The American College of Physicians (ACP) has issued policy recommendations to guide the use of telemedicine in primary care settings, along with physician considerations for those who use telemedicine in their practices, and policy recommendations on the practice and reimbursement of telemedicine. ACP’s position is that telemedicine can potentially be a beneficial and important part of the future of health care delivery; however, it also stresses the importance of balancing the benefits of telemedicine against the potential risks for patients. Among the ACP position statements and recommendations are:

• ACP believes that a valid patient-physician relationship must be established for a professionally responsible telemedicine service to take place.

• ACP recommends the telehealth activities address the needs of all patients without disenfranchising financially disadvantaged populations or those with low literacy or low technologic literacy.

ACP believes that physicians should use their professional judgment about whether the use of telemedicine is appropriate for a patient.

Citation: Daniel H, Snyder Sulmasy, L. Policy recommendations to guide the use of telemedicine in primary care settings: An American College of Physicians position paper. Ann Intern Med. [Published online ahead of print September 8, 2015]. doi:10.7326/M15-0498.

Commentary: The issue of professional judgment about when it is sufficient to see a patient using a digital interface will ultimately determine the safety and effectiveness of telemedicine. It is a mode of health care delivery that was non-existent just a few years ago and which now has a growth rate estimated to be 20% per year and an expected 7 million visit per year by 2018. The potential advantage includes health savings, convenience, and the potential to deliver specialized services to people who might otherwise not have access to those services. In addition, the use of telemedicine as a part of case-management and patient follow-up has shown promise. In this era of ever changing technologies, we need to embrace new modes of care with skeptical open arms, and be honest about the potential benefits as well as the risks. —Neil Skolnik, MD