, Lee P. et al. High-confidence medical device software and systems. Computer (Long Beach Calif) 2006; 39 (04) 33-8.
- 29 Lupton D. Critical perspectives on digital health technologies. Sociol Compass 2014; 8 (12) 1344-59.
- 30 Venkatesh V, Bala H. Technology acceptance model 3 and a research agenda on interventions. Decis Sci 2008; 39 (02) 273-315.
- 31 Graziano F, Maugeri R, Iacopino DG. Whatsapp versus Telemedicine. Neuroreport 2015; 26 (10) 602-3.
- 32 Norum J, Pedersen S, Størmer JL, Rumpsfeld M, Stormo A, Jamissen N. et al. Prioritisation of tele-medicine services for large scale implementation in Norway. J Telemed Telecare 2007; 13: 185-92.
- 33 Aronson SH, Mackenzie C, Bell AG. The Lancet on the telephone 1876-1975. Med Hist 1977; 21: 69-87.
- 34 Law Journal Library - HeinOnline.org [Internet]. [cited 2015 Dec 13]. Available from: http://heinonline.org/HOL/Page?handle=hein.journals/jlah20&div=16&g_sent=1&collection=journals.
- 35 dod telemedicine licensure - Google Search [Internet]. [cited 2015 Dec 13]. Available from: https://www.google.com/search?q=VA+telemedicne+licensure&ie=utf-8&oe=utf-8#newwindow=1&safe=off&q=dod+telemedicine+licensure.
- 36 Will the TELE-MED Act of 2015 Really Change Licensure Rules? Health Care Law Today [Internet]. [cited 2015 Dec 13]. Available from: https://www.healthcarelawtoday.com/2015/08/26/will-the-telemed-act-of-2015-really-change-licensure-rules.
- 37 Commonwealth Health Ministers Book 2008: E-Health, Book 2008 [Internet]. Commonwealth Secretariat; 2008 [cited 2015 Dec 13]. 211 p. Available from: https://books.google.co.za/books/about/Commonwealth_Health_Ministers_Book_2008.html?id=7jYfAQAAIAAJ&pgis=1.
- 38 Gerber T, Olazabal V, Brown K, Pablos-Mendez A. An Agenda For Action On Global E-Health. Health Aff 2010; 29 (02) 233-6.
- 39 Spoofing porn sites..anyone experience? -Pirate4x4. Com : 4x4 and Off-Road Forum [Internet]. [cited 2015 Dec 14]. Available from: http://www.pirate4x4.com/forum/general-chit-chat/422770-spoofing-porn-sites-anyone-experience.html.
- 40 Practo and rating systems | Bespoke Data Insights [Internet]. [cited 2015 Dec 14]. Available from: http://bespokedata.in/practo-and-rating-systems.
- 41 Market Research Report - 25583. mHealth Market - Global Mobile Health Industry Analysis, Size, Share, Growth, Trends and Forecast, 2012 - 2018 [Internet]. Transparency Market Research; 2013 Available from: http://www.giiresearch.com/report/tsm258823-mhealth-market-global-mobile-health-industry.html.
- 42 Global Teledensity Hits 100%. Mobile payments world. 2015
- 43 de Assis Moura Jr. L. Embracing Strategies for eHealth. Yearb Med Inform 2015; Aug 13 10 (01) 1.
- 44 Gogia SB. Planning for Telemedicine in Community Health Care - the Road Ahead. In: Agarwala KN. editor. IIIT-A Series on E-Governance:3rd book: IT and Rural Health. Allahabad, Indian: Mcmillan; 2009. p. 103-20.
- 45 Bhatia S. Proof your EMR for color blind Clinicians [Internet]. 2016 [cited 2016 May 20]. Available from: http://blog.saurabhbhatia.com/2016/05/proof-your-emr-for-color-blind.html.