Shedding Light on Telemedicine & Online Prescribing: The Need to Balance Access to Health Care and Quality of Care

• Published in: American journal of law & medicine 2020-05, Vol.46 (2-3), p.237-251
• Main Author: Hoffman, Laura C.
• Format: Article
• Language: English
• Subjects: Antibiotics; Computerized physician order entry; Drug Prescriptions; Drug resistance; Ethics; Health care access; Health care delivery; Health Services Accessibility; Humans; Inappropriate Prescribing; Infections; Internet; Internet-Based Intervention; Medical education; Physician-Patient Relations; Practice Patterns, Physicians; Primary care; Quality of care; Quality of Health Care; Telemedicine; Telemedicine - ethics; Telemedicine - legislation & jurisprudence
• ISSN: 0098-8588; 2375-835X
• DOI: 10.1177/0098858820933497

The issue of online prescribing through the use of telemedicine raises ethical concerns. In particular, several studies suggest a correlation between telemedicine and overprescribing. Meanwhile, new developments in the law also have the potential to significantly impact online prescribing using telemedicine. In the absence of concrete federal guidance and a continued delay in issuing required federal regulations, states have developed their own laws, which vary considerably, regarding the ability of physicians to engage in online prescribing through telemedicine. As legal developments open doors for physicians to prescribe through telemedicine, current evidence of overprescribing, although limited, suggests the need to carefully balance access to health care and quality of care in this context, especially when crafting innovative legislative responses. This article attempts to explore this dynamic issue by closely evaluating the research on overprescribing involving telemedicine and the ethical issues surrounding online prescribing. It will continue by analyzing the current legal landscape for online prescribing for telemedicine at both the federal and state levels. Next, this article will examine ethics opinions offered by medical groups that touch this issue. Finally, this article will suggest several recommendations for law and policy moving forward by shedding light on the ethical issues surrounding telemedicine and online prescribing and how to strike a balance between access and quality of care.