Abstract:
BACKGROUND:Many health information providers on the Internet and doctors with email accounts are confronted with the phenomenon of receiving unsolicited emails from patients asking for medical advice. Also, a growing number of websites offer "ask-the-doctor" services, where patients can ask questions to health professionals via email or other means of telecommunication. It is unclear whether these types of interactions constitute medical practice, and whether physicians have the ethical obligation to respond to unsolicited patient emails. OBJECTIVE:To improve the quality of online communication between patients and health professionals (physicians, experts) in the absence of a pre-existing patient-physician relationship or face-to-face communication, by preparing a set of guiding ethical principles applicable to this kind of interaction. METHODS:Systematic review of the literature, professional, and ethical codes; and consultation with experts. RESULTS:Two different types of patient-physician encounters have to be distinguished. "Traditional" clinical encounters or telemedicine applications are called "Type B" interactions here (Bona fide relationship). In comparison, online interactions lack many of the characteristics of bona fide interactions; most notably there is no pre-existing relationship and the information available to the physician is limited if, for example, a physician responds to the email of a patient who he has never seen before. I call these "Type A" consultations (Absence of pre-existing patient-physician relationship). While guidelines for Type B interactions on the Internet exist (Kane, 1998), this is not the case for Type A interactions. The following principles are suggested: Physicians responding to patients' requests on the Internet should act within the limitations of telecommunication services and keep the global nature of the Internet in mind; not every aspect of medicine requires face-to-face communication; requests for help, including unsolicited patient questions, should not be ignored, but dealt with in some appropriate manner; informed consent requires fair and honest labeling; health professionals and information providers must maintain confidentiality; health professionals should define internal procedures and perform quality control measures. CONCLUSIONS:Different media are appropriate at each point on the continuum between dispensing general health information and handling patient problems that would require the practice of medicine to solve. For example, email is a sufficiently capable medium for giving out general health information, while diagnosis and treatment usually requires at least advanced telemedical technology. Patients have to be educated that it is unethical to diagnose and treat over the Internet in the absence of a pre-existing patient-physician relationship, and if the interaction is limited to a single email. More research is needed to establish more evidence regarding situations in which teleadvice is beneficial and efficient.
journal_name
J Med Internet Resjournal_title
Journal of medical Internet researchauthors
Eysenbach Gdoi
10.2196/jmir.2.1.e1keywords:
subject
Has Abstractpub_date
2000-01-01 00:00:00pages
E1issue
1eissn
1439-4456issn
1438-8871journal_volume
2pub_type
杂志文章abstract:BACKGROUND:Patient registries are commonly used to track survival and medical outcomes in large cohorts. However, large-scale collection of health-related quality of life (HRQOL) data is more challenging because such data must be collected directly from patients. Internet-based HRQOL questionnaires are a potential solu...
journal_title:Journal of medical Internet research
pub_type: 杂志文章
doi:10.2196/jmir.1214
更新日期:2010-08-19 00:00:00
abstract:BACKGROUND:In many countries, there has been substantial progress in establishing the electronic transmission of patients' health information between health care providers, but little is known about how best to engage patients in the process. OBJECTIVE:We explored patients' views about sharing of electronic health inf...
journal_title:Journal of medical Internet research
pub_type: 杂志文章
doi:10.2196/jmir.1164
更新日期:2009-08-06 00:00:00
abstract:BACKGROUND:The last decade has witnessed unprecedented growth in the number of mobile phones in the developing world, thus linking millions of previously unconnected people. The ubiquity of mobile phones, which allow for short message service (SMS), provides new and innovative opportunities for disease prevention effor...
journal_title:Journal of medical Internet research
pub_type: 杂志文章,评审
doi:10.2196/jmir.1823
更新日期:2012-01-12 00:00:00
abstract:BACKGROUND:Digital health stations offer an affordable and accessible platform for people to monitor their health; however, there is limited information regarding the demographic profile of users and the health benefits of this technology. OBJECTIVE:This study aimed to assess the demographic representativeness of heal...
journal_title:Journal of medical Internet research
pub_type: 杂志文章
doi:10.2196/14977
更新日期:2020-06-26 00:00:00
abstract:BACKGROUND:The need for effective interventions to improve mental health and emotional well-being at a population level are gaining prominence both in the United Kingdom and globally. Advances in technology and widespread adoption of Internet capable devices have facilitated rapid development of Web-delivered psycholog...
journal_title:Journal of medical Internet research
pub_type: 杂志文章,meta分析,评审
doi:10.2196/jmir.6200
更新日期:2016-08-24 00:00:00
abstract:BACKGROUND:Excessive gestational weight gain (GWG) contributes to the development of obesity in mother and child. Internet-based interventions have the potential for delivering innovative and interactive options for prevention of excessive GWG to large numbers of people. OBJECTIVE:The objective of this study was to cr...
journal_title:Journal of medical Internet research
pub_type: 杂志文章,随机对照试验
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更新日期:2017-01-09 00:00:00
abstract:BACKGROUND:Health behavior interventions using periodic prompts have utilized technology, such as the Internet, that allows messages to be sent to participants in cost-effective ways. To our knowledge, no comprehensive evidence review has been performed specifically to evaluate the effectiveness of communicating regula...
journal_title:Journal of medical Internet research
pub_type: 杂志文章,评审
doi:10.2196/jmir.1138
更新日期:2009-05-14 00:00:00
abstract:BACKGROUND:Internet technologies can create advanced and rich web-based apps that allow radiologists to easily access teleradiology systems and remotely view medical images. However, each technology has its own drawbacks. It is difficult to balance the advantages and disadvantages of these internet technologies and ide...
journal_title:Journal of medical Internet research
pub_type: 杂志文章
doi:10.2196/16224
更新日期:2020-09-25 00:00:00
abstract:BACKGROUND:A clinical algorithm (Algo) in paper form is used in Quebec, Canada, to allow health care workers other than occupational therapists (OTs) to make bathroom adaptation recommendations for older adults. An integrated knowledge transfer process around Algo suggested an electronic version of this decision suppor...
journal_title:Journal of medical Internet research
pub_type: 杂志文章
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更新日期:2020-08-10 00:00:00
abstract:BACKGROUND:Advance care planning allows patients to articulate their future care preferences should they no longer be able to make decisions on their own. Early advance care planning in outpatient settings provides benefits such as less aggressive care and fewer hospitalizations, yet it is underutilized due to barriers...
journal_title:Journal of medical Internet research
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更新日期:2018-06-26 00:00:00
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journal_title:Journal of medical Internet research
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更新日期:2018-08-29 00:00:00
abstract:BACKGROUND:Many systematic reviews exist on the use of remote patient monitoring (RPM) interventions to improve clinical outcomes and psychological well-being of patients with heart failure. However, research is broadly distributed from simple telephone-based to complex technology-based interventions. The scope and foc...
journal_title:Journal of medical Internet research
pub_type: 杂志文章,评审
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更新日期:2017-01-20 00:00:00
abstract:BACKGROUND:Poor quality primary health care is a major issue in China, particularly in blindness prevention. Artificial intelligence (AI) could provide early screening and accurate auxiliary diagnosis to improve primary care services and reduce unnecessary referrals, but the application of AI in medical settings is sti...
journal_title:Journal of medical Internet research
pub_type: 杂志文章
doi:10.2196/14316
更新日期:2019-10-17 00:00:00
abstract:BACKGROUND:Exposure to risk behavior on social media is associated with risk behavior tendencies among adolescents, but research on the mechanisms underlying the effects of social media exposure is sparse. OBJECTIVE:This study aimed to investigate the motivations of social media use and the mediating and moderating me...
journal_title:Journal of medical Internet research
pub_type: 杂志文章
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更新日期:2019-06-27 00:00:00
abstract:BACKGROUND:Patients are increasingly taking an active role in their health. In doing so, they combine both mass and interpersonal media to gratify their cognitive and affective needs (ie, convergence). Owing to methodological challenges when studying convergence, a detailed view of how patients are using different type...
journal_title:Journal of medical Internet research
pub_type: 杂志文章
doi:10.2196/18303
更新日期:2020-10-19 00:00:00
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journal_title:Journal of medical Internet research
pub_type: 杂志文章
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更新日期:2017-11-30 00:00:00
abstract:BACKGROUND:Cardiovascular diseases are a leading cause of premature death worldwide. International guidelines recommend routine delivery of all phases of cardiac rehabilitation. Uptake of traditional cardiac rehabilitation remains suboptimal, as attendance at formal hospital-based cardiac rehabilitation programs is low...
journal_title:Journal of medical Internet research
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更新日期:2018-05-08 00:00:00
abstract:BACKGROUND:OpenNotes, a national initiative to share clinicians' visit notes with patients, can improve patient engagement, but effects on vulnerable populations are not known very well. OBJECTIVE:Our aim is to examine the importance of visit notes to nonwhite and less educated patients. METHODS:Patients at an urban ...
journal_title:Journal of medical Internet research
pub_type: 杂志文章
doi:10.2196/jmir.9196
更新日期:2018-05-24 00:00:00
abstract:BACKGROUND:The massive scale of social media platforms requires an automatic solution for detecting hate speech. These automatic solutions will help reduce the need for manual analysis of content. Most previous literature has cast the hate speech detection problem as a supervised text classification task using classica...
journal_title:Journal of medical Internet research
pub_type: 杂志文章
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更新日期:2020-12-08 00:00:00
abstract:BACKGROUND:In randomized controlled trials Internet sites have been shown to be effective in the treatment of depression and anxiety. However, it is unclear if the positive effects demonstrated in these trials transfer to community users of such sites. OBJECTIVE:To compare anxiety and depression outcomes for spontaneo...
journal_title:Journal of medical Internet research
pub_type: 杂志文章,随机对照试验
doi:10.2196/jmir.6.4.e46
更新日期:2004-12-22 00:00:00
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journal_title:Journal of medical Internet research
pub_type: 杂志文章
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journal_title:Journal of medical Internet research
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更新日期:2019-06-18 00:00:00
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journal_title:Journal of medical Internet research
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更新日期:2016-09-30 00:00:00
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更新日期:2020-12-08 00:00:00
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journal_title:Journal of medical Internet research
pub_type: 杂志文章
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更新日期:2018-06-22 00:00:00
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journal_title:Journal of medical Internet research
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更新日期:2019-10-31 00:00:00
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journal_title:Journal of medical Internet research
pub_type: 杂志文章
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更新日期:2015-03-26 00:00:00
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journal_title:Journal of medical Internet research
pub_type: 杂志文章,评审
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更新日期:2016-03-03 00:00:00
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journal_title:Journal of medical Internet research
pub_type: 杂志文章
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更新日期:2016-06-15 00:00:00
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journal_title:Journal of medical Internet research
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更新日期:2017-04-07 00:00:00