Telemedicine Malpractice Risks

 

Telemedicine Policy

Earlier this summer the AMA adopted an eight guideline policy motivated to improve access to care for patients using telemedicine. You can find the AMA Telemedicine policy here.

Over the past year, we have experienced a higher volume of request from physicians who are setting up new practices involving telemedicine, and who are looking for guidance to purchase medical malpractice insurance coverage. In the past, most medical malpractice companies were not interested in providing coverage for telemedicine, but through the advancements and support of healthcare technology, #HIT, and non-travel benefits to patients, telemedicine is becoming an increasingly attractive form of care and insurance carriers are now considering coverage.

With the shift from fee-for-service payments to payments based on performance outcomes along with the punishment by Medicare for hospital admissions, physicians have a vested interested in caring for their patients more efficiently. Telemedicine provides convenience to physicians and saves patients time from visiting medical offices, especially when getting there is difficult. Here are a few ways Telemedicine is being used today:

Telemedicine in Practice

• Dermatologists examine patients’ skin conditions and recommend treatment
• Follow-up orthopedic visits to assess healing of fractures
• Assessment and management of care for housebound patients, including diagnostic testing monitoring

The Federation of State Medical Boards has worked aggressively on creating the Interstate Medical Licensure Compact, which once approved by state legislatures and medical boards, promises to allow ease of access for multi-state physician licensure. This will enable physicians to treat a much larger population of patients across several states.

Although obtaining multi-state physician licensure may seem to be the largest risk in telemedicine, the greatest risk is not having a valid physician-patient relationship, which must be established prior to caring for patients via telemedicine. Our recommendations to reduce medical malpractice risk are as follows:

Telemedicine Malpractice Recommendations:

1. Check with your state to verify what forms of patient communication are acceptable in your state, such as using Skype, Google Hangouts, and other platforms. A physician in Oklahoma was disciplined in 2013 for using Skype for telemedicine.
2. Be sure you are licensed, not only in your state, but in the states where patients come from.
3. Be sure to use consent forms that clearly define and explain how telemedicine is being used.
4. Be sure an established and valid physician/patient relationship exists.

The Center for Connected Health Policy – The National Telehealth Policy & Resource Center has a phenomenal website of information and Resources. Check out their State Law and Reimbursement Policies page.

Have you started using Telemedicine in your practice? If so, we’d love to know what you are doing and how it is working.