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Implications for Telehealth in a Postpandemic FutureRegulatory and Privacy Issues

Educational Objective
To understand the privacy and regulatory issues posed by increased telehealth in the post-COVID world
1 Credit CME

The coronavirus disease 2019 (COVID-19) pandemic has required health care systems to radically and rapidly rethink the delivery of care. One of the most remarkable ongoing changes has been the unprecedented accelerated expansion of telehealth. The pandemic may provide the incentive needed to realize the potential of telehealth. Nevertheless, concerns remain that safety and privacy may be compromised by rapid deregulation, despite data, although limited, regarding good overall quality.1 In studies conducted before the COVID-19 pandemic, patients reported high levels of satisfaction.2

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Article Information

Corresponding Author: Carmel Shachar, JD, MPH, Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics at Harvard Law School, 23 Everett St, Cambridge, MA 02138 (cshachar@law.harvard.edu).

Published Online: May 18, 2020. doi:10.1001/jama.2020.7943

Conflict of Interest Disclosures: Ms Shachar reported receiving a grant from the Collaborative Research Program for Biomedical Innovation Law, a scientifically independent collaborative research program supported by a Novo Nordisk Foundation grant (NNF17SA0027784). Dr Elwyn reported receiving active research grants from the Patient-Centered Outcomes Research Institute, Robert Wood Johnson Foundation, and Cystic Fibrosis Foundation and advising for EBSCO Health, PatientWisdom, Abridge AI, and Bind Insurance.

Additional Contributions: Some of the concepts and ideas incorporated in the article were based on discussion and interviews with Sanjeev Arora, MD, ECHO Institute; Elliot Fisher, MD, MPH, Dartmouth Institute for Health Policy and Clinical Practice; Matthew Handley, MD, Kaiser Permanente of Washington; Judd Hollander, MD, Sidney Kimmel Medical College at Thomas Jefferson University; Surena Matin, MD, MD Anderson Cancer Center; Lois Ramondetta, MD, MD Anderson Cancer Center; Robert Satcher, MD, PhD, MD Anderson Cancer Center; and Rahul Sharma, MD, MBA, New York Presbyterian–Weill Cornell Medical Center. None of these individuals were compensated for their participation.

References
1.
Noel  K , Messina  C , Hou  W , Schoenfeld  E , Kelly  G .  Tele-Transitions of Care (TTOC).   BMC Fam Pract. 2020;21(1):27. doi:10.1186/s12875-020-1094-5PubMedGoogle ScholarCrossref
2.
Kruse  CS , Krowski  N , Rodriguez  B , Tran  L , Vela  J , Brooks  M .  Telehealth and patient satisfaction.   BMJ Open. 2017;7(8):e016242.PubMedGoogle Scholar
3.
State Telehealth Laws and Reimbursement Policies Report. Center for Connected Health Policy. Published 2020. Accessed April 12, 2020. https://www.cchpca.org/telehealth-policy/state-telehealth-laws-and-reimbursement-policies-report
4.
Henry  BW , Block  DE , Ciesla  JR , McGowan  BA , Vozenilek  JA .  Clinician behaviors in telehealth care delivery.   Adv Health Sci Educ Theory Pract. 2017;22(4):869-888. doi:10.1007/s10459-016-9717-2PubMedGoogle ScholarCrossref
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COVID-19 telehealth coverage policies. Center for Connected Health Policy. Published 2020. Accessed April 12, 2020. https://www.cchpca.org/resources/covid-19-telehealth-coverage-policies
6.
Lonergan  PE , Washington  SL  III , Branagan  L ,  et al. Rapid utilization of telehealth in a comprehensive cancer center as a response to COVID-19. Health Informatics. Published online April 15, 2020. doi:10.1101/2020.04.10.20061259
7.
Office for Civil Rights (OCR). Notification of enforcement discretion for telehealth. HHS.gov. Published March 30, 2020. Accessed April 12, 2020. https://www.hhs.gov/hipaa/for-professionals/special-topics/emergency-preparedness/notification-enforcement-discretion-telehealth/index.html
8.
Telehealth after visit summaries. Abridge for Clinicians. Accessed April 15, 2020. https://www.abridge.com/clinicians
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