أسئلة المحاضرة الثانية PCM (قبل التعديل)

E-Professionalism

• Reflects traditional professionalism paradigms manifested through digital media.
• The intersection of medical professionalism and social media is also called online professionalism or digital professionalism.

Social Media

• Online applications allowing for creation and exchange of user-generated content.
• Significant growth in social media use for linking patients and healthcare professionals, and for communication between healthcare professionals.
• Popularity has increased despite concerns about privacy, hacking, fake news, and other negative aspects of online life.

Types of Social Media

• Collaborative projects: Wikipedia
• Content communities: YouTube
• Social networking sites: Facebook
• Virtual gaming or social worlds: Second Life
• Blogs and microblogging: Blogger, Twitter

Benefits of Social Media on E-Professionalism

• Professional networking:
  • Connecting with others and sharing experiences.
  • Creating communities for support.
  • Facilitating student interactions, including studying and mentorship with faculty.
  • Engaging discussion medium for acquiring current information.
  • Faster feedback, increasing interactivity, learner engagement, confidence, and student satisfaction.
  • Positively influencing learner outcomes.
• Professional education and training:
  • Acquiring knowledge from experts.
  • Creating communities for learning and support.
  • Improving professional knowledge through technology use in healthcare services.
  • Physicians promoting their services.
• Patient education and health promotion:
  • Social networking sites suitable tools for patient education and raising public health awareness.

Dangers of Social Media on E-Professionalism

• Loosening accountability:
  • Eroding public trust with poor quality information.
  • Damaging professional image, especially as employers check social media profiles of candidates.
• Compromising confidentiality:
  • Ethical and legal issue.
  • Posting pictures, videos, or audio recordings of patients or clinical interactions breaches confidentiality.

Benefits of Telemedicine

• Healthcare professionals:
  • Improved diagnosis and treatment strategies.
  • Continued education and training.
  • Access to computerized patient data (offline and real-time).
• Patients:
  • Early diagnosis and treatment.
  • Early disease detection.
  • Access to specialists in rural and remote areas.
  • Reduced travel expenses.
  • Reduced visits to specialty hospitals.
  • Reduced burden of morbidity.

Types of Telemedicine

• According to timing of information transmission:
  • Real-time (interactive services): Immediate advice through videoconferencing, medical history consultations, assessments, etc. (e.g., tele neuropsychology).
  • Store and forward (asynchronous exchange of relevant information): Data sent to specialists as needed (e.g., medical images, bio-signals). Common in radiology, pathology, and dermatology.
  • Remote monitoring (self-monitoring or self-testing): Technological devices monitor health and clinical signs remotely, commonly used for chronic diseases like cardiovascular disease, diabetes, and asthma.
• According to mode of communication:
  • Video: Apps, video on chat platforms.
  • Audio: Phone.
  • Text-based: Specialized telemedicine apps, websites, internet-based systems, email, fax.
• According to the purpose of the consultation:
  • Non-emergency consult: First consultations for diagnosis, treatment, health education, or counseling; follow-up consultations on ongoing treatment.
  • Emergency consult: First aid, life-saving measures, counselling, and referral advice.
• According to individuals involved:
  • Patient to physician.
  • Caregiver to physician.
  • Physician to physician.
  • Health worker to physician.

Considerations for Telemedicine

• Physicians should:
  • Employ telemedicine when in-person presence is not possible within a reasonable timeframe.
  • Build relationships based on trust and respect, allowing reliable identification of each other.
  • Obtain informed consent from patients.
  • Ensure confidentiality, privacy, and data integrity are not compromised.
  • Ensure the patient understands advice and treatment.
  • Adhere to local rules and regulations regarding telemedicine services.
• Face-to-face consultation is preferred over telemedicine in:
  • High-risk patients with complex presentations.
  • Lack of access to the patient's medical records.
  • Need to examine the patient.
  • Uncertainty about the patient's mental capacity.
  • Prescribing high-risk drugs.
• Challenges in implementing telemedicine:
  • Patient fear and unfamiliarity.
  • Financial unavailability.
  • Literacy rate and language diversity.
  • Government support.
  • Physician perspectives.
  • Lack of basic amenities.

Essential Elements of Telemedicine Consultations

• Identification of physician and patient.
• Mode of communication.
• Consent.
• Patient evaluation.
• Patient management.

E-Professionalism

• Refers to traditional professionalism paradigms manifested through digital media.
• The intersection of medical professionalism and social media is also called online or digital professionalism.

Social Media

• A group of online applications that allow for the creation and exchange of user-generated content.
• There has been significant growth in social media use:
  • Linking patients and health care professionals.
  • Communication among health care professionals.
• Social media use has increased substantially despite controversies around privacy, hacking, fake news, and other negative aspects of online life.

Types of Social Media

• Collaborative projects (e.g., Wikipedia)
• Content Communities (e.g., YouTube)
• Social networking sites (SNSs) (e.g., Facebook)
• Blogs / Microblogs (e.g., Blogger, Twitter)
• Virtual gaming or social worlds (e.g., Second Life)

Benefits of Social Media for Health Care Professionals

• Professional networking:
  • Connecting with others and sharing experiences.
  • Creating communities for support.
  • Enabling students to help each other with studying and interacting with faculty for advice, encouragement, and virtual mentorship.
• Public health campaigns and awareness:
  • Sharing information regarding health issues.
  • Promoting healthy lifestyle choices.
  • Reaching broader audiences.
• Keeping up to date with latest medical advancements:
  • Accessing and sharing medical research.
  • Participating in online discussions with other professionals.
• Improved patient care:
  • Connecting with patients.
  • Providing health information and answering questions.
  • Building stronger patient-physician relationships.

Blurred Professional Boundaries

• Blurred lines between professional and personal spheres of social media use.
• Concerns arise about exposure of one's private life and separating private from professional use.

Depiction of unprofessional behavior

• Unprofessional behavior is often associated with online content related to:
  • Alcohol intoxication; substance or illegal drug use.
  • Nudity and sexuality.
  • Demeaning content about patients, peers, educators, clinical sites, or the profession as a whole.
  • Discriminatory content.
  • Profanity, aggressive, or bullying content towards coworkers.
• Posting pictures from holidays, nightclubs, and photos wearing swimwear or underwear have been reported.
• Alcohol consumption and smoking have also been published online by health professionals.

Legal Issues

• Unprofessional behavior on social media can have legal consequences for healthcare professionals, potentially affecting their credibility and licensure.
• There is ongoing debate about whether medical regulatory bodies should monitor the social media activities of health care professionals.

Barriers to Social Media Use for Healthcare Professionals

• Lack of:
  • Time.
  • Knowledge or technical skills.
  • Previous education.
  • Supportive institutional social media policies.
• Difficulty developing and sustaining mutual trust on social media.

Telemedicine Definition

• Practicing medicine over a distance, using telecommunication systems or video-conferencing tools to transmit patient data, documents, and other information for diagnosis and treatment recommendations.

Telehealth

• Can refer to remote non-clinical services like tele-training, tele-education, tele-monitoring, and tele-support.

Benefits of Telemedicine

For Healthcare Professionals

• Improved diagnosis and treatment strategies.
• Continued education and training.
• Access to computerized comprehensive data of patients, both offline and in real-time.

For Patients

• Early diagnosis and treatment.
• Early detection of disease.
• Access to expertise of medical specialists.
• Quick and timely follow-up of discharged patients.
• Access to specialized health care services in rural and remote areas.
• Reduced travel expenses.
• Reduced visits to specialty hospitals.
• Reduced burden of morbidity.

Types of Telemedicine: Classification

By Timing of Information Transmitted

• Real-Time (Interactive Services): Immediate advice provided to patients who require medical attention through videoconferencing. Examples include tele-neuropsychology.
• Store and Forward (Asynchronous Exchange of Relevant Information): Data like medical images or bio signals are sent to specialists when needed, bypassing in-person appointments. Common in fields like radiology, pathology, dermatology.
• Remote Monitoring (Self-Monitoring or Self-Testing): Technological devices monitor patient health and clinical signs remotely. Extensively used in managing chronic diseases like cardiovascular disease, diabetes mellitus, and asthma.

By Mode of Communication

• Video (e.g., telemedicine facility, apps, video on chat platforms)
• Audio (e.g., phone)
• Text-based (e.g., telemedicine smartphone apps, websites, internet-based systems, email, fax)

By Purpose of Consultation

• Non-Emergency Consult: First consult for diagnosis, treatment, health education, or counseling. Can be either the first contact between physician and patient or a follow-up consult more than 6 months after the last appointment.
• Emergency Consult: Limited to first aid, life-saving measures, counseling, and referral advice.

By Individuals Involved

• Patient to physician.
• Caregiver to physician.
• Physician to physician.
• Health worker to physician.

Key Considerations for Telemedicine

• Telemedicine should be employed primarily when a physician cannot be physically present within a safe and acceptable time period.
• The patient-physician relationship must be based on mutual trust and respect. Reliable identification is essential.
• Informed consent must be obtained from the patient.
• Patient confidentiality, privacy, and data integrity must not be compromised.
• The physician must ensure the patient understands the advice and treatment provided.
• Physicians participating in telemedicine services must adhere to local rules and regulations.

Conditions Where Face-to-Face Consultation is Preferred

• High-risk patients with complex presentations.
• Lack of access to the patient’s medical records.
• Need to examine the patient.
• Uncertainty about the patient’s mental capacity.
• Prescribing high-risk drugs.

Barriers to Telemedicine

• Patient fear and unfamiliarity.
• Financial unavailability.
• Literacy rate and diversity in languages.
• Government support.
• Perspective of medical practitioners.
• Lack of basic amenities.

Elements to Consider Before a Telemedicine Consultation

• Identification of physician and patient.
• Mode of communication.
• Consent.
• Patient evaluation.
• Patient management.