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Lasheras-Pérez MA, Taberner R, Martínez-Jarreta B. Bioethical Conflicts in Current Dermatology: A Narrative Review. ACTAS DERMO-SIFILIOGRAFICAS 2024:S0001-7310(24)00264-3. [PMID: 38556205 DOI: 10.1016/j.ad.2024.02.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 02/14/2024] [Accepted: 02/26/2024] [Indexed: 04/02/2024] Open
Abstract
Both the functions and equipment of dermatologists have increased over the past few years, some examples being cosmetic dermatology, artificial intelligence, tele-dermatology, and social media, which added to the pharmaceutical industry and cosmetic selling has become a source of bioethical conflicts. The objective of this narrative review is to identify the bioethical conflicts of everyday dermatology practice and highlight the proposed solutions. Therefore, we conducted searches across PubMed, Web of Science and Scopus databases. Also, the main Spanish and American deontological codes of physicians and dermatologists have been revised. The authors recommend declaring all conflicts of interest while respecting the patients' autonomy, confidentiality, and privacy. Cosmetic dermatology, cosmetic selling, artificial intelligence, tele-dermatology, and social media are feasible as long as the same standards of conventional dermatology are applied. Nonetheless, the deontological codes associated with these innovations need to be refurbished.
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Affiliation(s)
- M A Lasheras-Pérez
- Servicios de Dermatología, Hospital Universitario y Politécnico la Fe, Valencia, España
| | - R Taberner
- Unidad de Dermatología, Hospital Universitari Son Llàtzer, Palma de Mallorca, España.
| | - B Martínez-Jarreta
- Departamento de Medicina Legal y Forense, Universidad de Zaragoza, Zaragoza, España
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Tommasino N, Megna M, Cacciapuoti S, Villani A, Martora F, Ruggiero A, Genco L, Potestio L. The Past, the Present and the Future of Teledermatology: A Narrative Review. Clin Cosmet Investig Dermatol 2024; 17:717-723. [PMID: 38529172 PMCID: PMC10962464 DOI: 10.2147/ccid.s462799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Accepted: 03/17/2024] [Indexed: 03/27/2024]
Abstract
Teledermatology may be defined as the application of telemedicine to dermatology. According to published data, teledermatology is more widespread in Europe and North America, probably where resources for health care are greater than in other areas of the world. Indeed, teledermatology requires advanced technology to be efficient, as high image quality is necessary to allow the dermatologist to make correct diagnoses. Thanks to the recent advances in this field, teledermatology is become routinary in daily clinical practice. However, its use has been improved over time, overcoming several challenges. The aim of this narrative review is to retrace the almost 30-year history of teledermatology, to address the new challenges posed by advancing technologies such as artificial intelligence and the implications it may have on healthcare.
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Affiliation(s)
- Nello Tommasino
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Matteo Megna
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Sara Cacciapuoti
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Alessia Villani
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Fabrizio Martora
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Angelo Ruggiero
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Lucia Genco
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Luca Potestio
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
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Arimany-Manso J, Saigí U, Roda-Faura M, Martin-Fumadó C. Legal and medicolegal approach to medical consultation recordings. Med Clin (Barc) 2023:S0025-7753(23)00178-1. [PMID: 37173183 DOI: 10.1016/j.medcli.2023.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 04/04/2023] [Accepted: 04/05/2023] [Indexed: 05/15/2023]
Affiliation(s)
- Josep Arimany-Manso
- Servicio de Responsabilidad Profesional, Colegio de Médicos de Barcelona, Barcelona, España; Cátedra de Medicina Legal, Responsabilidad Profesional y Seguridad Clínica, Universidad de Barcelona, Barcelona, España.
| | - Umbert Saigí
- Servicio de Responsabilidad Profesional, Colegio de Médicos de Barcelona, Barcelona, España
| | - Marc Roda-Faura
- Cátedra de Medicina Legal, Responsabilidad Profesional y Seguridad Clínica, Universidad de Barcelona, Barcelona, España; Asesoría Jurídica, Hospital Clínico de Barcelona, Barcelona, España
| | - Carles Martin-Fumadó
- Servicio de Responsabilidad Profesional, Colegio de Médicos de Barcelona, Barcelona, España; Cátedra de Responsabilidad Profesional Médica y Medicina Legal, Universitat Autònoma de Barcelona, Barcelona, España
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Sud E, Anjankar A. Applications of Telemedicine in Dermatology. Cureus 2022; 14:e27740. [PMID: 36106261 PMCID: PMC9445412 DOI: 10.7759/cureus.27740] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 08/07/2022] [Indexed: 11/30/2022] Open
Abstract
Telemedicine is a technological tool that enhances well-being all around the globe. Practicing medicine or performing a clinical examination from a distance was a mere thought until this decade's pandemic hit the world. Telemedicine is practicing medicine sitting on one side of a globe and diagnosing and treating a different individual from the opposite part of the world. There is a long way to go for medical practitioners to execute an entire clinical examination analogous to an accurate clinical examination. Telemedicine is a supplement to a patient's total care, not a replacement for in-person doctor visits. Family doctors can easily access specialists using telemedicine, which enables them to monitor their patients closely. Numerous telemedicine systems, including store and forward, real-time and remote, or self-monitoring, are used worldwide for education, healthcare delivery and control, sickness screening, and disaster management. Even if telemedicine cannot solve every issue, it can significantly lessen the strain on the healthcare system. Nevertheless, investigations performed via telemedicine have started incorporating various medical instruments called telemedicine peripherals, including electronic stethoscopes, teleophthalmoscopes, and video-otoscopes. The prevailing disease around the globe of coronavirus has remarkably debilitated the medical infrastructure in providing diagnosis, treatment, monitoring, and follow-ups. As a result, there is a significant change in the way of practicing medicine and managing patients. Telemedicine provides timely patient care and reduces the risk of exposure to various communicable diseases offered to medical practitioners. The development of imaging technologies has significantly impacted dermatology, a specialty that relies on visual signals. Reviewing dermatology's existing situation and potential digital future, in brief, is the goal of this study. This study provides brief information on telemedicine, its application and scope in dermatology, and how it can alter the healthcare system.
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[Translated article] Dermatology Care in Spanish Public Hospitals: A Mapping Study of Health Care Resources and Medical and Surgical Activity in Dermatology Departments in 2019. ACTAS DERMO-SIFILIOGRAFICAS 2022. [DOI: 10.1016/j.ad.2021.10.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Mapa asistencial dermatológico: descripción de los recursos estructurales y de la actividad médico-quirúrgica de los servicios de dermatología de los hospitales públicos españoles en 2019. ACTAS DERMO-SIFILIOGRAFICAS 2022; 113:467-480. [DOI: 10.1016/j.ad.2021.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 10/13/2021] [Indexed: 11/18/2022] Open
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Ethical and Legal Challenges of Telemedicine in the Era of the COVID-19 Pandemic. MEDICINA (KAUNAS, LITHUANIA) 2021; 57:medicina57121314. [PMID: 34946259 PMCID: PMC8705012 DOI: 10.3390/medicina57121314] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 11/26/2021] [Accepted: 11/28/2021] [Indexed: 12/11/2022]
Abstract
Background and objective: Telemedicine or telehealth services has been increasingly practiced in the recent years. During the COVID-19 pandemic, telemedicine turned into and indispensable service in order to avoid contagion between healthcare professionals and patients, involving a growing number of medical disciplines. Nevertheless, at present, several ethical and legal issues related to the practice of these services still remain unsolved and need adequate regulation. This narrative review will give a synthesis of the main ethical and legal issues of telemedicine practice during the COVID-19 pandemic. Material and Methods: A literature search was performed on PubMed using MeSH terms: Telemedicine (which includes Mobile Health or Health, Mobile, mHealth, Telehealth, and eHealth), Ethics, Legislation/Jurisprudence, and COVID-19. These terms were combined into a search string to better identify relevant articles published in the English language from March 2019 to September 2021. Results: Overall, 24 out of the initial 85 articles were considered eligible for this review. Legal and ethical issues concerned important aspects such as: informed consent (information about the risks and benefits of remote therapy) and autonomy (87%), patient privacy (78%) and confidentiality (57%), data protection and security (74%), malpractice and professional liability/integrity (70%), equity of access (30%), quality of care (30%), the professional–patient relationship (22%), and the principle of beneficence or being disposed to act for the benefit of others (13%). Conclusions: The ethical and legal issues related to the practice of telehealth or telemedicine services still need standard and specific rules of application in order to guarantee equitable access, quality of care, sustainable costs, professional liability, respect of patient privacy, data protection, and confidentiality. At present, telemedicine services could be only used as complementary or supplementary tools to the traditional healthcare services. Some indications for medical providers are suggested.
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Malouff TD, TerKonda SP, Knight D, Abu Dabrh AM, Perlman AI, Munipalli B, Dudenkov DV, Heckman MG, White LJ, Wert KM, Pascual JM, Rivera FA, Shoaei MM, Leak MA, Harrell AC, Trifiletti DM, Buskirk SJ. Physician Satisfaction With Telemedicine During the COVID-19 Pandemic: The Mayo Clinic Florida Experience. Mayo Clin Proc Innov Qual Outcomes 2021; 5:771-782. [PMID: 34226884 PMCID: PMC8245346 DOI: 10.1016/j.mayocpiqo.2021.06.006] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE To evaluate physician perceptions and attitudes toward telemedicine use at a tertiary care academic institution in northeast Florida during the coronavirus disease 2019 pandemic. PATIENTS AND METHODS An anonymous 38-question cross-sectional survey was developed using Qualtrics survey software (Qualtrics) and e-mailed to all staff physicians from all specialty disciplines at Mayo Clinic in Florida. The survey was open from August 17, 2020, through September 1, 2020. Collected data included general demographic characteristics and employment information, attitude and experience with telemedicine use before and during the coronavirus disease 2019 pandemic, perception of patients' experience, and the effect of telemedicine on burnout. RESULTS The survey was distributed to 529 eligible physicians at our institution, with 103 physicians responding (20%). The distribution of specialties was 22% primary care specialties, 41% other internal medicine subspecialties, and 18% surgical specialties. Collectively, 63% found comparable quality of care when provided virtually (vs in-person) whereas 80% perceived telemedicine as cost-effective. A total of 76% of physicians felt that telemedicine increased flexibility and control over patient care activities, with 36% reporting improved work-life balance and 30% reporting improved burnout symptoms. Overall, 42% preferred using telemedicine over in-person visits when possible. CONCLUSION Physicians generally had positive attitudes regarding the adoption of telemedicine and perceived that the quality of health care delivery as generally comparable to in-person care. Future studies are needed to explore attitudes regarding telemedicine after the pandemic and how this virtual technology may be further used to improve physicians' professional and personal well-being.
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Affiliation(s)
| | - Sarvam P. TerKonda
- Division of Plastic Surgery, Mayo Clinic, Jacksonville, FL
- Center for Connected Care, Mayo Clinic, Jacksonville, FL
| | - Dacre Knight
- Division of General Internal Medicine, Mayo Clinic, Jacksonville, FL
| | | | - Adam I. Perlman
- Division of General Internal Medicine, Mayo Clinic, Jacksonville, FL
| | - Bala Munipalli
- Division of General Internal Medicine, Mayo Clinic, Jacksonville, FL
| | | | - Michael G. Heckman
- Division of Biomedical Sciences and Informatics, Mayo Clinic, Jacksonville, FL
| | - Launia J. White
- Division of Biomedical Sciences and Informatics, Mayo Clinic, Jacksonville, FL
| | - Katey M. Wert
- Department of Radiation Oncology, Mayo Clinic, Jacksonville, FL
| | - Jorge M. Pascual
- Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Jacksonville, FL
| | | | | | | | - Anna C. Harrell
- Department of Radiation Oncology, Mayo Clinic, Jacksonville, FL
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