How the AMA is pushing telemedicine

The influential physicians organization seeks to ensure that medical students get telehealth training, formalizes ethical guidelines for distant care.

The American Medical Association continues to see telemedicine as part of the future of the practice of medicine, and it took two steps during its annual meeting to connect its members with new ways to deliver care.

With this week’s actions, the nation’s largest professional organization for doctors continued to embrace distant and virtual care delivery as an appropriate way to treat some patients. In years past, the AMA had questioned the efficacy of telemedicine care.

On Wednesday, the AMA approved a policy to include formalized training in telemedicine as a part of training for medical students and residents. The move means the organization wants to ensure that clinicians in training learn how to use telemedicine in clinical practice, said AMA Immediate Past President Robert M. Wah, M.D.

The new policy encourages accrediting bodies for both undergraduate and graduate medical education to include core competencies for telemedicine in their programs. The new policy also reaffirms existing AMA policy, which supports reducing barriers to incorporating the appropriate use of telemedicine into the education of physicians.

“The vast majority of medical students are not being taught how to use technologies such as telemedicine or electronic health records during medical school and residency,” said Wah, “As innovation in care delivery and technology continue to transform healthcare, we must ensure that our current and future physicians have the tools and resources they need to provide the best possible care for their patients. In particular, exposure to and evidence-based instruction in telemedicine’s capabilities and limitations at all levels of physician education will be essential to harnessing its potential”

Earlier in the week, the AMA adopted guidance for ethical practice in telemedicine, offering specific suggestions to physicians about how their fundamental responsibilities might be different when patient interactions occur through telemedicine, compared with their roles in traditional patient interactions in a medical office or hospital.

The guidance on telehealth and telemedicine was developed by the AMA’s Council on Ethics and Judicial Affairs, and adopted by a vote of physicians from every corner of the country. The AMA said the development of the new guidelines “coincides with innovations in technology that are changing the ways in which people live their lives, including reshaping the ways they engage with medicine.” 

“Telehealth and telemedicine are another stage in the ongoing evolution of new models for the delivery of care and patient-physician interactions,” said Jack Resneck, MD, an AMA board member. “The new AMA ethical guidance notes that while new technologies and new models of care will continue to emerge, physicians’ fundamental ethical responsibilities do not change.”

For example, Resneck cited that, in any model for care, patients need to be able to trust that physicians will place patient welfare above other interests, provide competent care, provide the information patients need to make well-considered decisions about care, respect patient privacy and confidentiality, and take steps needed to ensure continuity of care.

The evolution of telehealth and telemedicine capabilities offers increasingly sophisticated ways to conduct patient evaluations as technologies for obtaining patient information remotely continue to evolve and improve. The AMA guidelines permit physicians utilizing telehealth and telemedicine technology to exercise discretion in conducting a diagnostic evaluation and prescribing therapy, within certain safeguards.

The AMA positions on telemedicine continue a trend to support telemedicine in care delivery. In February, the organization voiced its support for the bipartisan Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act to expand the use of telemedicine to achieve quality care for patients. 

The AMA said the bill reflects its belief “that the appropriate use of telemedicine can greatly improve access to quality care while maintaining patient safety. According to an independent study, the bill could save $1.8 billion over 10 years, the AMA said in its statement.

"This legislation has the potential to remove barriers to new health care delivery models that promote coordinated and patient-centered care.  Importantly, the bill aims to maintain high standards whether a patient is seeing a physician in an office or via telemedicine," said AMA President Steven J. Stack, MD. "Telemedicine can strengthen the patient-physician relationship and improve access for patients with chronic conditions and limited access to quality care. The AMA's guiding principles on telemedicine seek to foster innovation while promoting quality care."

And this past October, the AMA began the process of creating new CPT codes to support the reimbursement of telemedicine. CPT codes are used by healthcare providers and insurers to communicate the nature of services performed by providers, and thus play a role in ensuring the clinicians can bill for telemedicine services.

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