Risk Management in Telemedicine
- Quality of care – Under most circumstances, a physician must be careful to provide the same quality of medical care that would be provided in an in-person examination and treatment. In other words, the physician should not use telemedicine if the use would result in inadequate care.
- Communication – Is the image viewed by the physician adequate to conduct the examination and render treatment? Is the equipment sufficient for accurate transmission of images and data? Can the physician and patient adequately communicate so that the encounter results in proper medical care?
- Documentation – Documentation needs to be later available regarding conversations and communications between the physician and patient; thus, proper entries should be made in the medical record. Consideration should be given to where the documentation is maintained – i.e., only in the clinic medical record.
- Technological advances – The physician should not allow device manufacturers to push them beyond what is safe or reasonable. Just because a sales person suggests that a telemedicine device or process is available, the physician should make an independent determination as to whether it is appropriate for his or her practice.
- Privacy should be protected – The patient’s right of privacy should be protected. Thus, the practitioner should have in place all necessary equipment, policies and processes to insure compliance with HIPAA and other privacy laws.
- Telemedicine must be appropriate – Telemedicine is not appropriate in every circumstance. Physicians will need to recognize when to forgo the use of telemedicine and insist on an in-person examination of the patient. The convenience of telemedicine should not override an in-person examination if such is needed.
- Physician should be trained – The physician should be adequately trained in the use of the telemedicine equipment, which includes audio, visual and medical record documentation equipment.
- Patients should be educated – Patients need to be aware of the purpose and limitations of telemedicine and when it is appropriate to be used in lieu of an in-person examination. The patients also need to be told that if either the telemedicine equipment at their location is not adequate or their medical condition warrants it, they will be instructed to come to the physician‘s clinic for an in-person examination. All of the clinic staff should also receive education on the clinic’s telemedicine procedures if they are to be involved in its use.
- Equipment – Telemedicine equipment should be maintained, tested and monitored constantly to be certain that it functions properly.
- Consent – The following statement or something similar should be included in the patient’s medical record:
“As a result of the COVID-19 pandemic, it was determined that this patient met the appropriate criteria for a telemedicine visit in lieu of an in-person visit. The patient was informed of the benefits and limitations of telemedicine including the possibility that the patient’s privacy could be compromised despite measures taken to maintain confidentiality and security. Any questions the patient had about telemedicine were addressed. The patient agreed to proceed with the telemedicine visit.”
This is provided for informational purposes. It is in no way intended to and should not be construed to be or to establish the standard of care applicable to physicians practicing in Mississippi. This information should not be regarded as legal advice.