The doctor-patient relationship in telemedicine and mobile health

  • Gianluca Montanari Vergallo
  • Simona Zaami
  • Alessandro di Luca
  • Natale Mario di Luca
  • Mariano Bizzarri
  • Enrico Marinelli
Keywords: Telemedicine, mobile health,, doctor-patient relationship, informed consent, privacy

Abstract

Telemedicine falls under the broader term of eHealth and involves the delivery of health care services, where distance is a critical
factor. Thanks to telemedicine patients can access treatments that would otherwise be unavailable.
The authors focus on whether doctor-patient relationship exist in telemedicine and mobile health. The answer should be found on a
case-by-case basis. There is a doctor-patient relationship when the two are connected, possibly electronically, for purposes related to
the prevention, diagnosis or treatment of diseases. But the doctor-patient relationship is absent when the patient downloads apps to
self diagnose rather than seeing a doctor. These apps encourage the use of ‘DIY’ medicine, making the doctor superfluous and can
often lead to misdiagnosis and misunderstanding.
Informed consent to the use of telemedicine should have the same prerequisites as those used in traditional medical practice.
However, telemedicine requires some additional information: risks related to the privacy of personal data and precautionary
measures to reduce them; further risks involved in the use of technology (for example, quality and efficiency of the telematic tools).
With regards to the processing of personal data in mobile health, informed consent should be even more specific than that for
medical treatment via telemedicine. In order to respect the requirement of specificity, the app should be structured in a way that
allows the user to express consent for each type of data that the app intends to collect. But such a solution presents various difficulties.
In conclusion, direct contact between a doctor and their patient should continue to be the preferred practice with which to carry out
the relationship. Telemedicine can be used when it is deemed to be in the best interest of the patient, for example when it can offer
the possibility of surgical treatment otherwise unavailable, or where contact is not possible.

Published
2017-02-06