Electronic Health Reporter

Telehealth has been in practice now for over 40 years, yet in the last 5 years it is seeing considerable growth in all sectors. There are a number of reasons for this, primarily, as the use of the internet and various new technologies are becoming more and more advanced and widespread, this has meant that the cost of using this technology for such purposes has decreased significantly. 

Also, a greater understanding of how best to make use of and implement telehealth has improved overtime, with new uses for it continually being developed. The increase of reliance on telehealth has sparked debate between physicians regarding the pros and cons of its usage, with particular consideration of the role it plays in medical malpractice.

The benefits of telehealth

One of the most obvious benefits of telehealth is the newfound ability to provide healthcare to patients in remote areas who otherwise may struggle to get access, while also being advantageous for elderly or disabled patients with mobility or logistical issues. 

It has the potential also to improve patient coverage given a shortage of physicians in relation to the number of patients in some cases. It also provides the opportunity for patients with rare conditions to get much needed medical advice from long distance specialists.

From a healthcare systems perspective, telehealth has the potential to both decrease costs and improve outcomes, however this needs to be weighed up against the potential risks involved.

It’s drawbacks

Telehealth represents a paradigm shift in medical care, changing the way that doctors operate and deal with their patients, it could be harder for more experienced doctors to adapt to these new ways of working as they were not trained that way, and many want to and are used to seeing the patient in their office. 

This technology removes the physician’s ability to see and interact with the patient face to face. It is natural that physicians will fear their ability to do their job will be reduced at such a distance plus any technological change also changes medical malpractice thresholds. It will be down to malpractice expects such as JJS Justice, and law courts to determine how telehealth and other new technologies relate to the acceptable healthcare provision threshold for patients. Doctors will need to adapt and learn to implement these technologies within these limits.

Other issues involve the quality of service that is being provided using this technology, can patients trust in this? Will they receive a quality of care equivalent to that of a face to face consultation? It also remains to be determined how exactly physicians will be reimbursed for their work done through this method.

The potential for medical malpractice in telehealth

There is still work to be done to ensure that telemedicine is controlled and regulated effectively, to maximise its efficacy and minimise the risk of medical malpractice. The main concerns around the potential for medical malpractice in telehealth include issues around online prescribing, informed consent and state licensure. 

With regard to online prescribing, in some cases it may be insufficient to prescribe medication on the basis of an over the phone consultation or upon review of a patient questionnaire submitted online. It Is therefore important that there are crystal clear guidelines and expectations set around when a physical examination is required. 

Laws around informed consent are different between states, physicians should therefore be au fait with the requirements on this front for the states where they are licensed to prescribe medication to patients. 

Finally, physicians should not operate beyond their jurisdiction, a doctor needs to be licensed in the patient’s home state in order to prescribe them medication. In fact, most malpractice issues in relation to telemedicine involve unlicensed activity. 

To avoid malpractice litigations, it is essential that physicians are licenced, have full knowledge of their duties and responsibilities, receive adequate training and that they have taken a full and extensive medical history of all the patients that they prescribe for.