The widely accepted definition of telemedicine is the delivery of healthcare at a distance, a term that is often used interchangeably with telehealth, which is the delivery of health-related education using technology.
“The problem is that everyone has their own definition of what telemedicine is,” said Patrick O’ Doherty, vice president and managing director of custom physicians at ProAssurance. “States sometimes define these terms and sometimes they do not, and navigating through all that really creates areas of difficulty.”
Telemedicine can include the use of phone apps to download patient information, using interactive video features, image delivery via email, at-home reporting tools and phone appointments to substitute for the in-person patient experience. Some specialties like radiologists have always been based on providing healthcare from a distance and were better prepared for the sudden shift to telemedicine as a foundation for healthcare delivery.
“Generally, low acuity cases result in lower exposure regardless of whether the visit was in-person or virtual,” said John Maszinski, spokesperson for ISMIE Health. “However, in rural areas, there are some higher risk telehealth consultation services that are provided because there are just no specialists in certain geographic areas.”
One common issue for telemedicine providers occurs when multiple providers care for a patient that files a malpractice claim, but all providers have different telemedicine coverage, making it impossible for a joint defense against the claim.
This leads to a direct ‘us versus them’ standoff as blame is passed between providers and the telemedicine organization. The lack of coordinated coverage has to be a significant concern for all providers of telemedicine, as well as for telemedicine organizations.
“The rules and regulations are everything with telemedicine, if you do not know them you can run into some serious problems,” O’ Doherty said. “It begins with understanding your coverage. If you are a physician practicing in a group and not a principal, you may not be prepared and not be aware of these pitfalls as you enter the telemedicine world, and you do not have the coverage that goes along with you.”
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