The risks of telemedicine were summarized in a report released by The Doctors Company, the nation’s largest physician-owned medical malpractice insurer.
The risks include the possibility of suboptimal diagnoses and treatments, along with the added threat of failure to refer. These issues raise the very real possibility that a rise in telehealth could lead to an increase in medical liability and an erosion of the doctor-patient relationship. Other risks involve confidentiality issues, reimbursement issues, and restrictions on online prescribing in some areas.
It’s still difficult to assess whether or by how much liability risks will tick up in the future, the report’s authors say. Over the past 15 years, while telemedicine-related claims have increased as more doctors have turned to virtual healthcare, the proportion of such claims within The Doctors Company database has remained relatively small.
Of filed claims, The Doctors Company found in a separate study that diagnostic errors are the most common allegation in telemedicine-related claims. In that study of claims from the company’s database, 71% of 28 telemedicine-related claims were related to diagnoses (especially a failure to diagnose cancer), 11% were associated with mismanagement of treatment, and 7% were related to improper management of a surgical patient. Other allegations included improper performance of treatment or procedure and improper performance of surgery.
There’s also the threat of the unknown. The COVID-19 pandemic is likely to change things. As both doctors and patients use telehealth more frequently and in new ways, “this may result in claims of types we have not yet seen; the results of those claims may take years to emerge,” say the study’s authors.
The authors say that doctors should adopt techniques and remote protocols — such as the Ottawa knee rule and ankle rules and the Roth score for preliminary assessment of shortness of breath — to protect both their patients and themselves. Notes the report: “Many medical societies have begun offering education on remote exam techniques specific to their specialties.”
More than 4 out of 10 (42%) Americans say they’ve used video visits during the pandemic, according to a Harris poll. This is a trend that’s likely to continue as practices reopen and virtual care becomes increasingly more common. But as physicians conduct more virtual visits, technology-related malpractice risks are expected to grow.
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