Applications and Current Medico-Legal Challenges of Telemedicine in Ophthalmology

Abstract

Background: The digital revolution is redesigning the healthcare model, and telemedicine offers a good example of the best cost-effectiveness ratio. The COVID-19 pandemic has catalysed the use of the telemedicine. The aim of this review is to describe and discuss the role and the main applications of telemedicine in the ophthalmic clinical practice as well as the related medico-legal aspects.

Methods: 45 original articles and 5 reviews focused on this topic and published in English language from 1997 and 2021 were searched on the online databases of Pubmed, Scopus, Web of Sciences and Embase, by using the following key words: "telemedicine", "privacy", "ophthalmology", "COVID-19" and "informed consent".

Results: Telemedicine is able to guarantee patient care using information and communication technologies. Technology creates an opportunity to link doctors with the aim of assessing clinical cases and maintaining high standards of care while performing and saving time as well. Ophthalmology is one of the fields in which telemedicine is most commonly used for patient management.

Conclusions: Telemedicine offers benefits to patients in terms of saving time and costs and avoiding physical contact; however, it is necessary to point out significant limitations such as the absence of physical examinations, the possibility of transmission failure and potential violations of privacy and confidentiality.

Keywords: COVID-19; clinical-practice; communication; eye; medico-legal; ophthalmology; privacy; telemedicine.

Figure 1

Flow chart. The figure analyzes the first part of review concerning all ophthalmological applications of telemedicine.

Figure 2

Flow chart. The figure analyzes the second part of review concerning all medico-legal implications of telemedicine. Numbers in each box correspond to the corresponding paragraph.