While little literature exists for pediatric movement disorders, in practice there is a large volume of unsynchronized telemedicine in this field. Most specialists receive videos via WhatsApp on a daily basis from colleagues, patients and friends consulting about diagnosis and treatment. This gap indicates 2-crucial issues: (1) instant messaging is trusted and widely used by the general public beyond the formal HMO recognition (2) Currently, most HMOs do not recognize, reimburse or document these consultations disregarding the specialists time knowledge and missing crucial data documentation. Moreover, Instant messaging raises questions of doctor to patient relationship, security and other ethical concerns.
Guidelines and questions
There is little guidance on legal and ethical issues of selfie telemedicine and instant messaging from patients regarding their health data. This is especially important to understand the patients’ responsibilities and physicians’ choices for unsolicited requests. Currently, there is no advice on how records are to be kept, or how images and videos stored and sent to and from mobile phones or computers should be managed. The new issues that arise need to be addressed. For instance, if one sends a selfie it considered Patient Generated Health Data. The main use on instant messaging is for a skin infection. The main question if this is doctor initiated the request as a part of the consultation. Today many video/ pictures are patient initiated- to their familiar doctor, other doctor within the HMO or is they found a doctor/company on the internet.
There are regulatory issues with this.
Questions: does the doctor have a choice? to open the message? to answer? Is there any doctor-patient relationship?
The recommendation is that if the doctor asks for the pictures: the doctor should ask the patients to remove the picture from the phone.
Selfie telemedicine is here to stay so medical norms will change…with time.