Prior to a telemedicine visit, its important for patients and physicians to establish a relationship, according to the recent edition of the American College of Physicians' ethics manual.

There are three notes on the ways to establish a patient-physician relationship using telemedicine, as outlined in the American College of Physicians' recently updated ethics manual:

1) There must be a "valid patient-physician relationship for a professionally responsible telemedicine service to take place." However, the manual mentions that a telemedicine encounter can be used to establish this relationship, if it takes place in real-time along with appropriate audiovisual technology.

2) In case where there hasn’t been a previous contact between a patient and a physician prior to the telemedicine visit, the physician has to take steps to establish a relationship based on the standards of care that are used during in-person visits. They should also consult a physician who has maintained a relationship with the patient.

3) The benefits of telemedicine must be balanced against the risks such as the potential for misdiagnosis, loss of personal interaction, lack of physical communication and issues with continuity of care for each patient encounter.

It is necessary to improve patient-provider communication to be able to deliver a better healthcare experience.